Transitioning Paper-based Charts to EMR

Medical practices that have either converted to an EMR solution or are planning the conversion to electronic must decide on how they will integrate existing paper-based patient charts as part of the overall implementation. These charts contain valuable history that should be available to physicians for electronic reference as part of the transition to a comprehensive EMR solution.

Scanning the existing paper-based charts and linking the imaged data to the EMR system is the best way to have access to the legacy chart data as new patient data is being populated directly into the EMR system.

There are a few options practices have in terms of scanning these paper-based charts: 1) Charts can be scanned directly into the EMR system when an existing patient returns. 2) On-site scanning service company can scan all existing patient charts and import directly into EMR system. 3) Charts can be sent off-site to a scanning company to be processed.

Let’s look at these options in detail and list the benefits and drawbacks of each:

1) Charts scanned directly into EMR system when patient returns

Benefits
• Not a huge disruption in current practice flow and charts that are converted over time will identify active patients vs. inactive patients.
• Cost-savings of not scanning charts all at one time.
• Charts never leave the premises
Drawbacks
• Paper charts will still take up valuable space in the Practice.
• Practice will continue to absorb off-site storage and retrieval costs.
• Practice will absorb administrative costs of retrieving paper charts, scanning the charts and re-filing.
• Hybrid solution of electronic and paper-based charts delays the ability for the Practice to realize the full benefit of the purchased EMR system.

2) Send charts off-site for scan and processing

Benefits
• Typically lower-cost due to speed of processing.
Drawbacks
• Shipping costs of charts to off-site facility typically absorbed by the practice.
• Image quality and format not optimal due to the speed of processing.
• Charts are off-site out of the control of the practice and not available for reference.
• Time of conversion can be lengthy.
• Once digital images return, practice might be forced to hire consultants to import into EMR system or keep the images in a non-integrated storage repository.


3) On-site scanning service company scans all patient charts and imports into EMR system.

Benefits
• All charts are scanned in batch methodically by an on-site scanning service allowing all charts to quickly be converted and available for electronic access.
• On-site scanning service companies have the experience to optimize image presentation and file size for quick loading and accurate representation.
• Eliminates off-site storage costs and retrieval fees.
• Scanning services have high-volume equipment and software capable of 60 – 85 page per minute rates, specialized barcode processing for patient tagging, image optimization software to enhance poor quality images, and methods for determining the best image format based on the pages being scanned.
• Scanned charts can be imported directly into the EMR system without using practice administration staff.
• Scanned charts imported into the EMR system can be shredded and valuable space taken up by folders and shelves can be freed up.
• Office staff will not be burdened with scanning, retrieval, and chart re-file.
• Efficiencies of being a completely paper-less office can be realized in a few months rather than over a few years.
• Charts never leave the premises and status of charts in process available to practice on-demand.
Drawbacks
• On-site scanning and preparation equipment and people will take up some additional space temporarily during conversion.
• Slight disruption of business when the charts are being processed.
• Cost of conversion is realized up-front.

Option 1 is a slow process that will burden the existing staff and requires the existing paper-charts to remain for an undetermined length of time. Costs of handling paper and storing the paper will continue for many months.

Option 2 is cost-effective initially but the delay in processing, inability to reference chart data while being processed, and the costs to integrate into the EMR system after processing should be considered.

Option 3 is the quickest and most complete way of making sure you get the benefits of electronically referencing legacy data while realizing the day-forward benefit of the implemented EMR solution.

The decision of how to handle existing patient charts can be a tough one like the decision to transition to EMR in the first place. If deciding to go with Option 2 or 3, make sure you contact references to make sure the scanning company you select is reputable.

Hopefully, this information provides practice decision makers additional insight on how existing patient charts can be digitized and integrated in the implemented EMR system. Optiscan has converted charts for multiple practices in AZ and is ready to talk with you about your chart scanning needs.

Michael S. Hawkins
Business Development – Scanning Services
OptiScan Inc.
mhawkins@optiscan.net
http://www.optiscan.net