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

The State of the Long Island Employment Market - Guest Post from Jason Banks of Lloyd Staffing

Posted by Michael Thomas on Thu, May 06, 2010 @ 06:34 PM
Jason-BanksThe following Guest Post is from an interview I recently conducted with Jason Banks, Executive Vice President of Lloyd Staffing. Lloyd Staffing is and is one of Long Islands most respected Employment Service Providers offering recruiting, hiring, retention and outsourcing, and is also a Strategic Partner of Shoreline's for staffing Document Scanning Projects.

Recently, I had an opportunity to ask Jason some questions about the Challenges and Opportunities in Long Island's Employment market, as well as how businesses can use the market to improve their operations. Here's What Jason had to share:

Lloyd Staffing LogoWhat are the biggest challenges facing Long Island Employers today?

Putting aside the current economy, which is starting to change and gain momentum, the long-term challenge for local employers is plugging the talent drain of fleeting Gen X/Gen Y workers needed to replace aging baby boomers who retire and move elsewhere.  This is a dynamic we have heard about, read about and had conferences on but there have been very little solutions presented. Both of these generational opposites may have trouble justifying remaining on LI if compensation is not competitive with cost of living.  This region is consistently faced with the challenges involved in relocating employees to this region.  LI companies need to make the investment in training and retaining their talent resources while exploring creative solutions to keep  an active talent pipeline.  Also, watch for the rapid increase in employees looking for virtual work options and consulting engagements rather than full-time direct employment.

Where are the biggest opportunities for those looking for employment?

Technology, Healthcare, Engineering and Sales.  Digital advancements and Economic Stimulus have ignited change in Healthcare, Technology and Engineering/Construction. Long Island employers are seeking versatile professionals who have dynamic skill-sets in these industries.  The need for Sales professionals has been steady for the last 8 months and now the mid-level sales management has come back. 

How can businesses use the market to help them improve their talent roster?

It has been a buyer's market, although we are now seeing small changes such as competitive offers and buy-backs. This is still a very good time to take advantage of the talent marketplace and acquire talent that might otherwise not be available financially, emotionally or intellectually.  However, don't bargain hunt; recognize value, take time to meet candidates, conduct exploratory interviews, bring on temporary staffing help to help with seasonal or project needs and keep talent close to your brand. Do not put your organization in the position where the market comes back, talent is scarce and you are stuck saying "we should have connected with the talent/candidates we often look for when we had the chance."   Recognize that good hires can be made at every level, but be mindful not to send the wrong message to your remaining staff.  Make it clear that such hires are not luxuries, but can put the company at a competitive advantage, during and after the economic recovery.

Thanks to Jason for taking the time to share his thoughts on the state of the Long Island Employment Market. Be sure to visit Lloyd Staffing for all of your Employment Service needs.

Tags: Document Scanning, Business Strategy, Healthcare

Digitizing Medical Records? Here are some things to consider

Posted by Tom Doyle on Tue, Apr 13, 2010 @ 05:28 PM

President Obama has vowed the U.S. will digitize all medical records by 2014, and an economic stimulus package passed by Congress last year allocates $20 billion toward the process. So Hospitals, group medical practices and physicians who for the most part have shied away from transitioning to a full-fledged Electronic Medical Record (EMR), are now compelled to take action. While the stimulus dollars will help defray the cost of implementing the infrastructure to migrate to EMR, the question of how or whether or not to digitize all or a portion of the Medical Record archive needs careful consideration.

Digitizing the archive requires a fairly labor intensive process; preparing the charts by removing paper clips, staples, etc., scanning, assigning index values to the scanned images and importing the data to the EMR. The value of having patient historical information as part of the new EMR system is clear, but what if the charts are rarely if ever accessed? What if, as in the instance of specialty practices such as Cardiology, it's not known when or if a patient will ever need to be seen again? Retention requirements mandate that the chart be maintained for as long as 10 years from the last visit.

One solution that should be considered is storing the older, less frequently retrieved charts offsite, at a secure, climate controlled location, with a Certified Document Management partner like Shoreline Records Management. Our Medical Record Storage Services allow healthcare organizations the flexibility to store charts in an efficient, cost effective manner, yet have them digitized on demand. Once digitized, the electronic chart is transmitted securely and imported directly into the organizations EMR system. Requests are fulfilled 24 hours, 7 days a week, often in as little as two hours.

