David,
That is actually a very good question. My rule of thumb is to scan everything that I want at my fingertips and which I would like to be able to print and send to consultants or when the patient transfers. That would be pretty much what I consider CLINICAL stuff and what you mentioned: lab reports, x-rays, consult reports, H & Ps, ED reports, etc. We do shred all those things, but I do worry less because all of these things can be produced again from the hospital online.
I don't think we will ever go paperless. We sometimes (as you do as well) receive records for patients who transfer in that are more than 500 pages. We simply put this in a patient chart and add the insurance stuff and all the other stuff in the paperchart as well.
All of our hospital H & Ps and ED reports get emailed to us so it is easy to put them right the chart. We used to print out all of the progress notes when we made them, but now we feel confident just relying on digital.
I read somewhere once that if you walked in the office of a company like Logician who tells you to go completely paperless, they most likely have paper files everywhere, too.
