A Guide to Bulk Scanning Medical Records into Your EHR
Have you been told that paper records no longer have a place in medical facilities thanks to the Electronic Health Record (EHR)?
Nothing could be further from the truth.
For instance, Accounts Payable and Human Resources are two of the largest departments within a typical medical facility, yet there isn’t a place in an typical EHR system for these types of records. So while it is true that the EHR has changed the way that medical information is gathered and shared, paper records are still alive and well in most medical facilities.
This resource will help any IT manager or office staff member to efficiently merge patient charts or other paper medical records into their existing EHR system. But first…
What is an EHR, What is an EMR, and Why Does it Matter?
You might have heard these two terms used interchangeably, but each has a unique role to play in healthcare and is worth understanding. Let’s define what an EMR & EHR is.
What is an EMR?
First, EMR is an abbreviation that stands for electronic medical record.
An EMR is “A digital version of a patient's chart. It contains the patient's medical and treatment history from one practice. Usually, this digital record stays in the doctor's office and does not get shared. If a patient switches doctors, his or her EMR is unlikely to follow.”
What is an EHR?
The term EHR stands for electronic health record.
The EHR covers a wider history than the EMR. ”An EHR contains the patient's records from multiple doctors and provides a more holistic, long-term view of a patient's health. It includes their demographics, test results, medical history, history of present illness (HPI), and medications.”
Why Does It Matter?
It is a important for a patients medical history to be accessible no matter where they seek out help. Thus, the idea behind an EHR system is to provide a comprehensive and accessible view of a patient’s health.
The problem is that often the specialty departments within a medical facility (e.g. occupational health, endoscopy, radiology, urgent care) do not have a corresponding module within the EHR for their services. As a result these records are still created and maintained in paper form.
According to the Patient Protection and Affordable Care Act (PPACA), all practitioners must offer a complete digital record for their patients. This means paper records in an organization must be digitized to constitute a complete digital record and satisfy compliance regulations. Let’s learn how to do that.
How to Bulk Scan Medical Records into Your EHR
1. Understand Your Resource Needs
The last thing an organization wants to do is to invest in costly hardware, software, training, and planning to realize a scanning project is far too time or cost intensive to be sustainable. This is a common scanning pitfall regardless of if the project is one-time or ongoing.
Avoiding this situation just takes slowing down beforehand to realistically understand the time and financial resources your team can dedicate to scanning.
Use these questions to brainstorm needed resources:
Are these paper records being created by an active process?
Why have you stored the paper files up to this point? How long do they need to be retained?
Are your paper records being kept due to HIPAA regulations, internal retainment practices, or other governance? If so, what rules do they enforce regarding scanning & retainment?
Understanding your resource needs will help avoid getting “in over your head” with a larger than expected scanning project. Also, it helps clarify if outsourcing or in-house will be a better fit in the 3rd step.
2. Pick Your Digital Storage
If you are going to be scanning in-house, you need to decide if your new digital records will be stored in a document management software or directly in your EHR platform. Most people advise against direct EHR storage, but why?
Experience has proven that scanning directly into the EHR software can be a costly mistake if the organization changes their EHR platform in the future. This is a likely event since software has a limited lifetime due to functionality gaps, technology advances, or new legislation.
Storing paper records in a dedicated document management system enables them to be easily re-integrated with new EHR platforms without expensive data transfer fees from software companies. Just have IT disconnect the image and database repository from the old platform and re-connect it to the new one.
3. Choose Your Scanning Approach
There are 2 approaches you can take to scanning paper health records into your EHR. Both styles of scanning have their own advantages.
In-House Scanning Advantages:
Using internal labor can decrease project cost
More control over project details (e.g. software, hardware choices, etc.)
Ongoing ability to decide if documents need to be scanned
Own scanners and software for good
Less storage costs since you will know if and when a document can be destroyed
Outsourced Scanning Advantages:
No need to buy or rent costly equipment
No employee time lost
Preview the cost of your project beforehand
Extensive knowledge of regulatory guidelines
Staff to help set up document management software (get ours free for 3 months here)
Experienced staff output quality
Physical space for processing records
Based on this comparison and the resource analysis from Step 1, determine which method is the best fit for your organization and follow the appropriate instructions below.
How To Outsource Scanning
One of the advantages of outsourced scanning - skip the heavy lifting (literally).
Your organization determined the best course of action is to outsource scanning. What’s next?
Your service provider should handle most of the details. After all, that’s a huge advantage of outsourcing for a busy organization. However, you need to find a digitization service. It can be tricky to find a reputable provider that understands your goals, but a general understanding of what you’re buying with a scanning service will help avoid buyer’s regret.
Resources to help you ask the right questions and make a decision:
How To Scan In-House
Your organization has determined the best course of action is to scan in-house/on-premises. Here’s how to efficiently scan physical records into an EHR in your own office.
Step 1. Calculate your staffing needs
As a rule of thumb you will need one scanning employee for every two practicing physicians. Considering this, determine if your staff can handle the extra workload on top of their normal duties. If this is unrealistic, then outside staff can be hired part-time or permanently.
The number of staff you will need also heavily relies on the experience, skill, and knowledge of your candidates. As a best practice, you need to find scanners that not only know how to work the scanning machines and software, but also know your business well. This means that there will likely be training required for any employee that comes on board. Be prepared for this ahead of time.
Step 2. Designate a project space
Without a dedicated space for your records scanning operation you are subject to lose important information and struggle to get through your project.
The average workspace requirement, according to data provided by Tab.com, is around 200 sq./ ft. per person. This will provide adequate space for their workstation, scanner, file staging area, wheel carts, and specialized preparation supplies.
Step 3. Purchase equipment
A good scanner can be the difference between “I’m going to pull my hair out because the scanner keeps jamming every 6 pages” or flying through 100 pages per minute. High quality equipment isn’t just more efficient. The image depth you get with a production level scanner should be around 200-300 dpi. This will provide a crystal clear image that can be zoomed in on to see tiny details physicians need to make important healthcare decisions.
Next, choose your document management software. A good one will make the ongoing retrieval and refiling of patient charts secure, fast, and effective. It is nearly impossible for digital files in a document management software to get lost in refiling, unlike paper documents that can easily get thrown away in the commotion of an office.
Step 4. Implement quality control measures
While quality control is important in any industry, the effect of misinformed health information has more serious consequences than most. A patient receiving the wrong treatment could be life altering; for the recipient, the doctor, and your organization.
It is crucial to have a reliable quality control process instituted at every step of records management. Ideally, quality control should be conducted by separate people than the scanning team to provide checks and balances. This will help ensure that your digital patient charts are always accurate and able to be found when needed.
Wrapping Up
Integrating an in-house or outsourced scanning strategy with your EHR and other lines of business is achievable for any size health institution. Implementing these strategies can ensure that you are never caught without data that could be a make-or- break situation for:
Someone’s personal health
Accurately paying an invoice
Rightfully billing your patient
Passing a compliance audit
Protection against an unemployment compensation issue
Other issues arising from unreliable record keeping
We hope this guide helped you understand how to scan patient health records into your EHR! If you would rather CST Data to scan for you, we can ensure ALL your patient information is accurate, accessible, compliant, and secure… we’ve been doing it for the past 21 years!