Abstract: The evolution of health information systems has been a transformative force in modern healthcare delivery. Traditionally, patient data and clinical notes were maintained on paper, a method that, while familiar, presented challenges in terms of storage, retrieval, accuracy, and continuity of care. The advent of Electronic Health Records (EHRs) has reshaped this landscape, offering digitized systems that streamline documentation, improve accessibility, and enable integration across health services. This review provides a comprehensive comparative analysis of conventional paper-based records and EHRs, examining their advantages, limitations, and implications for clinical practice, patient safety, healthcare management, and policy. The article discusses the transition process, including implementation challenges, cost implications, training requirements, ethical considerations, and the role of digital records in enhancing evidence-based practice and interoperability. Findings suggest that while paper records remain familiar and low-cost, they are increasingly insufficient for the demands of modern healthcare systems. Conversely, EHRs, despite barriers to adoption, are integral to advancing patient-centered, efficient, and data-driven care. This analysis concludes that a strategic, well-supported shift to digital systems is necessary to maximize healthcare quality and safety in the 21st century.