Frontlines of Document Scanning: Insider Describes Duties, Complexities of Helping Medical Practice Go Paperless

March 16th, 2010

Guest post provided by Keli S., a Scanner Operator with OptiScan.

I am a scanner, and I really enjoy my job. Now don’t get me wrong – there are parts of it that can be tedious and boring – but I’ve never had a job or even a hobby for that matter that wasn’t tedious and boring at some point.

Lately, I have been scanning charts for a cardiology practice, and I thought I’d share some of my thoughts with you. This is a rather large practice. It has several locations in Tucson, a few satellite offices in the surrounding areas and an office in Nogales. We are scanning all of the charts into NextGen EMR. Sounds like a royal mess doesn’t it?

Not so much. Here’s how we make it look easy:

Advanced Preparation is Key for Scanning Medical Charts

Normally, doctor appointments are made in advance (barring emergencies). So before we start scanning, the medical staff pulls all the charts needed for a week’s worth of appointments.

This makes the scanning process much easier, as any charts that aren’t scheduled remain on the shelves. The medical records department pulls those charts in alphabetical order, sticks 20 or so in a box, and then sends them to the preparation staff. The prep staff will pull the requested information from the charts and place the now loose papers (with their NextGen generated cover sheets and tab sheets) back into the box with the empty folders and give them to me. We call this a batch.

Each batch is numbered, and kept in alphabetical order. Since this practice has multiple locations, we can’t simply use a straight numeric format. The first letter of each office’s name is used with a three number string. For example, the Northwest office was N001 and up. (It actually had over 500 batches… now that I think of it… all of the locations I’ve scanned thus far have had more than 500 batches.)

Inside the Chart Scanning Process

Once I have the batch, I go through the massive pile of papers to double check for bent corners, staples, Post-It notes and half sheets of paper – all of which will cause imperfect images. The preparation staff look for and fix the aforementioned issues too, but I like to double check. Afterward, I break the massive pile of papers (often ranging from 600 to 1,800 individual sheets) into a pile the scanning machine can handle.

I am currently using an industrial Panasonic scanner that can accept a pile of some 300 pages in the tray.. Once I’ve reviewed all the batches, I can generally scan a batch in 20 minutes. An average-size batch is about 1,200 to 1,300 pages with approximately 18 to 22 charts in it. In most cases, charts are returned to the shelves within a day or two.

All and all, a simple and relatively painless process right? Oh wait, I said “barring emergency” appointments.

Expecting the Unexpected: Chart Availability
During Emergency Appointments

Unfortunately, we can’t all plan our doctor appointments with two weeks notice. So what happens if there is an emergency? What do you do when a needed chart is mixed up in the scanning process? You ask for it. When will I get the chart?

That depends on two things:
1) when you need the chart and 2) where the chart is in the scanning process.

If the answer to “when do you need it” is now, then no matter where in the process it is, we will find it and get it back to you. If the answer is in 20 minutes, then the chart will be found – and no matter what stage it is at – it will be hurried through the process.

What if I can’t find a chart and I think I gave it to you for scanning… but I don’t know when or even if I gave it to you? If we can’t find it in one of the batches, then we obtain enter the medical records number into the internal web application called the OptiScan Chart Finder. This OptiScan application allows us to search the database of all scanned charts.. It will tell us if the chart has been scanned and what batch it’s located in (and now you know why we number them).

The batch number allows us to search for a specific box, and tells us when that box was scanned. We keep a number of records to let us know when and who did a specific batch. The preparation staff keeps a spreadsheet listing of who prepped a batch number and who put back that batch number.

I keep like to keep a separate spreadsheet in which I record what day a batch is given to me, who prepped it, who scanned it, when it was scanned, how many charts were scanned and how many pages was in each batch.

I hope this give you a little more insight into chart scanning process. I encourage you to learn more:
Scanning Options for Patient Charts
Producing Quality Scanned Images
Medical Chart Processing Appliance

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