Objectives: To compare the use of three electronic medical records systems by doctors in Norwegian hospitals for general clinical tasks.

Design: Cross sectional questionnaire survey. Semistructured telephone interviews with key staff in information technology in each hospital for details of local implementation of the systems.

Setting: 32 hospital units in 19 Norwegian hospitals with electronic medical records systems.

Participants: 227 (72%) of 314 hospital doctors responded, equally distributed between the three electronic medical records systems.

Main outcome measures: Proportion of respondents who used the electronic system, calculated for each of 23 tasks; difference in proportions of users of different systems when functionality of systems was similar.

Results: Most tasks listed in the questionnaire (15/23) were generally covered with implemented functions in the electronic medical records systems. However, the systems were used for only 2–7 of the tasks, mainly associated with reading patient data. Respondents showed significant differences in frequency of use of the different systems for four tasks for which the systems offered equivalent functionality. The respondents scored highly in computer literacy (72.2/100), and computer use showed no correlation with respondents9 age, sex, or work position. User satisfaction scores were generally positive (67.2/100), with some difference between the systems.

Conclusions: Doctors used electronic medical records systems for far fewer tasks than the systems supported.

Electronic information systems in health care have not undergone systematic evaluation, and few comparisons between electronic medical records systems have been made

Given the information intensive nature of clinical work, electronic medical records systems should be of help to doctors for most clinical tasks

Doctors in Norwegian hospitals reported a low level of use of all electronic medical records systems

The systems were mainly used for reading patient data, and doctors used the systems for less than half of the tasks for which the systems were functional

Analyses of actual use of electronic medical records provide more information than user satisfaction or functionality of such records systems