An article in the October issue of Technology for Doctors deals with the management of external paper and historical paper charts. Inputting this data into the EMR is extremely time and labour intensive. So what is a practice to do in the transition to the EMR? Read on....
Escaping the tyranny of paper is harder than most doctors imagine – even after an EMR system is implemented. Family practices often go into an EMR conversion believing they’ll finally be rid of paper going forward, and only have to worry about storing historical patient files. But storage costs for thousands of paper patient files can be expensive. By law, family practices need to retain patient records on-site for 10 years after the last visit. To avoid these costs, many practices are scanning them to create space-saving digital records, and they often assume this task can be handled by hiring temporary staff to scan old files over the course of a few months.
.....Most doctors have an average of 1,500 patient files each to scan, and many of these are several inches thick for longstanding patients with complex conditions. But few family practices have the high-end equipment needed to handle the job. “We didn’t have a proper scanner for our student to do that volume,” says Blankenstein. “We had a multi-function scanner, fax and photocopy machine that we needed for our regular office tasks. If she scanned all day, then we couldn’t use it for anything else. Doing the job in-house would have entailed buying another expensive machine, but we didn’t have the office space for another piece of equipment.” There were also some longer-term paper issues that came as a big surprise, he says. Even after the initial year-long teething pains of converting paper for an EMR are finally over, family practices need to consider that many laboratories can’t or won’t upload results digitally. They need to either make arrangements to scan these reports on an ongoing basis, or partner with select labs that can provide information electronically.
Scanning and data input is one of the high interest areas on CanadianEMR. How have you approached the challenge of managing your paper records and incoming paper results and reports. To add your comments, click on the 'Comments' link below
In my experience implementing EMR systems, scanning is one of the big areas I found that clinics were least prepared to deal with. Having scanning being done properly and in an efficient time frame is key to having good physician adoption. By having the information available in the system in a similar or faster timeframe than it is available on paper makes the move toward having a chartless office significant easier. In my pre-implementation planning here are some of the key points I tried to get through to the clinics.
1. The person who does your filing is not necessarily the best person to be tasked with scanning. Scanning involves being comfortable with a computer, scanner, scanner software etc. You need to match the skill set to the best person available in your clinic. If you do not have this skill set then my recommendation is that you look elsewhere for a person with these skills.
2. Scanning is a job best done without interruption. Often I find that people think the person at the front desk can do the scanning while checking in patients and answering the phones. Scanning is a data entry type position and it most efficient when done without interruptions.
3. Have the proper equipment for the job. Prior to purchasing your scanner, evaluate the volume of paper that goes through your clinic in the day and ensure you have the right scanner to handle the volume. An automatic paper feeder is a must.
4. Look at where you can streamline the process. Contact local specialists, physiotherapists etc and ask if they can send their letters via email (encrypted of course). Also, you can have your fax machine setup to a PC or fax server and have incoming faxes received electronically. This means you get the skip the actually scanning processing step. To take the fax concept a step further, Omnipage can be setup to watch a folder and auto OCR (turn from image to text), this removes another step of the process.
Posted by: Keltie J | December 01, 2009 at 12:14 PM