Document Scanning and Conversion in HIM Department – an Overview

Document Scanning and Conversion in HIM Department – an Overview This article examines the process of document scanning and conversion in HIM departments and how to address challenges involved.

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With increasing use of the Internet on the global scene, document scanning and conversion of paperwork in all business sectors became a massive trend. As companies merge or grow they need to decide how to treat their document repositories. Corporations and entrepreneurs are turning paper into electronic format not only to dispose of large volumes of hard copy documentation that is taking up space but also to tremendously enhance their business performance. Conversion of documents into digital format improves speed and efficiency and also enables to perform different tasks using the internet that will allow much higher productivity. However, paper records continue to be a major part of business documentation, and in many business organizations digitization projects are under way.

The Need for Document Imaging Likely to Continue In HIM (Health Information Management) departments, medical records still continue to be partly paper documents. Most US hospitals continue operating in some form of a hybrid medical record environment; part paper and part electronic. Recently, a survey was conducted of over 200 healthcare information technology experts, out of which 172 experts considered it helpful if an electronic health record contained scanned documents and images along with discrete electronic data fields. EHR implementation can be improved if the patient’s earlier paper medical records are scanned and made available along with the electronic system.

When physicians can easily access the scanned patient record, it contributes to increased physician satisfaction and enables valuable time savings. This signifies that the need for document scanning and imaging technology/document conversion as well as the human resources to perform the job is likely to continue within HIM departments for the near future.

What Document Conversion in an HIM Department Involves The process of converting paper documents into digital format begins when the records are received in the HIM department. Typically, the document conversion process occurs in the following sequence.

Receiving

Prepping

Scanning

Indexing

Transferring

Quality Control Process

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The documents received are carefully monitored by the HIM department. They ensure that there is a smooth flow in the processing of the record and also implement quality control at each step of the conversion.

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The HIM department takes note of the time taken for performing each step. This is done in order to accurately measure and manage productivity, cost and staff accountability.

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Using workforce management software that includes a well-organized set of document conversion workflows and strong management reporting functions, HIM managers are ensured the lucidity vital to maintain the pulse of the process.

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The stringent QA procedure provides HIM managers with the information necessary to address and reassign work appropriately and ensure maximum productivity and quality.

Challenges Faced in Document Conversion There are certain typical challenges associated with the document conversion process, mainly with regard to the four areas – Quality, Technology, Cost and Turnaround Time.

Quality •Images of poor quality •Incorrect identification and indexing of document •Erratic entry of patient name, account number, date of service, etc.

•Mixed patient records • All pages are not captured

Technology •Poor performance stemming from poor maintenance •Improper handling of scanners and resultant damage •Wrong type and size of scanner •Malfunction of interface with imaging systems and EHR

Cost •Increase in overall staffing cost •Rising hardware, software and maintenance costs

Turnaround Time •Slow turnaround time transitioning from paper records to images in EHR •Employee turnover •Staff burnout

Effective Performance Measurement Vital in 3 Important Areas Document conversion is all about quality, timeliness and cost. Out of the three areas, quality is the most important one. 

Quality o Quality control checkpoints are necessary at each step of the document conversion process. o In addition to these, a final and more detailed QA process is also necessary.

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o The entire paper record must be compared to each page of the related imaged document. In this stage, there should be the capability of reporting to categorize the errors into types such as high severity or low severity. o It is important that staffs are held responsible for the errors they make, and a corrective action plan must be implemented for any staff member that continues to make the same error. o A good workflow design should also have the feature to allow authorized HIM staff to submit a request for correction/modification to the document conversion area in case it becomes necessary to make a change after the record is transferred to the EHR. The corrections should be made within specific timeframes.

 Turnaround time o Meeting a set turnaround time is an important objective of any HIM manager.

The medical records must be coded and distributed promptly without delay.

This is possible only if they can quickly find out where the document scanning delay is occurring, via availability of reports that point out which unit has been slow in delivering the records, the full chart as well as loose documentation. o The staff concerned must be able to know issues such as accounts that are nearing the imaging turnaround deadline, high priority documents that are missing such as progress notes, physicians’ orders and so on, and high risk accounts (multiple barcode values, mixed accounts and so on). o Ideally, an effective document conversion workflow should include a daily summary of the activity report that would provide HIM managers with necessary information such as total number of accounts received each day, total TAT (time of patient discharge to time when the imaged record is available in the EHR), document conversion centre TAT (time the record is received by the centre to the time when it is available in the EHR), details of QA performed, and error rate percentages on the basis of error type. 

Cost It refers to the cost per page to process, review and release the scanned documents to EHR. For in-house document conversion, this would include the cost involved in recruiting new staffs for the conversion process, and training them. Retaining and

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managing the staff and purchasing hardware and software required for the conversion process are all the components of the overall cost.

Advantages of Document Conversion

Digital files enhance access. information is made available in the form of indexable files.

Digitized Information documen can be shared. ts ensure Files can be more easily searched security and organized of after digitizing. informati on.

Saves valuable Prevents storage space and loss of important eliminates the need records. for file cabinets.

Improved care provision and improved level of patient satisfaction.

Hiring reliable document scanning and conversion services is the best way to ensure accuracy and efficiency in EHR. Expert professionals can complete the project quickly and resourcefully.

Considering EHR implementation in healthcare facilities and physician practices, maintaining onsite storage of archival records will not be cost effective any more. There should be a policy in place to get rid of obsolete medical records, scan the frequently accessed paper records to make them readily available and scan archival paper records as they are requested subsequently.

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