As meaningful use turns 1, printed records prevail

By Molly Merrill
09:45 AM

Wednesday marks the one year anniversary since CMS set the meaningful use criteria for electronic health records. And while that has helped drive adoption, a high percentage of hospitals report they expect to continue to treat patients using paper records for up to five more years.

The findings come from a recent survey from information management company Iron Mountain that asked 200 health information professionals how they’re scanning paper patient records and planning to use them moving forward.

[Q&A: ONC's Mostashari says we need to "improve over print-fax-scan" as EHR exchange method.]

According to the survey, 70 percent of hospitals expect to claim federal subsidies for meeting stage one requirements. Yet 78 percent said they may continue to use paper despite the financial incentive for meeting these requirements and the EHR's inherent promise of a paperless treatment cycle.

The results reveal that hospitals – lacking guidelines from CMS for scanning paper patient files – are taking different approaches to digitizing records, with scanning budgets sometimes exceeding $100 million. Key findings of the survey include:

  • Only half (49 percent) of hospitals say they’ve scanned what they need and are within their budget, while 23 percent report they’re within budget but still have a backlog of records to scan;
  • More than half (54 percent) are scanning records at onsite records rooms, while nearly one third (29 percent) use a centralized scanning location;
  • Seventy-two percent rely on full-time employees to scan compared to just nine percent who outsource to third parties and six percent who use part-time staff;
  • Forty-four percent of hospitals are not explicitly measuring the effectiveness or productivity of their scanning process;
  • Once scanning is complete, 58 percent will shred their paper records, while 38 percent plan to store the paper in their onsite records room or in an offsite facility.

“The meaningful use guidelines set the clock ticking for hospitals to claim their share of the billions set aside for successful EMR transition,” said Ken Rubin, senior vice president and general manager for healthcare at Iron Mountain. “Reaching those incentives involves changing the way paper records are used and accessed by hospitals, a process that leaves most hospitals in a prolonged period of using ‘hybrid’ records' – both paper and electronic. Accelerating through this hybrid period by effectively converting paper records is essential to greater utilization of an EMR to drive down costs and improve patient care.

[See also: EMR implementation requires right planning.]

"But without a formalized and efficient process for scanning records, many hospitals will struggle in this hybrid period to manage their records scanning process and drive physician utilization of a fully-electronic EMR system, Rubin said. "This research highlights that struggle, but also gives hospitals some ideas as to where they can look within their own processes and policies for opportunities to become more efficient and cost-effective.”

The survey findings suggest three areas for saving time and money during the EMR transition process – better preparation, scanning the right records, and improved resource utilization:

  • Better Preparation. More than one quarter of hospitals (28 percent) reported to scanning all patient records. Before scanning, hospitals should centralize their records so they can reclaim storage space spread across their organization and organize files to identify both duplicates and those past their state-mandated retention period. Destroying duplicate and outdated records saves hospitals from scanning the wrong records.
  • Scanning the Right Records. Records managers can ease the EMR transition by prioritizing which records caregivers need first and most often for scanning. Many hospitals (35 percent) are prioritizing the records of recently discharged patients. Others are adopting “day forward” method of scanning, digitizing paper records as they are created for patients.
  • Better Resource Utilization. Misuse of personnel can be the biggest drain on a scanning budget – costing both time and money – yet only nine percent of hospitals are outsourcing scanning to a third party. Hospitals who outsource their scanning free their teams to focus on patient care and often lower their cost per scan by increasing their output.

Conducted between April 7-18, 2011, the Scanning Services Survey polled 201 health information professionals involved in and/or responsible for scanning patient records and transitioning their organization to an EMR. Respondents were from hospitals of all sizes, including hospitals that are part of a larger healthcare system.

With the anniversary of Meaningful Use on Wednesday, July 13, Iron Mountain asked more than 200 hospital information professionals about their paper patient record scanning process and their transition to an electronic medical record system. (Graphic: Business Wire)