A short time after I moved to my present town outside Albany, back around 2005, I decided to find a primary care physician that was local. After consulting my insurance’s directory of providers, I booked an appointment with a doctor about ten minutes away. When I first visited, I was shocked and frankly a little alarmed to discover that not one computer was present–in 2005. There wasn’t even a relic of a beige tower with curved-screen CRT by its side.
Instead, there was, in a prominent location, a typewriter (IBM Selectric — with “the ball”) on a classic, steel-gray, wheeled typewriter cart. Behind the main counter, I could see a doorway that revealed a wall of files with a chaotic rainbow of color coded tabs that seemed to run to the other end of the building. “That is a lot of paper,” I thought. When I received my handwritten, triplicate co-pay receipt, I then thought, “I bet there is a lot of cursive writing in that file room!” In fact, everything there was still being done manually, via fax, via mail, via typewriter and triplicates. Only eight years ago.
True, some years have passed and there have been some dramatic changes since then. The issue remains however that in healthcare organizations as small as this suburban doctor’s office to multi-site hospital systems in major metropolitan areas, the migration to electronic patient records has been slow. The US government’s $35 billion “meaningful use” programs to incentivize healthcare organizations to adopt electronic health records (EHR or EMR for electronic medical records) has accelerated the adoption rate. Still, there remains a Grand Canyon-wide chasm between (A) new patient records that are created today on systems like Cerner, Epic, McKesson, Siemens, Meditech or other EHR vendors and (B) the existing volumes of paper, offline records for some of the very same patients who are coming in today and having a new, separate EHR file created.
For patients, myself included, trying to retrieve paper patient records that were beyond a certain age can now require a records request with a third party records management vendor that keeps patient records stored somewhere in a file box, on a shelf, in a remote warehouse. That request process usually took several days making a negative impact on the overall “quality of administrative care” for the patient. (In my case, it turned into a rabbit hole. Despite the efforts of a prominent records management company, my records at a former PCP were found in the third facility they checked — three tries!)
In some cases, IT vendors are bridging the old and the new in innovative ways. For example, in the Capital region, document imaging vendor Image Data works with small to large healthcare organizations to smooth the transition to digital and to make it as seamless as possible. Working with administrators and IT leaders like CMIOs and other medical informatics and healthcare IT leaders, they evaluate tailored processes to scan and index paper patient records for online access.
The end result is that the shelves and shelves of patient records maintained at a 3rd party location, can be replaced by a secure browser window where thousands upon thousands of records of multiple formats can be searched and retrieved from the cloud, to be displayed on-screen in the universally familiar format. Additionally, many documents with typed or printed text can be indexed so that searching can be done within the document. If a hard copy is ever needed for an immediate request, it’s only as far away as a click on a print icon.
Image Data CEO and co-founder, Tom Bourke talks about what this means for healthcare leaders that are eager to innovate, “Over and above the strategic necessity of these types of document imaging projects that we’re seeing parallel the implementation of EHR systems, there is a peace of mind the hospital secures that is priceless.”
Bourke emphasizes, “The confidence and peace of mind they can offer patients that they are being responsible stewards of contiguous patient care histories, even in the midst of implementations of vast EHR solutions, truly honors what’s at the core of the mission of today’s technology-adept hospitals and healthcare systems. And, considering the comparatively small cost to implement a document management project compared to the multi-million-dollar EHR implementations we’re seeing today, it’s an easy decision.”
Depending on a site’s configuration, doctors and clinicians can also take patient archive searches on the go, browsing for records via app or browser on their smartphone, iPad(R) or other tablet.
Some hospitals, working with document imaging and management vendors like Image Data want to make a tighter connection between their scanned paper records and their EHR. With more sophisticated IT development, there are instances where records from a year ago, or a decade ago can be retrieved directly within the EHR.
For clinicians and healthcare administrators, fewer clicks to the right record can mean a faster answer to a patient question, a better diagnosis, fewer unnecessary tests, and lower operational costs. The ROI of a migration from reliance on paper records management vendors to a virtual, turnkey, online document management solution is discovered in every moment there is a need to review a history and the costly time meter starts ticking before a record is delivered, before a clinical decision is made or while healing is held-up by a paperwork request.
Healthcare technology is a progressive, forward looking space. But, the most sagest CMIOs and HCIT leaders have discovered that preserving the capability to look backwards, principally when it comes to a patient’s history, must be a key element in the march forward toward better care.