Records Management Blog | Practical Records Management

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

Document Management and the EMR - Conflicting Signals

Posted by Michael Thomas on Wed, Apr 07, 2010 @ 06:07 PM

There's a great post on the Hyland Software blog about how the Electronic Health Record needs to show more than just Patient Data. The post highlights some feedback from Last Month's HIMSS Conference, but the point is that Healthcare Organizations need to keep their eyes and ears open as they move forward with implementing Electronic Medical Record Systems.

It's alarming how many of these EMR Vendors are creating completely closed systems and relying on inexperienced technical resources to develop their "Document Management" portfolio. I would compare this to Ford Motor Company deciding that they were going to let Automotive Engineers design the LCD Screens in their newest Vehicles... It just doesn't make sense. The logical choice is to let the LCD Screen Makers do what they do best while Ford focuses on producing quality vehicles.

The Document Management has an entire industry behind it with focused, specialized software products that address issues such as integration, distributed capture, and technical details such as Image Caching, Security, and Audit Trails. Most of the EMR Vendors that I've been exposed to have a great core competency in managing Data relating to a Patient - meaning that they excel information that is naively electronic or input directly into their product. I've seen a trend, however, where the Document Management piece of the solution is much more of a bolt-on that doesn't work quite as nicely or provide the features of a true Enterprise Content Management System.

In the end, the best case scenario for many practices, clinics, and hospitals is to choose the EMR that is going to suit their Clinical Practice the best, while at the same time exploring a Document Management Solution that enables efficient Medical Record Scanning for Legacy Information and tight integration with various business and clinical applications, including the EMR. This strategy provides the best long-term prognosis for success by leveraging the strengths of each technology while not sacrificing future flexibility or scale.

What's been your experience? Share your thoughts in the comments!

Tags: Document Management, OnBase, Medical Record Scanning, EMR, Healthcare

Medical Record Scanning gets New Meaning

Posted by Michael Thomas on Tue, Mar 23, 2010 @ 06:39 AM

The team at recently highlighted how a Bronx Healthcare clinic is using a new type of Optical Recognition to retrieve Medical Records, and it’s not quite what you’d think of when you bring up Medical Record Scanning . The clinic – Urban Health Plan – is using Scans of a Patient’s Iris (the unique part of the eye) to accurately locate and match patient records. The article cites many examples of why this technology is so useful, particularly in a clinic that boasts 103 Patients with the name Jose Rodriguez!

As this new, innovative technology begins to replace the old check-in process at this particular clinic, there must also be consideration given to another type of Medical Record Scanning – the physical patient chart. With a flurry of new technology being created, marketed, and sold to Medical Practices across the country, document scanning for the paper-based chart is becoming that much more important. While the CNN article doesn’t “Sight” (Sic) whether or not Urban Health Plans is retrieving a physical paper-based chart or using an Electronic Medical Record System, There is certainly another level of efficiency that can be achieved by having their Iris-Based Scan Technology retrieve an electronic copy of the Patient Chart directly to the point of care.

While Shoreline's primary focus is on helping practices convert their Paper-Based Charts to Digital Images through Medical Record Scanning, I must applaud Urban Health Plans for their innovative and effective use of emerging technology. As a technologist (and a Healthcare Consumer) I believe that anything that can help reduce errors, eliminate costs, and improve the quality of care is a step in the right direction. Kudos!

For More Information, Check Out:

Urban Health Plan - "At Bronx Clinic, The eyes are windows to Medical Records"

Shoreline Records Management - Medical Record Scanning 

Tags: Medical Record Scanning, EMR, Healthcare

Medical Record Scanning Project Preparation Guide

Posted by Michael Thomas on Thu, Mar 18, 2010 @ 08:59 AM

In order to efficiently manage a Medical Record Scanning Project, it’s helpful to understand what is involved in the process.  A clear step by step overview will help clarify expectations and will save you lots of time and frustration later on.

Scanning medical records is not overly complicated, and with some careful planning, you can ensure that your practice runs more smoothly and efficiently than ever before. Also, If you're inclined to outsource, selecting a company that works with you as a partner can result in greater satisfaction with the process and the end result.

The following are the steps to the medical document scanning process.

