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Scanning Is a Feature of Healthcare IT and Will Be Forever

Posted on October 11, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

When I first started writing about EMR and EHR, I regularly discussed the idea of a paperless office. What I didn’t realize at the time and what has become incredibly clear to me now is that paper will play a part in every office Forever (which I translate to my lifetime). While paper will still come into an office, that doesn’t mean you can’t have a paperless office when it comes to the storage and retrieval of those files. The simple answer to the paper is the scanner.

A great example of this point was discussed in this post by The Nerdy Nurse called “Network Scanning Makes Electronic Medical Records Work.” She provides an interesting discussion about the various scanning challenges from home health nurses to a network scanner used by multiple nurses in a hospital setting.

The good people at HITECH Answers also wrote about “Scanning and Your EHR Implementation.” Just yesterday I got an email from someone talking about how they should approach their old paper charts. It’s an important discussion that we’re still going to have for a while to come. I’m still intrigued by the Thinning Paper Charts approach to scanning, but if I could afford it I’d absolutely outsource the scanning to an outside company. They do amazing work really fast. They even offer services like clinical data abstraction so you can really enhance the value of your scanned charts.

However, even if you outsource your old paper charts, you’ll still need a heavy duty scanner for ongoing paper that enters your office. For example, I have the Canon DR-C125 sitting next to my desk and it’s a scanner that can handle the scanning load of healthcare. You’ll want a high speed scanner like this one for your scanning. Don’t try to lean on an All-in-One scanner-printer-copier. It seems like an inexpensive alternative, but the quality just isn’t the same and after a few months of heavy scanning you’ll have to buy a new All-in-One after you burn it out. Those are just made for one off scanning as opposed to the scanning you have to do in healthcare.

David Harlow also covers an interesting HIPAA angle when it comes to scanners. In many cases, scanners don’t store any PHI on the scanner. However, in some cases they do and so you’ll want to be aware of this so that the PHI stored on the device is cleaned before you dispose of it.

Certainly many organizations are overwhelmed by meaningful use, ICD-10, HIPAA Omnibus, and changing reimbursement. However, things like buying the right scanner make all the difference when it comes to the long term happiness of your users.

Sponsored by Canon U.S.A., Inc.  Canon’s extensive scanner product line enables businesses worldwide to capture, store and distribute information.

Canon imageFORMULA DR-C125 Scanner – Healthcare Gadget Corner

Posted on January 7, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

One of the biggest lessons I’ve learned over my years implementing EMR software and talking with others who implement EMR software is the need to have a heavy duty scanner available. Anyone who is still under the illusion that implementing an EMR will lead them to a “paperless office” is just mistaken.

While you will be able to largely do away with your paper charts, you will still have plenty of paper floating around your office. Much of that paper will come through your printer (EMR software is great at printing records), at your front desk, and brought in by your patients. The best way to deal with this influx of paper in your office is to purchase a heavy duty scanner. You can see that I have added a number of heavy duty scanners on my EMR Technology Products list and after this review you will see why I’m adding the Canon imageFORMULA DR-C125 scanner to that list as well.
DR-C125
I was able to test out the Canon imageFORMULA DR-C125for the last month and I have been quite pleased with its performance. The quality, speed, accuracy, and functionality of the scanner was as good as any of the other scanners I have used or implemented before. Plus, it comes in at about half the price of the relatively comparable Fujitsu fi-6130 scanner and just a touch more expensive than the Ambir imageScan Pro 820i. That makes it a great value for those looking for a high volume scanner for their medical office.

What might be the imageFORMULA DR-C125’s best feature is the ability to switch to the U-turn scanning mode which stacks the scanned pages neatly in an upright tray or to have the scanned pages sent through the bottom of the scanner. The bottom scanning is best used when scanning thicker items like ID cards or credit cards. This simple switch on the side of the scanner is a great feature that can save a lot of desk space since you don’t have to leave room below the scanner for the scanned pages. Plus, the upright U-turn scanning pathway makes it easy for you to grab the scanned pages from the scanner.

Along with standard features such as duplex scanning, auto-duplex recognition, and card scanning the imageFORMULA DR-C125 has a number of features worth noting. It has a really simple one touch scanning button which integrates well with the CaptureOnTouch software. The scanner also supports OCR (Optical Character Recognition) of the scanned documents and supports the TWAIN driver which is supported by most EHR software vendors.

Another really cool feature is the Ultrasonic Double-Feed Detection that comes with the scanner. This ensures that no data is lost in the event that a double-feed occurs during scanning. You can resolve the double-feed as it occurs which will save you time having to re-scan items.

