With the advent of electronic medical records came a whole slew of promises, hopes and dreams…
“Purchase an EMR and go paperless!”
“Less HIM staff time scanning and fixing paper records!”
But the reality is that healthcare will never go totally paperless. Yes, I said it, and I’ll say it again – the healthcare industry will never go paperless! There are a number of reasons why.
Information systems are built by humans. Humans introduce flaws. As a result, there will inevitably be times when an EMR must be taken offline, whether it is for an emergency fix or a planned upgrade. During these downtimes, a hospital must resort to using paper documentation in order to minimize any impact on operations and patient safety. This might include ordering medications or obtaining signatures on regulatory documents.
Speaking of which, unless your organization has implemented the capture of signatures electronically, chances are your patients still sign hard copies of documents like consents and privacy agreements. These paper documents are still considered part of the legal medical record, even if the rest of the record is electronic.
One of the problems with EMRs is that not every healthcare organization is using them. Many smaller, standalone practices simply cannot afford the large implementation and maintenance costs of an EMR. As such, these practices still document and communicate using paper.
And then there are those departments within healthcare organizations whose practices are simply not supported by the enterprise EMR. Behavioral health is one department that comes to mind. While the rest of the organization may utilize an EMR, some behavioral health departments are still documenting and communicating on paper.
But just because an organization will still rely on paper after the implementation of an EMR doesn’t mean that EMRs are not beneficial. I’ve seen numerous efficiencies that were gained as a result of implementing an EMR. These gains translated directly into cost savings. And of course, there is the patient safety aspect of EMRs – they are a wonderful tool for double checking one’s “work.”
One important thing to do when planning an EMR roll out is to remain realistic and future minded. This means planning for the continued use of paper in some areas. The success of an EMR roll out is directly correlated to the amount of planning conducted. Planning for the continued use of paper should involve the following:
• Identification of workflows that still use paper – Identify those areas that will continue to document and /or communicate on paper in the future. Document these processes and communicate them to the end users.
• Training – In addition to training end users on use of the EMR, it’s important to train users on what to do with paper documentation that comes into the organization.
• Policies and Procedures for paper document handling – In addition to training end users on the paper process flows, it’s more important than ever to identify polices and procedures regarding paper. Clinical documentation that comes in is part of the LMR and must be handled with the same amount of security as the electronic documentation. Additionally, there must be formal procedures in place that ensure the paper documentation is available when needed.
• Integration of paper documentation into the EMR – Many healthcare organizations purchase an electronic content/document management system along with their EMR. These systems offer many benefits, including easy retrieval and high availability of scanned paper documentation. For even more seamless workflows, most of these systems can be integrated into the EMR via HL7 messaging.
So I’ll say it a third time – paper is here to stay in our healthcare environment! However, with the proper planning, you can ensure that you’ll have less paper along with seamless workflows to handle the paper that does come in. You’ll also have a scalable solution that will allow you to optimize, with a clear path to further reduce your dependence on paper in the future.
