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Matthew Petito

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What to do With Paper Patient Charts When Transitioning to Electronic Medical Records

Posted by Matthew Petito on Mon, Apr 18, 2016 @ 02:40 PM

As Doctors across the country transition to Electronic Medical Record Systems, they’re confronted with a major decision, what do I do with my paper charts? Practices and Doctors have a few options to choose from:

  1. Continue to use the paper chart for all patient visits.

Yes, Practices have the option to not implement an Electronic Medical Record System and continue to use paper charts like they always have. Financially is it the best option? It depends on how much of a penalty the practice will have to pay. Will operations and efficiency change? Maybe, they will probably remain the same but eventually start to decline.

With the volume of patients increasing, and patients wanting instant access to their records and answers to medical questions, patient satisfaction may begin to slip and small problems of the past may become large problems in the future.

  1. Use both, the EMR for day forward patient visits and use the paper chart when reference to historical information before the EMR was implemented.

Most practices start the EMR transition with this option first, and it is a good way to ease into having electronic records. All important information is imported into the EMR (vaccines, allergies, some medical history, etc.) and the EMR is used on a day forward basis. If there is a specific piece of information that is not in the EMR during an office visit, the practice can locate the paper chart and reference that piece of information.

The practice will be electronic going forward, but they still will have the same issues with maintaining a paper medical record archive that they had previously. Time spent searching for charts, searching for misfiled charts, needing space to store and maintain a paper archive (paper charts need to be kept until the patient’s retention period is up, regardless of what information is on paper and what is in the EMR), and not finding charts.

This option is a good starting point, but with time, the practice should consider taking the active paper patient charts, scanning them, and uploading them into the EMR.

  1. Scan active patient charts and reference historical information as electronic images in the EMR. Store inactive patient charts and have the ability to scan these charts ‘on demand’ if/when a chart is needed.

This is the most cost effective approach to transition to an EMR, convert the paper medical records that are actively being used by the practice, while retaining the inactive paper charts physically. The inactive charts can be stored at the practice or at a record storage facility with the ability to pull, scan, and electronically send a requested chart on demand.

All active paper patient information is scanned and the images can be referenced either in the EMR, stored on the practices internal network, or a document management system outside of the EMR. The three options for viewing the electronic images can be chosen by practice, and all three are great ways to host, search, and retrieve scanned patient information.

For the inactive patient charts, (each practice has its own definition of active and inactive), it may not be finically possible to scan all their information. But, the records can be stored at a secure, offsite storage facility, and have a patient manifest created (Ex. Box 1 contains these 25 patients). A patient’s chart can be requested by the practice and scanned ‘on demand’ and the scanned patient chart can be delivered to the practice within a few hours or less.

This is the most cost effective option, to have active patient charts instantly accessible either in the EMR or an internal network and have inactive charts securely stored physically but can be electronically delivered when requested.

  1. Scan all charts into the EMR.

No office is 100% paperless, but this is as close as they can get. All patient charts are scanned and accessible within seconds and a few mouse clicks. This option requires the largest investment, but also provides the largest return.

There is no paper archive to manage and store, charts cannot be misfiled or lost, all charts can be found within seconds, and charts can be transferred to other practices instantaneously. Going forward, the practice can scan the small amount of paper it will receive from other practices, insurance companies, patients, etc.

Converting to an Electronic Medical Record System can be difficult, time consuming, and frustrating, but the records management part of the transition does not have to be.

Tags: Scanning, Medical Record Scanning, EMR, Healthcare, Electronic Medical Records

What Should Businesses Do With Their Existing Paper Records?

Posted by Matthew Petito on Wed, May 13, 2015 @ 03:23 PM

Now that the panic has subsided from the Brooklyn CitiStorage document warehouse fire (even though it shouldn’t) everyone is back in the out of sight, out of mind thinking as it relates to records management. Businesses need to consider what steps to take to create efficiency with their unique records process, and prevent a crisis like this from happening again. Documents in storage should be there only for retention purposes. Certain documents that will have an adverse effect on your business if destroyed should be in an electronic format and backed up.

There will always be documents that should be stored rather than scanned. It could be ten year old accounting documents, inactive medical records, closed legal files, terminated employee files… the list goes on and on. If these documents should ever become inaccessible or destroyed unintentionally, the business should be able to function properly without them. No business, other than one with thousands of dollars to spend, would even consider taking boxes of records that no one looks at out of a storage facility and convert them into electronic records that no one will look at.

But what does make sense is to convert records that are frequently retrieved and actively used in the office, such as active medical records, employee files, pending legal files, current accounting documents, active customer files, all documents that the business relies on to function. Electronic files are more secure, have audit trails, can limit accessibility, have easy to manage destruction dates, can be viewed by multiple people at different locations, have multiple backups, and are easier to manage than paper files.

