Leslie:
I did not scan any old notes. The first time I saw a patient with AC, I had them fill out a history form, and I Dragon-dictated that, supplemented by a quick audit of their chart. I find that I never look through the progress notes again after that, if I feel that I do a thorough job.
For the rest, I had not decided to scan and shred at the time, though I would now. So, I tried to come up with guidelines that untrained staff could follow and get it right MOST of the time, to save me from MOST of the old chart-pulling.
I told my staff to scan ALL x-rays and EKGs, because they are few, and I didn't want my staff to exclude their only chest x-ray or EKG from two years ago, that I need for comparison today.
Lab is a little tougher. If they only had a few sheets, I would scan it all, no matter how old, because it tells me how long it has been since it was checked, and again it provides some basis for comparison. If it is someone who gets lab checked all the time, I would not want to go back as far, maybe just as far as the last off-beat lab they got, the SPEP or serum gliadin, when I was really reaching for a diagnosis. It is difficult to provide untrained staff with that kind of training or discretion.
A practical limit on lab scanned might be the number of pages which fit comfortably into your scanner without jamming.
