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Scanning Paper Charts

A number of practices have gone about scanning all of their paper charts. Some practices scan them into their EMR or EHR. Many others scan them into a third party database where they can access the charts electronically, but not directly in the EMR. As can be expected, this is a very costly, time consuming and problematic process. Many practices have delayed implementation of an EMR or EHR in order to scan all of the paper charts. Most people would suggest against scanning all of your paper charts in favor of one of the solutions below.

Medical Abstractor Mass Scanning

Scanning the entire paper chart is wasteful since much of the old chart isn't needed. However, there are some items that are useful to have in an EMR or EHR from the outset such as: old EKGs (for comparison to future ones), old mammography reports, or colon cancer screening reports (or any other HEDIS data point that can be the basis of good medical practice as well as Pay For Performance reporting). Some practices have hired a medical abstractor clerical person to go through all the old charts and pull out the selectively-desired items for mass scanning. The biggest challenge to this approach is that it can be very daunting and expensive.

Thinning and "Retiring" Paper Charts

The idea of thinning the paper charts is to pull the paper chart when seeing the patient (just like always), and use it alongside the EMR. Then the desired "old" pages can be pulled from the paper chart as-you-go, set aside for scanning and importing into the EMR, and then the paper chart can be retired to off-site storage. Over time, the number of patient visits for which there is still an "un-retired" paper chart diminishes.