With the publication of the meaningful use guidelines on July 13, it is now clear what hospitals and doctors must demonstrate in their adoption of electronic medical records to grab a share of the billions of dollars available in federal incentives. Not as obvious, however, are the steps to take in negotiating this transition.
More than just the right technology, there must be a plan for preparing paper records and workflow processes for a “new normal,” where doctors will utilize both paper and electronic records to treat patients. The need for this “EMR enablement” work has been mostly lost amid the discussion of what technology milestones hospitals must hit and by when.


Hospitals that correctly complete this preparatory stage will realize three benefits: a more efficient records management program that returns cost savings to apply toward EMR; a better-organized records system that makes EMR implementation easier; and improved workflows for treating patients with hardcopy and digital records. Below are key EMR-enablement steps:


Centralize paper records for better access and lower costs
Today, most hospitals have patient records and films bottled up in specific departments, with no ability to share this information across the entire organization. In many cases, this produces unnecessary duplication of records and inconsistent management processes. Consolidating hardcopy patient records and films and then re-engineering how the organization stores and uses them can save time, cut costs and improve the quality of care through faster access to patient data. These new workflows need to account for how organizations archive, use and protect patient records in paper and electronic form. 
Stop saving – and paying for – outdated and duplicate records

Going digital does not mean digitizing every patient record. A thoughtful approach – what to digitize versus what can remain paper-based or securely destroyed – is required to reduce costs and improve care. A study from the American Health Information Management Association found that more than half of U.S. hospitals keep medical records forever, a behavior driven by the twin forces of industry regulations like HIPPA and state retention laws. Hospitals should comb through their records and destroy duplicates as well as those records past state-mandated retention periods. Destroying these outdated files and redundant copies cuts storage costs and makes digitization more cost-effective.
Begin your EMR journey with the right records

Make no mistake: paper records are not going to disappear any time soon. A portion of the physical patient record will continue to exist and grow at least in the near term. Information technology will certainly change how records are accessed and stored, but paper will continue to coexist with electronic information in a so-called “hybrid” record environment for many years to come. An intelligent approach to digitizing records will control costs and change how documents are shared and protected, improving workflow-based functions like billing, coding, and chart completion. Records can be shared simultaneously by many different departments instead of being handed off piece-by-piece to complete these functions. Scanning only what is needed as it is needed – and not just scanning every record, or even the entire record – ensures that the investment in an EMR is on par with treatment requirements, using patient history and clinical needs as criteria for conversion.

The opportunities of moving to the EMR are great. By addressing the core issues of what (and how) information needs to be stored, accessed and protected, healthcare providers can develop a more efficient pathway to the EMR and, in the process, deliver the patient care and cost savings benefits promised by this transition.

Ken Rubin is senior vice president and general manager, healthcare services at Iron Mountain.