I was quite pleased with the simple usability of the CaptureOnTouch software that’s provided with the scanner. I loved how it simply handled combining multiple scans into one document (if so desired). The scanner also comes with the more advanced PaperPort 11 and OmniPage (which you’ll need for OCR). I’m a big fan of PaperPort software for many situations, but in most healthcare situations you will likely want to integrate your scanner directly to your EHR software and so you won’t likely need the PaperPort functions.

I’d say my only real complaint about the Canon imageFORMULA DR-C125 scanner was that it has a bit of a plasticy feel to its design. I haven’t run into any troubles with the design myself, but those trained in the visual aesthetics of Apple like design will likely be disappointed by its visual appeal. I’m personally a function over form kind of guy in most situations and the DR-C125 function makes up for whatever it lacks in form.

For those who have the environment on your mind, you’ll be happy to know that the imageFORMULA DR-C125 meets the ENERGY STAR® guidelines for energy efficiency.

I’m glad to add the Canon imageFORMULA DR-C125 scanner to my list of EMR Technology products. If there are other questions you have about the scanner, I’d love to get them in the comments and I’ll do my best to answer them.

Full Disclosure: Canon is an advertiser on the site and provided me the scanner to review.

HIM Staff and EHR Implementations

Posted on August 1, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I got into a recent discussion about the role of HIM professionals in an EHR implementation. I thought this was also a timely post since I got a request today to again attend the AHIMA annual conference. I had such a good time at the AHIMA conference last year, that it looks like I’m going to attend AHIMA 2012 in Chicago, but I digress.

In response to the discussion about the HIM professionals role in EHR implementations, I offered the following comment:

I think they’re an essential part of the implementation. The place I see them most used is in how to deal with the old paper charts. The challenge is usually turning them on the idea that they’re useful and valuable even in an EHR world. Many just assume (incorrectly) that their job is gone. It’s not, but it does change.

Just a few places where they will still have to be involved post EHR implementation can include:
-ROI (Release of Information) from the EHR and the old paper charts
-Scanning Loose Paper into EHR (or overseeing that process)
-Quality Checking (similar to paper chart audits)

I’m sure there are more, but those are a few off the top of my head.

Personally, I loved talking with our HIM staff during our EHR implementation. In many ways they were a great “sanity” check for me. They weren’t afraid to point out things that I may not have considered. I did feel bad, because I could tell that the HIM director always felt like HIM wasn’t really listened to during the EHR implementation. I can’t speak for some of the other clinical leadership, but I was always grateful for the role that HIM played in the EHR implementation.

EMR Scanning and Chart Retention – EMR and HIPAA Video Series

Posted on May 27, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

As I mentioned in my previous post, I decided to try out some videos related to EMR, EHR and healthcare IT. I’m still not sure if it’s a good idea or not, but I created 4 videos in my inaugural experience. I just used a simple web cam to create the videos since I was also streaming it live on uStream. Maybe next time I’ll set up my HD camera and do it that way.

Either way, here’s one of the videos I recorded where I respond to the following question:
Once converting paper to digital in an EMR, how long do providers plan to keep their charts?

Full Dislaimer: I’m not a lawyer, so be sure to consult a lawyer for legal advice:-)

If you like the video, be sure to check out one of the other videos I posted on EMR and EHR about EMR Data Sharing.

Let me know what you think of the videos. Should I do more? Should my face not be on video ever again? Are there other questions you’d like me to answer?

Guest Post: Scanning Paper Charts in an EMR Office

Posted on July 6, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

One of EMR and HIPAA readers, John Meewes, was reading some of the comments on my previous post, “Paper Chart Disposal After Implementing an EMR” and wanted to provide a scanning companies perspective on what he’s seeing in the market. The following is his guest blog post on the subject.

Discretionary scanning, hiring temporary help, and re-purposing office
staff to scan patient charts has been a growing trend.

While the costs associated with these practices may at first glance seem
lower, there are hidden costs and liabilities that far outweigh the
expected savings.

When selecting a scanner, the first number potential buyers see is the
“Pages per Minute” (ppm). This is the number of sheets that the scanner
can read under optimum conditions (and usually at lower resolution and
page size). The number usually not published or ignored is the daily
duty cycle – often just several thousand pages per day.

In real world settings, the actual throughput is less than 1/4 of the
published PPM. Jams, indexing, and software glitches all slow the
process. Equipment maintenance, software installation, training, and
employee turnover further add to the time spent on the scanning project.

As labor costs (which are a function of throughput) increase fourfold or
more, the ROI model that may have initially shown cost savings with a
“do it yourself” project may no longer support that decision.

