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Scanning - Paper to Bits
Given the pressures to convert from paper systems to EMRs, document scanners are quickly becoming the new indispensible item in the doctor’s office. “Inevitably, there is going to be paper or documentation that needs to be scanned and integrated into a patient record that includes registration, insurance, clinical notes, lab, radiology, prescription, referral notes, etc,” says Scott C. McCabe, chief operating officer at IMR. ‘The list of information that is not native to the EMR is endless.”
Fortunately, scanner technology is steadily improving to meet the task but don’t expect to notice the changes at first glance. “Scanners continue to improve in incremental, rather than revolutionary, fashion,” says DoX Systems’ CXO, William L. Horvath II. “I haven't seen any ‘Wow, that's new and exciting!’ features in scanners in quite a while.”
However, it is a profound mistake to believe that your old office scanner is ‘good enough.’
“Scanning technology really hasn't changed significantly but what has changed is the software that automates the document classification and filing process,” explains Abe Niedzwiecki, vice president of Technology at CNG. “Software is now available to assist with classification of documents, send them to automated workflow processes, set retention policies, and control access rights all simply by checking a box on a document.”
Oh, but there’s more to look for in scanners if the goal is scanning accuracy.
“When doctors are looking for scanners for their office, they should make sure that the new scanners come with ultrasound technology,” advises Adam Kootman, director of Operations at Pacific Scanning, a company that specializes in scanning documents for businesses including doctor’s offices. “This allows the scanner to tell you when two pieces of paper are stuck together or if a post-it note is covering any information.”
Actually, there are several specific features doctors should look for and weigh.
“The newest features to look for when considering a scanner is speed, how the scanner handles double-feed detection, and the types of media that can be fed through the scanner,” says Al Hawkins, president of OptiScan a document scanning company in Arizona. “Image quality is also an important consideration when dealing with EKG strip charts and paper with very fine details.”
Be careful, though, just because a scanner has high-quality imaging doesn’t mean that’s what it will deliver straight out of the box. “It’s not only the capabilities of the scanner hardware, it’s how the software settings are configured to get the best image quality,” adds Hawkins.
Rather than judge scanners by the salesman’s demo, consider what documents you will be scanning, how many you will be scanning and what level of detail you need. Look for those specific abilities in scanners before deciding which to buy.
“Documents to be scanned should include anything that will impact patient care and protect both the patient and physician,” says Niedzwiecki. Typically this would be the items found in the patient paper based chart. Common items include but are not limited to: Insurance cards, patient registration information, lab results, outside radiology reports, referral letters, HIPAA documentation, office notes, etc.
Fortunately, many items such as vital signs and internally generated documents are now being captured directly in an electronic medical record application or document management system which speeds the integration process.
“Scanners are frequently used to capture key demographic information from patients—such as driver’s license, insurance card, even signed HIPPA forms–at registration,” says Steve Dale, account executive at ImageSoft, a company that provides enterprise content management solutions for healthcare and other industries. “It’s a very fast, efficient and accurate means of obtaining the data and has a very small footprint, so it consumes very little desk space.”
There are inherent dangers in scanning, however. “If you have OCR software, you could convert a document into a searchable, character-based format, but you run an inherent risk that, for example, a number would get misinterpreted as an 8, instead of a 0, and if you base a treatment decision on that data point, you could harm a patient,” warns Horvath.
If your biggest scanning project at hand is to move legacy charts and records into an EMR, you may want to consider hiring a document scanning firm rather than overwhelming your office staff with the task. In general, look for a scanner with software that can handle your normal daily workload to your exact specifications.