Below are abstracts from a more detailed, day forward, application specific scanning service, with detailed posts to follow:

 

  • Proof of Delivery:

Everyone has had customers that do not want to pay for products or services that have been delivered to them, but with dozens or hundreds of deliveries per day, it can be a daunting task to track down signed delivery tickets to prove the delivery or service was completed. Instead of looking through thousands of delivery tickets, you can simply search for a specific delivery ticket by customer name, date, or other specific search criteria. Your company can even have the images integrated into your accounting software. Once the documents are electronic, you can instantly see who signed for the delivery or service and email it to their AP department, decreasing your receivables significantly.

 

  • Accounting Documents:

Unless your company has a fully automated accounts payable processing system (which it most certainly could), the accounting department most likely has the vendor payables and customer receivables in file cabinets organized alphabetically by month or year, depending on volume. Excluding very small accounting departments and businesses, most of these files are going to be accessed by multiple people and possibly from multiple locations. Being able to retrieve frequently accessed documents saves time searching for documents, increases efficiency, and eliminates issues related to lost or mis-filed invoices. Images can be hosted on a cloud based document management system, stored on internal servers, or integrated into the existing accounting software.

 

  • Human Resource Documents and Employee Files:

Human Resource departments are far more complicated than many people in business understand. They can be responsible for payroll, recruitment, benefits, employee relations, employee development, risk management, and many other specialized departments. With all this information being managed by HR, there is a lot of paper that can pile up quickly. Limiting the access to these documents by keeping them in file cabinets can cause inefficiencies that often go overlooked. Converting paper HR documents to easily accessible electronic images, allows remote and concurrent access, all within seconds, and with increased security and audit trails.

 

  • Medical Records:

With the transition to Electronic Medical Records in full swing, many practices are put in the situation where they have to make a decision on what to do with their paper medical records. They have a few options: they could do nothing, and use the EMR for billing and scheduling only, and continue to use the paper chart for patient notes, they could use both the EMR for day forward progress notes and the paper chart for the historical data, or they can scan the paper chart information into the EMR and centralize their patient care in one location.

Doing nothing does not make the most sense; you implemented the EMR for a reason. Using both can be a viable option for a while, but mistakes can be easily made when working from two forms of media. Medications, allergies, or immunizations can be in the EMR and not the paper record or vice versa, and if another practice or the patient calls looking for that information, someone at the practice might not think to check both the EMR and paper chart.

Scanning paper records into an EMR allows a smooth transition to comprehensive patient chart management. The images from the paper chart are easily viewed in the EMR, and everything day forward is input directly through the EMR interface. New patients are completely paperless. This solution is most appropriate for active patients with paper records that are frequently accessed.

Tags: Document Management, Records Management, Document Scanning, Medical Record Scanning, Brooklyn Storage Fire, Paper Records

The Recent Brooklyn Document Storage Warehouse Fire, and Many Other Tragedies, Point Out Why Digitizing Paper Documents Should Be Considered.

Posted by Matthew Petito on Thu, Feb 12, 2015 @ 04:41 PM

The massive fire last week in Brooklyn’s CitiStorage Document Storage warehouse was not the first time a document storage facility has been destroyed. To name a few, 1997 South Brunswick, NJ, USA, 2006 London, England, 2006 Ottawa, Canada, 2011 Aprilia, Italy, and 2014 Buenos Aires, Argentina.

With 1.1 Million Cubic Feet of records potentially destroyed at CitiStorage, including that of legal firms, financial intuitions, medical practices and hospitals (Mount Sinai Health System, New York-Presbyterian Hospital, North Shore-LIJ Health System and NYU Langone Medical Center), accounting firms, and both small and large businesses, the main question is and has been, why have these documents not been converted to electronic images?

Aside from the why haven’t records been converted, businesses also have to contemplate what would the cost be to recreate destroyed documents? What would be involved? And what if those records cannot be recreated? What would happen if original blueprints, medical records, legal cases, or financial documents are destroyed with no way of reproducing them? “It’s 2015, why isn’t this information electronic?” many people have asked.

Once records are digitized, companies will no longer have to pay for records management services related to document storage. After the documents are scanned, no more costs will be incurred. The electronic images can be on a hard drive, an internal network, or cloud based storage all allowing constant and instant access.Brooklyn Storage fire

On Sunday, 2/1, many New Yorkers woke up to thousands of pages of private and protected information floating along the Williamsburg waterfront and spewing through the air. Not only are the records that hundreds of businesses and government agencies depend on destroyed, the private and protected information of their customers and employee’s was put on full display. Many of these have names, addresses, account numbers, social security numbers, which can be used to easily steal someone’s identity.

 “About the possibility that confidential patient information might have been disclosed on a large scale as the wind scattered unburned records, Brian Conway, of the Greater New York Hospital Association, said, “There’s no reason to believe that’s a possibility.” Yet in one indication of the city’s concern, the disaster recovery contractors, in their neon yellow jackets, sealed off the entrance to the rocky jetty with yellow caution tape early Sunday and began to scoop documents out of the water with nets and shovels.” – NY Times.

The electronic images of scanned documents are more often of a higher quality than the original and much more secure. The entire CitiStorage warehouse could be scanned and stored on a few hard drives, which are much easier to protect, keep organized, and secured than thousands of boxes.

Tags: Paperless Office, Document Management, Records Management, Document Scanning, Document Imaging, Medical Record Scanning