The number of clinics and hospitals implementing EHR programs in order to participate in the meaningful use program as well as other federal initiatives is rapidly increasing. But physicians are finding that other projects need to be completed before EHR implementation can even begin.
An EHR can only be successful if it has enough data to work with and that data must be in digital format. So before you can implement EHR software, you need to ensure that paper records have been converted to the corresponding digital format. The process of digitization itself is a challenging task and before the actual work can begin, physicians need to evaluate the current state of record keeping.
At the outset, every practice needs to consider the amount and priority of data they need to convert. For example, some patients may have years worth of medical history on paper which will take more time to convert than newer patients with shorter records. A smaller subset of such patients may not have returned to the clinic in well over a decade and these records may be given less priority.
Similarly, managers have to decide if the digitization process will start with older or newer files. Whether a practice starts digitizing the latest records and moves backwards or vice versa, it is important to set a cutoff date for the transition to software. From that point on, medical records for new patients or encounters should be created digitally rather than on paper.
Another important aspect to consider is whether the complete chart will be digitized or only the relevant portions. Both approaches have their pros and cons and doctors will have to decide if the effort and expense of conversion is worth it for all patients. Provided the clinic has the resources to digitize the complete record, this option may be preferred since converting only part of the chart means that both the digital and paper records have to be maintained simultaneously.
Depending on the type of data (charts, notes, x-rays etc.) digitization may involve both automatic and manual processes. When humans are involved, it is imperative that the staff have knowledge of medical terminology and be able to decipher handwritten notes. Additionally, some medical data cannot be handled by outsiders under federal law and such sensitive work should be undertaken by in-house employees only.
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