Scanning, Resolution, Format and Document Management
Posted Oct 30 2008 3:21pm
The importance of clear guidelines and principles for scanning documents continues to grow in importance as more physicians and practices move to EMR. There are currently millions of paper patient records that exist either in back room storage or in secure facilities for practices that have made the transition to EMR. While the go-forward approach (enter key data and critical doccuments into an EMR) works for a new EMR implementation, this still does not resolve the issue of the volumes of paper records that must somehow be stored according to College guidelines for the retention and storage of records. For example in British Columbia, medical records must be stored for a minimum of 7 years plus the age of majority. In some cases, this could be as long as 25 years (for a newborn infant).
The advantage of the EMR is that once a practice has fully transitioned, there is limited to need to access the paper records which can then be moved off site, freeing up expensive office space. However records may not be destroyed and still require storage. It is my understanding that if a full electronic version of the record exists and can be reproduced accurately and in its entirety, then a paper copy is no longer required.
Some key questions keep coming up on CanadianEMR.
What is the best format in which to scan a document for inclusion in an EMR?
Is there a required minimum resolution?
What are the most commonly used formats?
Is the size of the document (in Megabytes) an issue?
Are there any existing medical legal requirements or precedents that can help guide the development of these policies?
As a basic principle, a scanned record needs to be Non-editable. In other words, once it has been scanned, it must not be possible to modify the record or document in any way. In addition, the document must be readable. This is where the question of resolution comes in. The higher the resolution of the scan, the larger the file. So there is a trade-off between document size and resolution, but is there a minimum that is acceptable.
Adobe acrobat (.pdf) and Tagged Image Formet (.TIF) seem to be the most common formats that are easily readable. Are there other formats that physicians or EMR systems are using?
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