Home Forums Discussions General Discussion What DON'T you scan??

Hi, I am working on hooking up a fujitsu 5120c scanner to our system but I am overwhelmed at how much paper actually crosses our desks each day. I know that lab, xray, consults, etc need to go in to the chart but we get inundated with insurance forms, home health forms, etc. Do you all scan that also? If not what do you actually do with the paper? And once you scan something, do you shred the original? I would apprecite it if someone who is acutally doing a lot of scanning, would put their routine (who scans, where is the actually scanned document sent to,what type of file isused to save to)up for discussion. thanks much. I really learn a lot from this support page.
Dave Stroh

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.

My office is completely paperless.
Here is what I scan: EKG, lab, spirometry, Xray/CT reports, consult notes, insurance cards.
Here is what I shred without scanning: ER records, hospital records (except D/C summary), home health and nursing home communication, faxes from pharmacy for prescription refills, applications for wheel chairs, O2 or diabetic supplies, PT records
Previous records - I go through them and select those I would want to keep and scan them, and throw away the rest. From what I learn on HIPPA seminars, I am only obligated to keep and release upon request those records generated by myself. I don't have to keep or release records received from patients' previous physicians.

Funny because I just went to a 4 lawyer, Nancy's IPA/PO sponsered seminar on a number of topics. One of the covered issues was this "re-transmission" thing. It was this "brain-trust's" opinion that we should save and retain, and forward when records are requested and that should include other "old" docs stuff that had been forwarded, copies, sent to us. Nancy is an FP and so some of the charts we get from older or sicker patients can be pretty big. Now one can always "assist" the patients in being picky about what they really need or don't need when they make such a request to keep the printing and copying down.

I usually send previous records upon request, but I always add a note, "These are incomplete medical records from the period from *** to ***. Complete medical records for this period can be requested directly from ***".

Hi everyone. While it is true that providers are not obligated to send records which were not generated at his or her office (I wasn't aware you didn't have to keep them), you also can send them. Personally, and especially since we can charge quite a bit (more than I think we should be able to -- 10.00 first page and .37 cents a pager thereafter, I think) I think we owe it to our patients to at least send the complete medical record especially when they transfer. Or offer to send it as has been noted.

I used to feel the other way, until I recently left my old practice and opened my own practice. Over 1,000 patients transferred in one month. At first my old practice was refusing to send the entire chart. This, of course, caused quite an uproar. But, I just don't see how a special needs or chronically ill patient who has see 10 consultants and been hospitalized 20 times should be expected to track down all those records.

Of course, as everyone knows since we are talking about scanning, in the year 2007 everything should be digitalized anyway and done over the net. The copying and faxing is a bit archaic. : )

Our office is in the process of going completely paperless for all new records. I would like to add a scanner to the front desk so they could directly scan in new pt. registration forms, history forms, insurance cards, HIPAA forms, etc. - currently we make this and attach it to the first superbill. Currently 2 people in our small office scan everything in and then basically shred almost everything we get - I am getting ready to fully quit making new charts -- simply put them with the superbill and then scan/shred. It was getting overwhelming how much paper comes through our office. I have been in practice 5 years and the charts in my office take up more space then the previous doctor in practice in that building had used (he was there 15 years).

Currently we get labs printed to paper and I review them, make notes and generate a preprinted form which I put in the results for them and any followup instructions - this is scanned in with the labs (last page of that lab) and then mailed to the patient (although costly - easier than trying over and over to call patients with results), x-rays the same way. Notes, forms, records from consultants are all handled the same way.

We currently use a fujitsu scanner (only drawback is that it is not TWAIN compatible) - 2 people know how (plus me - I do sometimes also on weekends when am working). Easy to scan, but takes some computer savvy to learn. I set everything on highest compression, black and white (except when I get retinal pictures or colonoscopy pictures etc - thinking about not keeping these since I did not generate them and they can be obtained elsewhere). My wife who works in my office does a lot of the scanning and says that it goes very fast - she likes the fact that we are not keeping so many files.

I am considering scanning old records and then getting rid of the old charts, but that would take a lot of scanning and I am not sure how much Amazing Charts could store and not be overwhelmed. I would also be more likely to do this if there was a way to transfer records by CD/DVD/Thumb Drive when pt. want to go to another office or move. I have suggested this using the suggest improvements button and hope that this would be something other users would suggest also. Wouldn't it be great if you had 5 years of records and wanted to transfer them all on a CD/DVD to another doctor or to someone else if you wanted another entity to become the record custodian ????