Most importantly, though, is the liability physicians face for
improperly scanned charts. Transient help is cheap, but they have no
responsibility to monitor quality, ensure that records are properly
filed & attached to EMR, or to ensure that misplaced records are found.
We even worked with a physician who had temporary help literally
throwing charts away to create the illusion of higher productivity.

Physicians are required by law to maintain a medical record for each
patient which completely and accurately documents the person’s
evaluation and treatment. The failure to maintain a record for each
patient constitutes professional misconduct. A missing chart could
have serious consequences on the provider’s ability to defend themselves
in a malpractice claim. If you can’t produce the documentation, then
your version of the events will be suspect.

Reputable service bureaus have quality and auditing measures in place to
ensure accurate and complete conversion of paper charts. While the
upfront costs may seem higher, the peace of mind and longer term savings
are worthy of consideration.

John Meewes, President of National Scanning. National Scanning offers secure nationwide HIPAA compliant patient chart scanning services and EMR implementation consultation. www.nationalscanning.com – Patient Chart Scanning Services (888) 211-1797

Paper Chart to EMR Scanning List

Posted on November 13, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve previously written about chart disposal after an EMR implementation and the concept of “thinning your paper chart for scanning into an EMR.” Because of those posts, one reader asked me about feedback on a list of what things should be included in the “thinned” paper chart.

Of course, my first reaction was to tell them to ask the doctors. Each doctor/specialty/clinic is unique and so every one of those would have their own list of what they thought was important. However, I also said I’d post their list on here for people to take a look at and provide feedback on things that shouldn’t be on the list or things that might be missing from this list. So, check out this list and I’d love to hear feedback on it in the comments:

Paper Chart to EMR Scanning List (in no particular order):
Birth records, Nursery, NICU, State Screen, Type/cross.
Growth Charts front and back.
Immunization record (multiples may exist, scan all).
Master Problem List.
Chronic/incidental/PRN medications.
Allergies/sensitivities.
All prior well child checks.
School/Scout/etc PE’s.
All acute visits if chronically ill, otherwise do not include uncomplicated CCD.
All special evaluations (ADHD/Feeding/Nutrition etc done in house).
All referral and specialists’ consults/findings.
Family History if known. Adoption may prohibit this.
City water vs well water.
Lab reports – baselines and all if chronic medical issues.
All diagnostic imaging reports.
Insurance history.
Demographic sheet/all address changes.
All legal documents – custody/state/adoption/POA/living will etc.

A look at this list makes me think about what types of things might be useful when exchanging patient records electronically. Seems like the concept of thinning the chart and exchanging data might be worth considering together.

Best Scanners for High Volume Scanning in a Doctor’s Office

Posted on March 2, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

We now interrupt all this HITECH act EHR stimulus money talk for our regularly scheduled program.

If you are looking at implementing EHR, then you better become familiar with a nice high quality scanner. Don’t believe anyone who tells you that they are paperless. Sure, many don’t store paper, but even the very best EMR or EHR implementation has loads of paper that needs to be scanned.

Still don’t believe me, then how do you plan on handling a new patient who brings in a stack of paper records from their old doctor. I’ll leave the rest of the list of possible paper for another day. Suffice it to say that you’ll NEED a high quality scanner that can handle high volume.

When we first implemented we used a nice little all in one scanner. Worked well, except we literally burnt it out after less than a month of scanning.

After that we finally ponied up the money and bought some high quality, high volume fujitsu scanners. 4 years later we’re still scanning with no end in sight. We do have to do regular cleaning (about 5 minutes max) to clean off all the ink that gets on the feeder. Otherwise, these babies are the best I’ve seen. Here’s links to the 2 models fujitsu currently offers.

Fujitsu fi-6130 Duplex Scanner
Update: The Fujitsu Fi-6130 is no longer available, but here’s the Fujitsu Fi-7160

Fujitsu FI-6230 Clr Duplex 40PPM/30PPM USB
Flat bed and ADF feeder:
Update: The Fujitsu Fi-6230 is no longer available, but here’s the Fujitsu Fi-7260

One has a flat bed for those hard to feed scan items (ie. prescriptions) and the other is just the feeder for the high volume scanning.  Some may think it’s a little expensive for a scanner, but it’s worth it.

I’ll be updating my list of EMR and EHR technology with items like the scanners above. Many people have asked me which scanners are best, which computers are best, what about tablets, fax servers, etc, etc. Now you can just check out my list of software, tablets, computers, fax servers, scanners, printers, etc and see some recommended items to help your office.