In these years the Danish state og Regions have taken a tremendous interest in the digitization of the Danish Health Care Organizations. It leaves its mark on the daily work at the hospitals, where the implementation of electronic health records has the highest priority and the word 'paperless' has become a buzz word.
Many researchers have studied the effects of replacing paper records with an electronic medical record, including Signe Svenningsen whose experiences I include in my project. Also, many foreign researchers have dealt with the topic. Campbell et al. have investigated the use of paper that persists after the introduction of a CPOE module and identified lack of integrations as a cause.
As North Jutland is very close to having met RSI benchmark about one consolidated EHR landscape, I found it interesting to investigate the use of paper that takes place parallel with the use of IT systems in the region.

Method.
To illuminate the subject, I chose to use participant observation and qualitative, semi-structured interviews. Data is analyzed within a theoretical framework that includes actor-network theory (ANT) and Grounded Theory.

Results.
My data analysis showed, that physicians in an outpatient clinic in North Jutland during a working day are related to many different papers. The role of the paper is diverse. It serves as notification of tasks, provides an overview of data in a way that IT systems cannot match, it is preferable when the user's computer skills are deficient, have a communicative role between patient and doctor and between clinicians, compensates for immature IT systems and lack of integration of medical devices, involves the patient as the author of the journal and takes sometimes a unique position to hold data that exists only in one instance. Many of the doctors found it difficult to get an overview of data in the IT systems, which they perceived as a time waster. Availability of the systems is a great force, while the paper is volatile.

Conclusion.
After North Jutland almost met RSI benchmark of having a single, consolidated EHR landscape, the paper continues to be an actor who is deeply involved in keeping the hospital together as a stable unit and an indispensable medium in the daily work of a doctor in an outpatient clinic.