In the scenario of frequently retrieved charts such as Pediatrics, digitizing the entire archive is more likely. Our Medical Record scanning service center is equipped with several of the latest high speed document scanners capable of capturing images at a rate of over 120 pages per minute. Projects that would take months or even years if done in house with current staff can be done quickly and affordably, allowing the organization to access historical Patient information within the new EMR system.

Tags: Scanning, Medical Record Scanning, Healthcare

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

How Much Does Medical Record Scanning Cost?

Posted by Michael Thomas on Thu, Apr 01, 2010 @ 12:05 PM

We talk a lot on our blog about Medical Record Scanning as more and more people are out there looking for services to support the nationwide rollout of EMR Solutions. It's common, however, that we get a request from someone looking for a rough idea of Medical Record Scanning Prices. It's an understandable question, as I know that I wouldn't want to sign up for anything without at least having an idea as to what the price was!

Well, I first need to preface this with the standard - your Mileage may vary, but depending on the complexity of your project, typical medical record scanning prices are between $.04 and $.12 Per Image. Some of the factors that will influence these prices are:

  • The amount of Document Preparation Required - If your Medical Records have a lot of Staples, Clips, and fastners, or if you need files to be sorted based on sections and sub-sections of the chart, you'll likely be toward the higher end of the pricing scale.
  • The Volume of Medical Records to be Converted - Document Scanning Services are one of those things where it definitely pays to buy in Bulk. Our Price per page builds in all of the setup and administrative costs, and those are offset by having a higher number of pages to convert.
  • The Indexing Criteria Required - If you need to search for Patient Information based on First Name, Last Name, and Medical Record ID Number, that's pretty standard. If, however, you want to add additional information to your images - Phone Number, Addresses, etc. - it will require more time, and ultimately will affect the price per image. (Keep in Mind that if you already have a EMR or Database system that we can use to lookup additional data based on Medial Record ID Number, you can add as much or as little of this information as you'd like.
If you're looking to get a quote for your Medical Record Scanning project, please take the time to get an estimate based on your specific requirements. We'll be glad to provide you with an estimate, and we can even provide you with a sample of our services to let you see how easy our process is and so that you can get a feel for the quality of our work.

Tags: Document Scanning, Medical Record Scanning, Healthcare

Medical Record Scanning gets New Meaning

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

The team at CNN.com 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

CNN.com - "At Bronx Clinic, The eyes are windows to Medical Records"

Shoreline Records Management - Medical Record Scanning 

Tags: Medical Record Scanning, EMR, Healthcare

Medical Records Scanning Services help Reduce Risk

Posted by Michael Thomas on Wed, Mar 17, 2010 @ 11:00 AM

Hurricane force winds and gale rains toppled trees and created havoc in the New York Metropolitan area this weekend. Thousands were without power, and the storms caused  damage to countless homes and businesses. So What does this have to do with medical record scanning?

Scanning medical documentsand other important records is a safe way to

Medical Record Scanning

 ensure that your files are safe in the event of a natural disaster.  Case in point, most group practices try to make the most of the space that they use for offices, patient rooms, waiting areas. When it comes to documents and storing them, often a less desirable space is where the documents are stored. Many doctor’s offices will use a basement or garage area for storage where thousands of files are kept.

During the recent downpours in the NY Metro area, there were downed trees, localized flooding and damage to buildings.  High winds and Nor’easter conditions are not that frequent, but they do happen, just like Tornados on the Plains or Hurricanes on the Gulf Coast. From a Document Management perspective, The dilemma is that when the rainfall is coupled with the soggy, saturated ground conditions, there is nowhere for the water to go and consequently, many previously dry basement storage areas are suddenly prone to wet conditions or flooding.

Wet files are then a place where mold and other toxic and bio-hazards can grow.  In the damp environment, even a relatively dry area can be a breeding ground. Retrieving the files is unpleasant, and may also result in exposure to the mold.  Not the healthiest of conditions.

