Patient Paper Records: The Challenges of Digitization

Once the decision to switch from paper records has been made, practices face the daunting task of digitizing charts, patient correspondence, consulting notes etc. Before starting the conversion process, patient records have to be checked for completeness and accuracy. Once the data has been checked and categorized according to priority or utility, the conversion process can begin.

  

There are primarily 3 digitizing methods which are commonly used when converting paper records to electronic format and each has its own pros and cons.

  

1. Scanning

Scanning is the quickest and easiest method of converting paper charts. Many practices already have scanners in their clinics and employees require no additional training to use them. This method is used most often to convert the bulk of records because of its simplicity. However, images produced through scanning cannot be edited later and hence not suitable for all types of records. It is best used for diagnostic reports, consult notes from an external source such as a specialist or patient correspondence since the practice has no need to make edits and are needed mostly for reference.

  

2. Converting electronic data from legacy/external sources

Certain information may be already available in digital format from an older application or provided by external sources such as reports from a diagnostic lab. It is easy to import this data into your EDR provided the system can handle the format. In some cases, EDR vendors work with practices to provide them with customized programs which can convert and import the data, although this can often be expensive. This process is usually used to import demographic data from practice management systems already in use by the office. Usually a small group of employees are also needed to verify the success of the conversion process with an initial sample.

  

3. Manual data entry

Sometimes data needs to be entered into the system manually either through dictation, typing or selecting entries from a preconfigured list. Even though this process is time-consuming, it tends to be the most accurate since employees are able to identify errors and mistakes at the time of data entry itself. It also serves as hands-on training for the staff and they can get familiar with the interface before the system goes live. This method is best suited for allergy and medication lists, clinical notes etc. where the time taken is justified by the need for accuracy.

  

A well-planned strategy of identifying data and converting them according to the most suitable method will minimize the most common challenges faced in digitization of patient records.

  

  

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