<p>I am curious as to whether you used office staff or an outside service to scan your extant paper documents. If you did use an outside service, how much did it cost and how long did it take for the scanning alone? Also, approximately how many charts did you have to be scanned?</p>
<p>My wife’s office assigned a staff person to scan. Don’t know how many charts but it’s a 4 doctor surgery practice that has been around decades. The oldest Doc still wants the paper charts.</p>
<p>Not at all an answer to your question, but a couple of negative points I’ve read/observed about electronic record-keeping. A policy paper by the Syracuse University Maxwell School recently noted an increase in mortality related to electronic record keeping, thought to result from less face-to-face communication between physicians and nurses. I think we’d all agree that face-to-face communication when you’re taking care of really sick people should not be minimized.</p>
<p>My husband’s practice, also of 4 MDs, switched to an electronic record keeping system last year when it was shown to be a possible way for the practice to save money. They deeply regret it now because it’s a huge sucking time hole for them; the technology is lousy and often just stops working. Before electronic record keeping, my dh had a day out of the office once a week; now he’s in 7 days a week to stay current. :(</p>
<p>Like frazzled1’s husband, my husband HATES EMR!! What use to take my husband 1 1/2 minutes to dictate notes not takes over 10 minutes to click through the different tabs. This adds hours a day just to take care of his regular record keeping, which translate into a longer wait for his patients. It also doesn’t help that his group’s owner purchased the cheapest and oldest EMR; according to our daughter, they have the first generation of a program that now is in it’s 10th version!!</p>
<p>Just yesterday my husband was trying to finish up his day when their internet when out; he then couldn’t finish his charts. He ended up leaving them for today which means he will never get home tonight!</p>
<p>we are making a decision not to do it…of course that means our reimbursement will be reduced BUT as my husband is 67 the outlay and then the computer support per quarter, upgrades in computers etc…it will be cheaper for us. …</p>
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<p>The reduction in reimbursement will not begin for several years, 2017 I believe. What you will miss out on are the incentive payments between now and then. It is a shame that your husband is using a system that takes him more time rather than saving time. The systems where you can use voice dictation to create a note rather than clicking through screen after screen are actually time savers.</p>
<p>Speaking as a patient and someone who has worked in transcription & medical records management for a hospital, I LOVE the EMR. As a patient, I can see much of my record online, and can graph things like test results over time to see the changes. When I am in the ER or at a clinic based in the hospital, my record is there (lots of times it wasn’t in the past, as the paper flow/tracking just wasn’t that good).</p>
<p>It is a godsend for the back office of a hospital, where the flow of handling the paper chart for coding and billing is a nightmare; with the electronic record, multiple departments can access the record at once. No more charts hidden above the ceiling tiles by frazzled residents who didn’t have time to do their paperwork, or found in the trunks of their cars at the end of their residency. And someone had to type up that “voice dictation” in the transcription department – I can’t feel too sorry that this data is entered into the system instead in many cases now. It also provides a great basis for studies, since less data is in the notes and more is in specific fields that can be mined electronically.</p>
<p>I can see how the individual small practice might find it to be a hassle, but for large clinics and hospitals, it is great from my vantage point.</p>
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<p>Couldn’t he keep dictating his notes and just have whoever used to type them out onto paper type and click them into the EMR instead?</p>
<p>Speaking as a patient, I dislike it. Speaking as a fan of technology, I can see its advantages, esp. for transferal of records, patient access to them, etc. However, my personal experience has been negative. I have seen the same PA for more than 15 years. She and I became friends, had common interests, and she knew and had seen at one time or another H & both sons. The last 5-6 times I’ve visited, she hardly once looked at me. She was busy answering all the questions on the screen. Instead, of just asking me “Has anything changed since you were last here?” Each individual question had to be answered. There was very little of the usual interaction that might have allowed her to observe if something were bothering me, if I looked “different” etc. None of those things were applicable, but if they were, she wouldn’t have seen.</p>
<p>I’ve used EMR’s for at least a decade, and while they are great for “database” stuff (how manyy patients with X diagnosis get Y tx), it totally dilutes the “story”. A real problem the way I practice. I remember favorite transcribers anticipating, and then losing their jobs.</p>
<p>Oh well. I use it sometimes, sometimes not. Small practice.I entered data, but did not scan records.Backed up the practice management stuff, but not the EMR. Then computer crashed. Ouch.</p>
