On Wed, 2004-10-06 at 02:16, will ross wrote: > We're agreed on the ultimate goal of capturing the data as standardised > fields rather than rasters of handwriting. However, I know of one local > clinic where the latter is a milestone en route to the former. > Combining transcription saved as text files with scanned lab reports > and other handwritten documents, they now have a complete offsite > backup of their entire paper charts, including patient signatures > captured on HIPAA forms in pdf. Is it searchable like an EHR? No. Is > the electronic chart primary? No, the paper chart remains primary. But > perhaps more importantly, they have internalised in their clinical > documentation workflow a key interim step towards a future dependency > upon electronic data storage and retrieval. They are now fluent in > backup archives, and this is before thinking about EHR. When they > finally jump to EHR in a few years, they will have an easy walk to the > next milestone compared to their sister clinics which don't currently > scan documents, are still all paper and have limited experience with > data backups.
Yes. Many general practices here in Australia which operate EMRs are forced to scan correspondence and reports, particularly letters from specialists, and then store the scans in an electronic archive, usually linked to the main EMR by a unique patient ID number and/or name (and store the original paper copies in a filing cabinet or other physical archive, which is rarely consulted). Everyone agrees that retreival of scanned documents is much more efficient, but there is much debate about the best way of doing the scanning, linking and archiving in the least disruptive manner possible. Everyone looks forward to a time when all reports are received in encrypted electronic form - if not as HL7 messages, then at least as word processor or PDF documents. Alas, the uptake of a national PKI for health has been slow, but there is at least an excellent open source, fully-supported, HL7-aware, secure communications gateway system available to practices - see http://www.argusconnect.com.au/ The majority of path labs now offer results in electronic form, as do some radiology and imaging services. Government sponsorship of broadband (well, 256k ADSL connections at least) for general practices will mean that more practices will be interested in receiving everything in electronic form. Still a way to go, and scanning in paper reports will still be an unavoidable nuisance for the next 3 to 5 years, it seems. -- Tim C PGP/GnuPG Key 1024D/EAF993D0 available from keyservers everywhere or at http://members.optushome.com.au/tchur/pubkey.asc Key fingerprint = 8C22 BF76 33BA B3B5 1D5B EB37 7891 46A9 EAF9 93D0
