Scanning and Document Management in an EHR

As practices migrate from paper records to EHRs, there are millions of paper charts that need to be partially or completely digitized and archived or incorporated into EHRs. What are the principles and guidelines that practices should follow in terms of scanning and archiving paper records?

The advantage of the EHR is that once a practice has fully transitioned, there is limited need to access paper charts that can then be moved off site, freeing up expensive storage space. However records may need to be retained for legal purposes or based upon organizational/practice policies.

Some key questions come up regarding document scanning and retention.

  1. What is the best format in which to scan a document for inclusion in an EHR?
  2. Is there a required minimum resolution?
  3. What are the most commonly used formats?
  4. Is the size of the document (in Megabytes) an issue?
  5. Are there any existing legal requirements or precedents governing these guidelines?

As a basic principle, a scanned record needs to be non-editable. In other words, once it has been scanned, it must not be possible to modify the record or document in any way. In addition, the document must be readable. This is where the question of resolution comes in. The higher the resolution of the scan, the larger the file. So there is a trade-off between document size and resolution, but is there a minimum that is acceptable?

Adobe acrobat (.pdf) and Tagged Image Formet (.TIF) seem to be the most common formats that are easily readable. Are there other formats that physicians or EHR systems are using?

Share your experiences by clicking on the “Comments” link below.

This post is the personal opinion of the author and does not necessarily reflect the official policy or position of the American College of Physicians (ACP). ACP does not endorse a specific EHR brand or product and ACP makes no representations, warranties, or assurances as to the accuracy or completeness of the information provided herein.

Comments:

One response to "Scanning and Document Management in an EHR"
  • February 13, 2015
    Christopher Zybert
    said:

    In addition to these key questions, it is important to detail how these files are currently being stored and accessed so that any conversion project can be replicated to fit your process needs. Tagging/labeling your records with metadata will enable better searching, analytics, and overall process improvement. An unorganized electronic filing system can be just as bad, if not worse than managing physical paper.

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