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EHR Benefit – Space Savings

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It’s time for the next installment in my series of posts looking at the long list of EHR benefits.

Space Savings
I’ve heard many clinics use the space savings as a great way to justify the cost of their EHR. This works better in the small physician office market than it does in the hospital market, but the principles are similar. However, the scale is different.

The obvious space savings is the storage of all the paper charts. While many clinics are quite creative in how they’ve stored paper charts (see the walls around the front desk of many clinics), the most common storage is a chart room dedicated to the storage of all the paper charts. Each state has its own requirements for the retention of paper charts, but its usually somewhere in the neighborhood of 6 years. 6 years of paper charts amounts to a lot of storage space. Plus, many doctors I know keep their paper charts well beyond the required retention period (the liability of doing so is a different discussion).

There are many different approaches to dealing with your paper charts during an EHR implementation. Many continue referencing and pulling the paper chart, but just start any future documentation in the EHR. Others scan the patient charts for the following day’s appointments. Others choose to only scan parts of the paper chart similar to how they use to “thin” the paper charts. In each of these situations, the space savings will start to accrue over time, but you won’t experience a big space opening up right away.

One way that some clinics gain space is by moving the charts from a very accessible place to one less accessible. As you move to EMR, there isn’t as much of a need to access the old paper charts and so you can often optimize your space in a way to free up the previous paper chart storage space and move the paper charts to a different space in your office.

Another option many clinics are doing is outsourcing the scanning of all their old paper charts to an outside company. While not the topic of this post, the cost and quality of such outsourced scanning has made it a really attractive option for many clinics. Many chart scanning companies will even do clinical data abstraction as I’ve written about before. In this case, all of your paper charts get scanned into digital form and you no longer have any paper charts storage needed at your office. It’s always amazing to see an entire room full of paper charts sitting on a little hard drive.

I’ve heard of clinics use the previous chart storage space in a variety of ways. The most interesting is when the previous chart storage space is turned into an exam room(s). This extra exam room can allow a clinic to see more patients or even hire another provider who sees patients in their clinic. In this current fee for service environment, that translates directly to dollar signs for the clinic. If you can achieve this during your EHR implementation, it’s a great way to justify the cost of the EHR and is a tremendous financial benefit to consider.

In other cases, the chart room is turned into an office for the billing staff, practice manager, nurses, or doctor. Doing so can’t easily translate to a specific dollar amount, but can also lead to valuable benefits such as employee satisfaction, quality of care, quality of billing, etc.

Saving space isn’t always a result of implementing an EHR, but it can be in many EHR implementations. So, consider how the chart storage space can benefit your clinic.

January 30, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

Clinical Data Abstraction to Meet Meaningful Use – Meaningful Use Monday

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In many of our Meaningful Use Monday series we focused on a lot of the details around the meaningful use regulations. In this post I want to highlight one of the strategies that I’ve seen a bunch of EHR vendors and other EHR related companies employing to meet Meaningful Use. It’s an interesting concept that will be exciting to see play out.

The idea is what many are calling clinical data abstraction. I’ve actually heard some people refer to it as other names as well, but clinical data abstraction is the one that I like most.

I’ve seen two main types of clinical data abstraction. One is the automated clinical data abstraction. The other is manual clinical data abstraction. The first type is where your computer or server goes through the clinical content and using some combination of natural language processing (NLP) or other technology it identifies the important clinical data elements in a narrative passage. The second type is where a trained medical professional pulls out the various clinical data elements.

I asked one vendor that is working on clinical data abstraction whether they thought that the automated, computer generated clinical abstraction would be the predominate means or whether some manual abstraction will always be necessary. They were confident that we could get there with the automated computer abstraction of the clinical data. I’m not so confident. I think like transcription the computer could help speed up the abstraction, but there might still need to be someone who checks and verifies the data abstraction.

Why does this matter for meaningful use?
One of the challenges for meaningful use is that it really wants to know that you’ve documented certain discrete data elements. It’s not enough for you to just document the smoking status in a narrative paragraph. You have to not only document the smoking status, but your EMR has to have a way to report that you have documented the various meaningful use measures. In comes clinical data abstraction.

Proponents of clinical data abstraction argue that clinical data abstraction provides the best of both worlds: narrative with discrete data elements. It’s an interesting argument to make since many doctors love to see and read the narrative. However, all indications are that we need discrete data elements in order to improve patient care and see some of the other benefits of capturing all this healthcare data. In fact, the future Smart EMR that I wrote about before won’t be possible without these discrete healthcare data elements.

So far I believe that most people who have shown meaningful use haven’t used clinical data abstraction to meet the various meaningful use measures. Although, it’s an intriguing story to tell and could be an interesting way for doctors to meet meaningful use while minimizing changes to their workflow.

Side Note: Clinical data abstraction is also becoming popular when scanning old paper charts into your EHR. Although, that’s a topic for a future post.

November 21, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.