The Digital Evolution of the Patient Chart: A Narrative Review of Advances in Medical Records Technology from Paper-Based Systems to Cloud and Blockchain Solutions

Background: The evolution of medical records from fragmented paper files to integrated digital systems represents a fundamental transformation in healthcare delivery. Despite the global adoption of Electronic Health Records (EHRs), challenges in interoperability, data security, patient access, and integrity persist. Aim: This narrative review synthesizes the literature on the technological trajectory of medical records, critically evaluating the transition from paper-based systems to contemporary cloud and blockchain-based solutions, and their implications for healthcare systems. Methods: A comprehensive search of peer-reviewed literature published between 2010 and 2025 was conducted across PubMed, IEEE Xplore, and Scopus databases. Keywords included "electronic health records," "cloud computing," "blockchain," "interoperability," and "data security." Relevant studies were selected and thematically analyzed. Results: The review delineates a clear progression: paper records imposed significant limitations in access and efficiency; EHRs improved data availability but introduced siloes and security concerns; cloud computing offered scalability and enhanced collaboration; and blockchain technology emerges as a promising paradigm for decentralized security, immutable audit trails, and patient-centric data control. Each phase introduces distinct advantages and new challenges. Conclusion: The future of medical records lies in hybrid, intelligent systems that leverage the strengths of cloud architecture for storage and computation, and blockchain for security and access control, ultimately moving towards patient-mediated, interoperable health information ecosystems.