One of the greatest misconceptions about electronic health records (EHR) is that as soon as they are “turned on,” all of the data a practice has collected to date is immediately available for viewing and use in the system.
Though all of the data that is entered into the system from implementation forward is available for use, all historical and previously collected paper information obviously still needs to get scanned and entered into the EHR. A major challenge, which is often overlooked or completely ignored, is how practices are going to get the information into the EHR and what paper information they need to enter (and keep).
At the same time, just because a practice implements an electronic system doesn’t mean it will be a completely paperless office going forward. In fact, in almost every instance, a practice is never paperless.
According to Sean Morris, vice president of business development of the electronic content management provider Digitech Systems, ambulatory practices and hospitals encounter paper daily and will continue to do so even if it’s in the form of something as simple insurance cards, patient IDs and third-party bills or patient documentation.
“Paper permeates every practice and will forever, no matter how savvy they are or technologically advanced they become,” said Morris. In most cases, we find that hospitals and practices need solutions to manage the paper they encounter and make sure it becomes part of the patient’s permanent record.”
In fact, as a practice moves farther from its papered medical records past, including a patient’s non-health-related data, like insurance and billing information, that’s not typically part of an EHR can play a key role in filling out and adding context to a patient’s record.
As a practice moves from paper records to an electronic system, the more information collected from the clinic’s historical past from the paper charts and entered into the new electronic record, the better all future experiences will be for providers within the care setting even if every morsel of paper collected prior to implementing an EHR is not entered into the record.
Essentially, the decision about how much of a paper record gets scanned into the electronic system is up to each practice, Morris said, and is based on a number of decisions, including what needs to be transferred, how long a record needs to be kept and what information is vitally important to caregivers in their exchanges with patients.
The primary goal of the move to an electronic record is creating additional operational efficiency. For those struggling with the move to electronic records and wanting to create the most accurate historical record possible, the most efficient path may be the one that employs a bridge technology to handle the task.
Bridge technology – also known at electronic content management – allows administrators to collect, scan and import information directly into an EHR, making it automatically available for use or for archiving appropriately in a searchable, HIPAA-compliant manner. Additionally, the information can be made available in the cloud or via an on-site server in the same or separate manner as the EHR.
Like all heath data in the electronic record, bridges allow what was once paper files to be encrypted, searchable and audited.
According to Michelle Hermann, director of medical records at Children’s Hospital of New Orleans, “When a doctor or nurse needs a patient’s complete medical history, they simply look the data up for themselves at the desk in the ER or place a quick phone call to records. Consequently, customer service has improved as patients’ needs are addressed more quickly and with better information at the doctor’s fingertips.”
Mary Peelan, records administrator at Denver Mental Health Center, also saw a dramatic increase in the organization’s efficiency once the clinic implemented an electronic content management system. “Our efficiency after reorganizing our workflow and after implementing the bridge technology has increased our productivity by 99%,” she said.
According to Peelan, the clinic’s system has been able to centralize its patient records in a single location through a cloud-based enterprise content management system even though thousands of pieces of patient’s paper continue to be collected across its 32 sites throughout the greater Denver area.
From an administrative perspective, the chain of clinics has saved well more than $250,000 simply by utilizing the content management bridge, which it uses to scan physical data for entry into the EHR.
“It was so easy to make the switch to managing all files electronically,” Peelen said. “It takes so much less time, and we would never go back to the way we did things before. Currently, we’re not passing out any paper records and the goal is to never touch the paper record again.”
However, once the clinic implemented the bridge software, which captures the information from of a paper record by scanning it and importing the data into the EHR – even drawing out specific data sets from the files and loading them into a searchable database – indexing and record management times have dropped to a fraction of what they were prior to the bridge.
But efficiency is not the only reason for the switch – HIPAA compliance and pressure from regulation also played a role, said Hermann, of the Children’s Hospital. The reams of unsecured paper records throughout the hospital necessitated the move to EHRs purely from a confidentiality and security standpoint.
Besides, managing paper records is costly, and hospital administrators were keen to the idea of paying once, to have the data scanned and entered into the electronic record, than trying to maintain reams of paper. The bridge technology smoothed the transition for both the hospital and for Denver Mental Health Clinic.
According to Morris, bridge technology can scan everything in a practice and make it available at the click of button. As such, there’s simply no need to keep the paper files on hand even though most practices do, just to be sure, he said.
Scott E. Rupp is an award-winning journalist, having written for a variety of publications throughout the U.S. including The Tampa Tribune, LA Weekly, Southern California Physician Magazine and Health Management Technology.