<p>Husband’s group uses one and it’s literally our new bed partner. </p>
<p>I asked sons pediatrician for a copy of a 13 year old consultation, and it was in the paper record, but not the EMR. </p>
<p>Less “errors”, but what’s to become of us?</p>
<p>The docs I’ve spoken with mostly HATE EMRs to varying degrees. One of the biggest problems is that the different EMRs are incompatible with one another. The docs are being FORCED to do it and many of the systems work poorly, which has already been posted. As a patient, I am uncomfortable due to many potential security breaches, as are already occurring with finances.</p>
<p>I have read that many docs do copy/paste because the forms are so danged long and require so many things to be entered that they have LESS time to interact with the patient and are looking at the computer screen instead of the patient. </p>
<p>Sometimes the copy/paste is so much that they copy descriptions of ANOTHER patient (e.g. wrong age, sex & other items, so you can’t tell what is really supposed to be in the record & what isn’t).</p>
<p>The theory of EMRs is good but the PRACTICE is quite painful & messy, from all I’ve heard to date.</p>
<p>Hire college students. My son did that in 2 doctors offices with other students the last 2 summers. Most of them are pre-meds.</p>
<p>good point davh01. When offices first start with their EMR they do have a lot of scanning to do to get online. Some offices use interns who are studying health management (not the medical ones) from colleges to help with the job. </p>
<p>HImom,the HITECH act is in place to help ensure that the systems are compatible. Hopefully anyone who is getting a system these days will be getting one that is certified and will be compatible with other systems. Of course if they don’t choose a certified system they won’t get their incentive money so that may be more of a motivation :-)</p>
<p>While there are plenty of certified systems, they are only compatible if you pay to have bridges made. In real life, they are NOT compatible. Basically you get info from another system via a fax server, and you have to manually load the digital file in. Labs do not go into labs, Xrays do not go into Xrays from a “compatible” system unless you pay big bucks to have a bridge program made. And if you make it too easy to load them in, they will not be “seen” or reviewed. That is a big problem.</p>
<p>And the stimulus money is a joke. The software is so jacked up in price, that the stimulus money will pay for new hardware and servers, with nothing left for software. Or, you use it up for hardware, and you pay $800 a month per provider (some give no discounts to part-time providers or for nurse practitioners/PAs) for a web-based system. Small practices are loosing money and often cannot afford to pay for something that uses way more provider time, and cuts down on bedside manner. For a large organization like a hospital or a large clinic, you can save money and be more efficient. For small and solo practices, it is a hardship, AND it is taking away from the physician patient interaction during visits. </p>
<p>And I can guarantee you that there will be abnormal results that get lost in the database.</p>
<p>Overlooking the general hate of EMRs, how long does it take to scan, say, 2000 charts.
And specifically, @davh01, do you know how much students did charge for this?</p>
<p>My D is doing this sort of work at a huge HMO. She is a senior in HS and a volunteer. Depending on your location, I suspect you could find competent HS students to do this in exchange for the opportunity to add “100+ hours volunteer service in local medical practice” on their college apps.</p>
<p>re the incentives… why not just pay us fairly instead of threatening the cut every year and continually adding to the potential cut (ie now at about 30%) instead of offering incentives to add a technology alot of us dont want and that will cost the doctor much more in the long run.</p>
<p>I am a solo practitioner with one nurse practitioner. We are not scanning old charts. It makes less sense and we can’t afford it. We know our patients. I have patients that I have seen for 25+ years. We will scan op notes and a few other things and a key SUMMARY PAGE. We will pull charts for the first year or two to have in the room for reference. A large practice will need to scan. A small one will not. </p>
<p>Sorry for diverging, but I don’t know how much it will cost. I have about 4000-5000 active charts. General estimates are between 4 and 12 cents a page. There is the low tech person who does the scanning, but you need a knowledgeable office staff member to move the pages to the appropriate place in the new EHR… </p>
<p><a href=“http://www.medicalpracticetrends.com/2010/07/27/scanning-paper-to-emr[/url]”>http://www.medicalpracticetrends.com/2010/07/27/scanning-paper-to-emr</a></p>
<p>Great. Just what I want–a high school volunteer looking at my medical record. </p>
<p>I have worked with sensitive confidential medical records. The possibilities for breach are pretty sobering even with manual systems. When they’re all digitized, the possibilities for breach become sad and likely. Yes, there are some advantages, but we are giving up a lot.</p>
<p>If I had a truly confidential problem, I would pay cash and use an alias, if possible.</p>
<p>Thank you sunnyflorida for that cost per page estimate, that’s what I’ve been trying to figure out since starting this thread.</p>