SHRED: Pick Up

Well, the day has come; for us to analyze how far we are in completing the project. We have handed over 350 regular size boxes filled with patient health information to shredding company. They seems to know what they are handling. They didn't leave a single paper behind and are decent while handling the boxes, wrapping them up in cellophane. 

I hope we are half way through in completing the project. So here is the estimate of work in terms of number of boxes:

Boxes Shred: 350 (~11,238 pounds)

     Patient Record(PR: 1992-1999) Boxes scanned: 129

    Patient Record(PR:  earlier to 1991) NOT scanned: 50

     EOB boxes scanned: 69

    EOB boxes NOT scanned: 52

Boxes yet to scan ~ 270(prepped)+150(unprepped)                               

Active Charts - Laborious Task

We have started prepping and scanning Active charts (OBGYN patients whose charts are active with visits). In order to integrate the scanned files in to EMR system, as briefed before in the blog; we are scanning a single patient record in to three files, Clinical Notes, Labs & Imaging and Miscellaneous. When you click on a folder of a patient you will be seeing three files with the above mention naming convention. As per the implementation plan, all the three files will be separately shown under respective titles when you open a patient account on EMR template. 

To show how laborious the scanning process is when it comes to EMR compatibilities, the following is an example:

For prepping and scanning a patient record for EMR compatibility, our efficient team is taking 7 minutes in total to get it done. When compared to Old record scanning which are not meant to be on EMR network, its a whole +3min extra time.

In other words, as the detail of indexing increases, so does the time. It is essential for the physicians and the clinic staff to come up with logical solution about details of indexing. As the indexing details increase, the time and costs associated are meant to raise.

EMR: TIME and its Essence

The following information (Old Patient Record scanning) provided represents personnel doing the work full time.

* Average time taken to prepare chart:   2.0 min

   (Include: Chart profiling, removing staples and folder clips)

* Average time taken to scan a patient chart (B&W):  2.0 min

   (Include: Scanning and file saving)

* Average number of patient charts prepared for scanning/day: 825

   (Include: 4 team members working approx 8hrs/day)

* Average number of prepped charts scanned/day: 660

   (Include: 2 personnel working 10hrs/day)

Observations and Foresight

Some of the interesting observations we have made during the process:

* Never use a GREEN highlighter in your clinic. Scanners might not be able

   to scan the green highlighted notes in B&W mode. Go crazy over 

   Florescent yellow, Orange and Blue.

* 70% of time taken for chart preparation is spent for removing staples. 

   Try to avoid large staples. You dont want to hear about the pain in

   removing them. Try using rubber bands, clips, binders. Most of them

   are reusable and doesn't leave any damage on papers.

The Limitations

With different resolution settings that are available in our sophisticated scanners, we are limited with the extent of advanced settings that we can use. Most of these are determined by the scanning speed, which is reduced to a significant level when you opt for color scan setting (When you are opting for a high speed color scanner ask the company about the speed of scanner in color mode, most often they say 90pages/ min which is for B&W setting only). When you know about these intricacies, no one would have bought a color scanner first of all for speed scanning. When I called the CANON support about this issue, they have blamed our 4GB, 2GHz desk top that we are using. Come on..

The second limit is when you start integrating your scanned patient health records to EMR software. Most of the EMR software networks are limited by the storage capacity they provide. Since the color settings take almost 3 times the space compared to similar DPI and B&W settings, why do you want to cramp your EMR system anyway.