Scanning and Importing Paper Charts Into an EMR

As many of you know, I love getting comments on my blog. Plus, comments on my blog often ask very good questions that I prefer to just answer as a separate blog post. I’ve considered a few times trying to integrate something that would allow people to ask questions that I could then answer, but I’ve never found just the right solution. Until then, just leave a comment and I’ll reply as best I can.

The following quotes are from a comment Sean made on my Choosing an EMR or EHR post.

Eric,

I’m not sure how he got my name as Eric since it’s not Eric. Possibly he was confusing it with my post about Eric Schmidt’s Google Health Announcement at HIMSS. I really don’t mind what you call me as long as you leave insightful comments and questions.

Thanks for the informative blog. I hope others have found it as interesting as I have.

Thanks. I’ll pay you later for the compliment.

I have a question about EMR implementation & you may be able to provide a good answer: When a practice adopts an EMR solution, what is the process by which all of the existing files get scanned & imported to the EMR? Do practices send their files to an outsourced (and presumably HIPAA compliant) scanning company? Or do they buy a scanner & have the staff or temps scan them in bulk? Or do they scan patient files as those patients come to the office?

Do you have any insights here? Seems like a big part of the process, but I’m having trouble finding information about it.

Of course, the obvious answer to your question is Yes! The reality is that every method you describe above has been done. I personally recommend sending the files to an outsourced HIPAA compliant scanning company. It’s a pretty smooth process to send them out and the company can often index them in such a way that you can access those files quickly if needed. I say I prefer this way, because we found that in the majority of cases there wasn’t a need to look back at the paper charts. In the beginning of our EMR use, we would pull the chart for each patient. After doing this for a short period, our clinicians found that more often than not, they didn’t have a need to see the paper chart. So, we decided to stop pulling the charts unless a clinician made a specific request.

I can imagine that this may not be realistic for many people. My clinic works with a younger population which don’t usually have an extensive medical history. However, our experience provides a good insight for other practices. Take a second to notice how often you look into the paper chart. How often do you need the information from past visits found in the paper chart? If you are like us and rarely needed the past history, then why waste your time pulling charts and scanning them individually?

For those that feel they need to see a past chart, you might consider my previous post about “Thinning Out the Chart for Scanning to an EMR.” The idea is just pulling out the relevant information that needs to be inputed into the EMR. The rest of the information can remain in the paper chart.

If you decide to start scanning the charts in yourself, I think it’s a good idea to scan as you go. I don’t expect that most offices have an abundance of people that are just sitting around needing something to do (ie. scanning). Scanning is a tedious process and it’s better to bite it off in little chunks. Then, once you’ve made a dent into the past charts, you can consider doing a bulk scan or sending it out to a third party scanner to clean things out.

I think the key milestone to achieve with your EMR is to reach a point where you no longer have need of a paper chart. This really takes a change of perspective for most people. It’s so easy to just drop a paper into a chart. Your medical records staff are probably trained well enough to create charts in their sleep. Teaching them to scan all the paper into your EMR takes focus and effort. However, with a little work it becomes second nature and people won’t remember what it was like to have paper charts.

Thanks very much in advance.

Thanks for stopping by EMR and HIPAA and asking some very good questions. A blog becomes much more interesting when their is interaction with the end users.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

12 Comments

  • We are doing a great job in scanning every document in a patient chart. Our clinic is a 30 year old practice with almost 15,000 charts to date. With health care team supervising the scanning, indexing and adhering to HIPAA regulations, I will be soon accepting other clinic contracts.

    Call for more information

    Dr.Parimi
    (412) 736 3681

  • I agree, scanning in the essentials in the beginning then scan as you go along. Once you’ve settled into the EMR, make a goal with your scanning personnel, 5 charts/day for example. That’s how we did it. My partner still has a significant amount of old charts that are stored in the basement of one of our clinics. It’s also a great summer job or “internship” opportunity for a College student.

  • Do you have any suggestions on how my company can become a HIPAA compliant scanning company?

  • Gretchen,
    I suggest consulting a local attorney to make sure you’re following all HIPAA laws and also the various state laws that govern patient information. Get their stamp of approval so you can comfortably tell people that you are HIPAA compliant. Without this stamp of approval, you’ll just be hoping that you did everything you needed to do.

  • Gretchen: Just what type of company do you have? What’s it’s purpose and what do you do? If you’re just providing a short term service for a medical practice or health facility, you can sign a “Vendor HIPAA Agreement” that addressed these sort of things. We have cleaning crew and other support people sign one for our practice. Of Course now that we’re an EMR practice, everything is password protected as long as you don’t leave your computer unattended and in someones chart.

  • Remember to be HIPAA compliant, all scans must be done so that the files are in a secure, non-public directory, or preferably scanned directly into an encrypted medical record.

    If you are using any kind of hosted ASP software, such as any of the products that run under Citrix or Terminal Services, you should probably consider looking into the product called RemoteScan, which is the accepted way of scanning securely straight into any EMR package.

  • Where can I receive educational training on how to scan EMR documents so that I may be considered for employment? I live in South Dakota. Thank-you

  • Shan,
    It’s kind of a misnomer to say scan EMR documents. EMR documents are already electronic and so they don’t need to be scanned. I assume you meant scanning paper documents into an EMR?

    Really there’s no need for training on this. The technology can easily be learned in a half hour. The real challenge to being good at it is being a detail oriented person. It’s all about the details when it comes to scanning.

    I’d recommend finding a local scanning company and see if they’re hiring. On the job training is the best way to learn it.

  • linda smith,
    Disclaimer: Consult a lawyer since some states have different requirements for records retention and I am not a lawyer.

    With that disclaimer, most people I know shred them once they’re scanned. They may keep them for some reasonable period after scanning, but then they shred them.

  • I’m starting our own small scanning company, I was just wondering… after scanning the paper documents(medical records), how are the documents being uploaded into the software? What kind of load files and image file are supported?

    Thank you very much…

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