In today’s small practices, there is a large move to incorporate Electronic Health Records (EHRs) into the day to day operations and workflows.  This is mainly established through recent government incentive plans from the American Recovery and Reinvestment Act (ARRA) and the subsequent Health Information Technology for Economic and Clinical Health (HITECH) act.  This transition to information technology for tracking patient data, care outcomes, and revenue cycle activities is a natural evolution; brought about through years of study, innovation, product development and investment.   What has resulted from these cases of “early adoption” is a struggle to transfer from the previous paper workflow, to the electronically maintained record networks.

This post will attempt to explain the best methods for paper records scanning, imaging and digital archiving.  These methods of course focused on common implementations among those physician practices, which comprise a majority of those care giving establishments in the United States, operating with  <25 physicians employed.  This will be performed by focusing on the following key issues:

§         The records technology markets serving practices in question; including imaging software for radiology and other picture archiving and communication systems in use (RIS/PACS)

§         Document scanning and management firms serving practices in question

§         General document scanning procedure at Enterprise Level

§         Data archiving and analytics via EHR technology for 1450, Inc.

EHR and PACS Tech

The necessity for creating long-term records that can be easily transferred, studied and generally referenced for a more efficient and effective processing of patient care and billing.  Already heavily used in hospitals, their implementation is just getting underway for smaller physicians’ offices and clinics via HITECH payouts, which have started this year (2011) and will continue through 2016.  The technology itself is derived mainly of windows based applications, each possessing their own proprietary composition using HL7 and other Basic programming to keep the resource consumption to a minimum—on pc client workstations.  There are however, significant quantities of EHRs, operating in the SaaS cloud environment; developed within MySQL operating environments.

In addition, when connecting to larger networks, there are some protocols and other global/national networks for such data streams as e-prescribing (i.e. Surescripts), laboratory and other various data sets which would be connected through an EHR.  In this sense and in actuality, an EHR is a compilation of multiple, specific, modules serving the aforementioned data sets, all developed aligned within requirements established by the CMS and it’s subsequent ONC “Meaningful Use” guidelines.  Some examples of the guidelines include interoperability between and among EHRs (including national health networks) and specific patient data requirements (such as medication and clinical decision support systems).  More globally however, the focus of health information aggregation lies upon research and epidemic tracking of communicable disease.  Health information systems for specialties such as radiology and neurology are not as prevalent nor is there the capital to invest in these efficiencies en masse.

Conversely, here in the United States, PACS systems are highly involved at the specialty level (i.e. Radiology) for managing those large imaging outputs for X-Ray, MRI, CT Scanning and other digital graphics.  Some of the leading PACS systems in use through major healthcare systems are from such industry leaders as Fujifilm*, GE*, and McKesson* with software Synapse*, Centricity* and Horizon* respectively; the latter two being integrated PACS/EHR solutions.

While the encompassing issues are quite large in scale, the software itself is plagued by data management problems, file transfer and uploading issues as well as other technologic bottlenecks.  The next few years of implementation will smooth these issues to a more reasonable degree, by bringing a larger amount of investment into the industry from governmental and corporate initiatives.  Some larger firms such as GE Healthcare and Blue Cross Blue Shield* have contributed to the advancement of technology implementation through programs such as Healthymagination® and other incentive programs for larger scale EHR and HIT implementations.  In addition to improved care for patients, it can be inferred that insurance payers and large research institutions inevitably will benefit quite significantly from the integration of health technology. The lessons learned from these more expansive health records integrations can be applied to the smaller practices directly with minimal modification.

Document Scanning and Records Management

As the use of paper record is reduced through the general workflow of the small practice, firms operating in these paper-to-digital record transfer activities will operate as they have in other industries and larger enterprise systems.  As one example, some excerpts from rules governing medical professionals in the state of Florida are as follows:

  • 64B8-10.001        Medical Records of Deceased Physician; Retention, Time Limitations
  • 64B8-10.002        Medical Records of Physicians Relocating or Terminating Practice; Retention,                   Disposition, Time Limitations
  • 64B8-10.003        Costs of Reproducing Medical Records
  • 64B8-10.004        Legal Representative Defined

By incorporation of this information (at the state level) to that of the Federal HHS guidelines, provided for paper reduction and EHR implementation, one can get a better picture of the requirements for any given document scanning and imaging archival service provision.

Enterprise level firms such as Iron Mountain Incorporated have been operating in this field for decades and in other industries.  Paper records are easily scanned and digitally converted using software equivalent to Nuance’s OmniPage*.  The documents are data recognized for their textual and image content, creating a PDF file that can be easily archived using various compression techniques.

At this point, when a larger health system communicates with its patients, data ware housing and transaction processing companies, such as MRO* (Disclosure Management Solutions), interface with EHR data for patient query of personal health information (PHI) and the invoicing arm of revenue cycle management (RCM).

Data archiving and Analytics for Your Practice’s EHR Transition

With the EHR boom at hand, scanning and records management firms are cropping up serving the small practices in transition from paper.  IT consulting firms and PDF-to-text recognition software can very easily convert those paper records and imaging outputs.  These services can be performed in a matter of days or weeks.  After scanning, there are multiple SaaS storage environments one could choose.

For easy records query and patient invoicing, there are disclosure management solutions similar to those in use by larger health systems.  But if that seems like too extreme a change to your records workflow, just maintaining your scanned PDFs on cloud storage is an entry level solution.  Not to mention an easy way to disaster proof your records through distributed storage.

Less paper is less storage space, less square footage at your office.  Add this to the time saved physically searching through filing towers and you get easily quantifiable savings.

For more information on document scanning contact the experts at EMR Consultant.

About EHR Scope, LLC

EHR Scope is a leader in EHR consulting and education.  They offer a variety of valuable resources to help physicians and practices navigate their way through the EMR implementation process.  EHR Scope includes a network of resources for EHR comparison, multimedia industry news and vital information to operating within current Healthcare legislation and guidelines for ARRA stimulus HITECH act.  Check out and for more information.