Execs at 658-bed Abington Memorial Hospital (PA) had had enough. Paper charting was filling up too much space, and keeping up with the information was burning through too much staff time. In response, the hospital developed an electronic document imaging system. Getting started involved a big investment of time and energy, including training on handling and preparing records for scanning for 750 clinical information staffer and caregivers. Within three months, the system was in place. The process included scanning documents within 24 hours of a patient's discharge, or within 24 hours of a patient's seventh day of stay. Staffers were then trained to access and use the scanned records electronically, a step which physicians say was very helpful in getting background information they otherwise didn't have time to order. The solution also included an "e-signature" option, which allowed doctors to complete and sign reports remotely, at times in response to alerts that a report or dictation was incomplete. The upgrade also involved using COLD (Computer Output to Laser Disk) feed interfaces, which allowed the hospital to archive older documents, saving almost $550,000 in the first year along on personnel and scanning costs. While this kind of chart manipulation is far from achieving the dream of a fully-digital EMR, it sounds like a step in the right direction, philosophically at least.
For the details on how the project worked:
- read this article from ADVANCE for Health Information Executives