1.  Analyze - First, identify what documents are to be scanned.  Medical Files can be boxed and labeled so they are able to be transported.  It’s important to have a system to be sure you know what’s in the boxes, just in case there is a need for one of the documents during this process.   A qualified vendor should work side by side with you when scanning medical records to be sure that you have access to your charts. Be sure to confirm this during your vendor selection process.

2.  Inventory - Prior to beginning a Medical Record Scanning Project, an inventory should be created highlighting all of the charts you want to convert. This can be something that your staff does, or your vendor offers.   Don't overlook this step - You will want to be absolutely sure that you've captured all of your Charts, and this is the best way to give you confidence in the process.   

3.  Preparation - Imagine the havoc that staples and ripped or torn documents can do to a copier... well, they don’t work well with scanners either.  Before scanning medical documents, any torn pages must be repaired, sorted, and staples, clips, fasteners, etc. must be removed.  This is time consuming, and most companies who take on scanning medical documents instead of outsourcing become frustrated at this point. Remember, Clean, clear, useful document scans are entirely dependent upon this step.

4.  Scanning. Each medical document is scanned.  During this phase the identification of the documents is entered. Again, somewhat labor intensive, this phase requires attention to detail that many companies just don’t put in.  If you are scanning medical records yourself, and hire temporary workers, you may wind up with less than professional results.  Especially for scanning medical records and documents, this is important.   (Shoreline’s team are expert at ensuring efficient and competent production at our service center.)

Medical Document Scanning


5.  Quality Control. The last thing that you want is to pull up a patient’s record at a critical moment and the information is indecipherable.  A good quality control to evaluate every image will assure this doesn’t happen. Missing documents, missing images are unacceptable. (At Shoreline, every image is reviewed to be sure it can be read. We also make sure we didn’t miss any documents or images during the scanning process.)

6.  Index. Indexing the documents is another critical element of scanning medical documents. In order to be found easily, the index utilizes an identifier such as the patient’s dob, patient ID, social, or patient number.   As records are scanned, charts are captured and tagged in a manner consistent with the EMR or EHR program.

7.  Import Data.  The scanned medical records that have been indexed are entered into the electronic records system.  The vendor should work with your records management vendor to assure that the documents are successfully accessed upon demand. Imaged information is integrated into the EMR or EHR system. 

8.  Disposition or Inventory.  From time to time, records must be destroyed or re-called to be accessed physically.  A document solution provider should be capable of providing a secure system for both. Whether the document is to be stored in a climate controlled environment within a warehouse, or to be destroyed, the security of the information is of paramount importance, particularly with HIPAA requirements of medical records.  (At Shoreline, Certified Document Destruction is offered for sensitive information.) 

Tags: Document Scanning, Medical Record Scanning, EMR

Not Ready for an Enterprise Electronic Medical Record? Investigate a DMI Solution

Posted by Tom Doyle on Tue, Mar 16, 2010 @ 09:36 AM

It's happening...slowly! Although the Federal Government has enacted legislation providing physicians with incentives to implement EMR technology and penalties for those who do not by 2015, today only six percent of U.S. physicians use a fully functioning system. Why?

For one, Enterprise Electronic Medical Records systems require physicians and their staff to change the way they accumulate, track, store and retrieve patient medical information. These systems require physicians and staff to leverage laptops, notepads, PC's and other electronic devices to capture and update all patient related data. In short, it changes the way the health care professional delivers medical care, and with all change comes resistance.

DMI, Document management and imaging is a tool that helps bridge a totally paper based solution to a full EMR. Through the use of scanning technology, healthcare organizations can change very little regarding how care is provided, while taking advantage of organizing, securing, protecting and sharing vital patient data.

Paper documents associated with the patient chart are scanned and indexed with metadata specific to that patient, for instance, patient id. #, social security number, last name, first name and date of birth. The electronic chart can be housed on an internal server or hosted through a secure Web site. Physicians and staff that have the proper security can access the data from any computer or device, thus eliminating the need to have the paper chart. Organizations that have multiple locations can share the information and there is no longer a need to maintain file cabinets full of paper charts or even an offsite location specific to storing patient charts.

Perhaps the greatest benefit of starting the shift to EMR with a DMI solution lies in overcoming the resistance of Physicians and staff. While paper documents and forms are still used in the delivery of care, the history and management of the ongoing data is handled electronically, resulting in a more cost effective, efficient process, helping to vastly improve the level of patient care.

Tags: Document Scanning, Medical Record Scanning, EMR, Healthcare