The digitization of patient charts is becoming more and more inevitable. One of the important aspects of implementing EMR/EHR is dealing with the digitization of current patient charts and your patient charts archive. There are a number of approaches to accomplishing this task. Here are some things to look for or think about when making this important decision. The first being the acquisition of a HIPAA Compliant EMR product that permits you to batch scan records, index records in a manner similar to current physical filing methods to reduce workflow interuption, organize chart sections by subject and a provide simple method to file and retrieve patients records. This method may be a long drawn out process if you lack the resources to dedicate to the digitization project. Without strict file inventory and tracking controls in place this could lead to chaos. Utilizing a scan enabled EMR application can allow you to scan patient records as each patient returns to recieve care. While this may take longer to achieve your goal it is easier to control and manage. An approach that will yield the fastest results and benefits would be to outsource the digitization of your records to an experienced HIPAA compliant services organization. There are certain steps that must be followed to protect your practice and your patients data when seeking out a provider of such services. Some of the initial steps you should perform are:
- review workflow and prepare a plan for storing and accessing the records after they are converted and prepare a statement of work or requirements,
- select an EMR product to manage the records that fits your workflow,
- select a provider to present a conversion process plan and associated cost,
- look at history of provider, experience in digitizing records and years in business,
- sign and execute a DHHS Business Associates Agreement (BAA),
- inquire about the security and access to your records during the digitization process.
Using a service provider with little or no experience, no patient records scanning knowledge, lack of understanding of HIPAA regulations and guidelines, and a unsecure facility may lead to poor quality images, patient data exposure, and lost records. If a provider selected does not know what a BAA is then move on to another provider. A good services provider at a minimum will do the following and provide a:
- Statement of Work outlining your requirements, indexing and filing schema, how records will be protected, scanning facility security features, format of records to be digitized and facility HIPAA controls utilized to protect, manage and prevent loss of patient data and images.
- Provide a DHHS mandated Business Associates Agreement covering services.
- Provide Capabilities Statement and References
- Provide a conversion schedule and conduct an inventory of records as they are packed during pick-up.
- Provide you with a copy of inventory.
- Log all records recieved upon arrival at scanning facility
- Store all records in a secure limited access document vault during process
- Log in and out all records in vault and return records at the close of each business each day.
- Log the status of each record in process at each step ( Prep, Scan, Index, QC and Release).
- Validate document counts at each step of the process to account for all patient records.
- Provide emergency retrieval services of a patients chart.
- Provide secure electronic access to records as they are completed during the process (if requested)
- Log all access to paper or electronic records.
- Return records with completed inventory for your review. Alternative is to hold records while you review completed electronic files returned, pending shredding by a certified HIPAA compliant process.
- Provide staff training on retrieving and filing records and the various features of the EMR application selected.
Locating a responsible service provider may be the most difficult step in the process. Beware of overnight consultants and offshore processing schemes that may expose patient data and documents, put your practice at risk and subject you to fines under the new regulations. If it sounds to good to be true then you can bet it is to good. The proper processing, management and security required to protect and secure your patients records has a cost. Only an experienced processor will know how to mitigate cost and not put itself or it’s client at risk.
Having covered the above there are service providers that will work with their clients by allowing the client to perform labor intensive activities and reduce cost by doing the following:
- Provide client with inventory forms in advance and allowing client to prepare and box records.
- Instruct client in culling methods to reduce the redundant and number of pages in file that need scanning.
- Allowing client to prep files by rem0ving paper clips, sticky notes, staples, unfolding pages etc.
- Provide client with barcode templates that can be completed in a word processing application and inserted in front of the file and as dividers for chart sections.
Any one of these steps if performed by client will reduce the service providers cost and accordingly should reduce the digitization project overall cost.
Despite all the rumors and comments floating around there are benefits to digitizing your records. Below is just a few of the many benefits you can realize:
- Reduced real estate in your office presently taken up by file cabinets and filing systems.
- Improved response to patient records request.
- Improved staff productivity with less administration
- Immediate access to records
- Ability to quickly search for patterns in a patients file.
- Automated HIPAA records access tracking
- Improved security of records
- No lost or misfiled documents and charts.
Please feel free to contact me directly on any concerns, projects we have finished, questions you might have and how to address them.