By scanning medical records, or by storing them offsite, this recipe for unpleasantness can be easily avoided.  In addition, a hybrid solution where scanned medical document and offsite document storage solution enables the practice to maintain medical records offsite, as well as access key information on demand.  Now is the time to take action and protect your valuable records. And keep in mind that whatever option you choose, Scanning medical records will lead to improved efficiency and reduced errors and also help your practice transition towards the future of the Paperless Medical Office

Tags: Document Scanning, Medical Record Scanning, Healthcare

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

Medical Document Scanning will Turn You Green

Posted by Michael Thomas on Mon, Mar 15, 2010 @ 07:16 AM

Medical document scanning is an efficient method to manage your medical records,  as well as a benefit to the environment as well as the economy.   By scanning medical records,  the amount of paper and trees that could be saved is astounding.  When you consider that the average patient medical file contains about 75 Pages, and multiply it by the total number of patients in the United States, which is upwards of  307 Million, there are more than 23 Billion Pages of Medical Information scattered across today’s hospitals, clinics, and medical practices. This number multiplies exponentially when you start to consider that most people have separate charts at their Dentist, Podiatrist, and other specialists that they may visit.

When it comes to the mountains of paper that is used every year to print medical records and the cost of space to store these records, as well as the liability of unauthorized access to medical information a medical document scanning solution becomes very attractive. By Scanning Medical Records, not only is there a positive impact on the environment, but there are even more significant economic benefits that come along with the Nationwide push towards Electronic Medical Records.

 

 
Recently,  grants that have been established to encourage states, doctors and hospitals to enter the age of computerized record keeping. 

Medical transactions require a minimum of one sheet of paper per medical record claim submission, another sheet for claim payment and another sheet for claim remittance.  Usually the file contains much more than the minimum, including updated insurance information and insurance authorization, signed copies of HIPAA consent,   studies or test results related to the patient, as well as the doctor’s notes and observations. 

According to the U.S. Healthcare Efficiency Index, paper medical records are “costly, inefficient and prone to errors.”   An independent actuarial study performed by Milliman Inc. considered six key transactions:

•   Claims Submission

•   Eligibility Verification

•   Referral Certification

•   Preauthorization for Care

•   Claim Status

•   Payment posting

According to their analysis scanning medical records and medical document scanning could reduce annual insurance administration costs by more than $42,000 per physician.  And so, While it may not literally turn YOU green, starting the process of scanning medical records in your practice , clinic, or hospital can help improve not only the environment, but also the efficiency and economics of the practice.

Tags: Records Management, Document Scanning, Medical Record Scanning, Healthcare

How are you protecting your Business Records?

Posted by Tom Doyle on Thu, Mar 04, 2010 @ 02:59 PM

It's 2010!!How important is your iphone, PDA, Laptop and cell phone to your ability to get your daily business done?  With each instant message, email, processed order and invoice, the importance of managing, archiving, storing and securing business information grows. The theory of the paperless office, while relatively attainable, is not practical or realistic. You receive a contract via email. It requires safekeeping and security. What do you and the six other people cc'd on the email do? Print it! Fast forward a year or five or ten. How many types of documents, paper or electronic have you created? Well, you don't have to be a public company or a 100 attorney law firm to have a real problem.  What to do and how to manage the lifecycle of your business information.

Today, depending on the industry you are in and who governs that industry, you are responsible, in fact liable and at risk if you don't protect that information or be able to produce it at a moment's notice. And, according to a recent survey by Cohasset Associates in conjunction with ARMA - The Association of Records Management Advisors, "while many organizations are moving in the right direction, research clearly indicates that for an alarming number, the efficient and systematic control over business records is still not getting done."

Why? Because it's an afterthought. Like insurance in many instances, people should have it and they know it, but they wait until it's too late or have a catastrophic event to realize it.

It doesn't have to and shouldn't come to that. Instead of boxing up your documents and putting them in a garage or a self-storage shed, or worse, your hallways, conference rooms and closets, exposed to all kinds of danger, both environmental and human, consider this - secure, climate controlled, off-site Record Storage.  For as little as .25 cents per box per month, your mind can rest easy knowing that your corporate business history is secure and retrievable at a moment's notice.

 In addition, many service providers offer additional value added services, such as scan on demand, whereby requests for documents are made by secure web portal, requested files are retrieved, scanned and securely sent to the requestor for a fraction of the cost of moving the file manually. Law firms, Health Care providers, Insurance companies, virtually any industry is a prime candidate for this undervalued, necessary function.

As a certified Record Storage partner who combines off-site document storage with Enterprise Document Management and Outsourced Scanning services, Shoreline Records Management also provides Records Management consulting services to create policies and procedures that manage the creation, lifecycle and destruction of your corporate information.

Today, every industry is regulated, and as a result of that regulation, audit control and compliance surrounding business transactions warrant the expertise of a professional Records Management company. Don't continue to waste time and money while exposing a serious risk to your business.   

Tags: File Storage, Records Management, Healthcare