Health Information Technologies and Processes

Point of Care Scanning

  • 1.  Point of Care Scanning

    Posted 05-14-2019 01:21
    ​Hi All,

    Hoping for some feedback and best practices from hospital systems that have successfully implemented point of care scanning on their inpatient units. Last May our organization pushed hard and fast to achieve HIMSS7. POC scanning was one of the large components of achieving HIMMS7 as we had always scanned/indexed post-discharge. Nursing Informatics delegated the task of scanning to unit clerks across 5 acute care hospitals. Documents would be indexed by HIM at an off-site central location.

    Fast forward to today and we have major quality issues. Relying on unit clerks to scan and own this process has not been effective. We are performing QA on 100% of the documents that come back to us via courier post discharge. This is necessary because so many documents aren't being scanned at the POC. We have let Senior Management know our intention of having HIM assume the responsibility of scanning on the units. We've piloted a few units and things go well when HIM scans documents left in a designated bin on each unit. However, we always hit one roadblock preventing us from moving forward which is the hard copy patient binders still being used on units that house all already scanned documents for admitted patients.

    Providers, Residents, Nurses and others are placing un-scanned documents into these binders before HIM can scan them.  Despite multiple re-education attempts we still can't seem to break through. We're spinning our wheels on where to go next. Do we eliminate the binders (I can't see providers going for that but it's the ultimate goal), do we spend significant time checking through all binders while scanning, or go another route? Any insight at all would be much appreciated.

    Feel free to reach me by email as well at Kenneth.starkey1@umassmemorial.org

    Thanks!

    ------------------------------
    Kenneth Starkey
    Supervisor, Document Management
    UMass Memorial Healthcare
    Kenneth.Starkey1@umassmemorial.org
    ------------------------------


  • 2.  RE: Point of Care Scanning

    Posted 05-15-2019 07:48

    Is it an option to remove the hard copies from the unit after scanning or is there too much of a delay before indexing occurs that staff may need the papers?  For HIMSS Stage 7, it requires "clinically relevant" documents be in the electronic record within 24 hours – what "clinically relevant" documents are you having to scan?  Any chance of eliminating some of those?

     

    Wendy Mangin, MS, RHIA

    Executive Project Director – Regulatory Compliance/Privacy Officer

     

    Good Samaritan 

    520 S. Seventh St. | Vincennes, Indiana | 47591

    Hospital: 812.882.5220 | Direct: 812.885.3487 

    Fax: 812.885.3912 | wmangin@gshvin.org 

    b326b5f8d23cd1e0f18df4c9265416f7  images   Website | Videos | News | Events

     






  • 3.  RE: Point of Care Scanning

    Posted 05-15-2019 12:17

    Hi, I believe you can determine what "clinically relevant" is for your organization. When we plan on doing it, HIM will be taking the hard copies from the units as we will scan them and bring them back to HIM.


    Thanks,

    Karla

     






  • 4.  RE: Point of Care Scanning

    Posted 05-15-2019 13:22
    Our TAT is in good shape where we are having all records scanned at the POC for inpatient documentation in the EMR in under an hours time. In terms of clinically relevant documentation it isn't an expansive document set. It's outside records from other entities, EKGs (Our EKGs don't interface until about 24 hours until after they're performed), and certain downtime forms. To me our lag time between scanning and having the doc accessible within the EMR isn't an issue. We've even offered to have a single binder on the units with all EKGs for admitted patients in case of an emergency where a provider needs it for reference.

    To me our issue is communication and education. We need the backing from senior leadership and a physician champion to make this work. That and the fact clinical staff need to be willing to transition away from having that hard copy document in front of them, and access the EMR (where they already do all their documenting) to view scans.

    ------------------------------
    Kenneth Starkey
    Supervisor, Document Management
    UMass Memorial Healthcare
    Kenneth.Starkey1@umassmemorial.org
    ------------------------------



  • 5.  RE: Point of Care Scanning

    Posted 05-17-2019 14:47
    Edited by Sarah Keppen 05-17-2019 14:47
    Unfortunately, I do not have an answer to your original question, but I wanted to make a comment on this discussion thread. It is completely frustrating how clinical staff do not understand their role in ensuring a patient has a complete and accurate legal medical record. This isn't new with EMRs but I feel that it's more pronounced. With front end documentation, quality of provider documentation is going down. There's a reduction of overall documentation, higher percentage of spelling, grammar, and other ​errors. Providers and other clinical staff are inappropriately using the copy/paste feature. The onerous of ensuring a complete and accurate legal medical record too often falls completely on HIM. Working in IT, I often have customers trying to use EMR workflows to drive practice. That never works out as intended. Practice should drive EMRs, not the other way around.

    ------------------------------
    Sarah R. Keppen RHIA
    Applications Analyst
    Facilitator Certification Exam Prep Community
    2016 Chair Engage Advisory Committee
    skeppen@regionalhealth.com
    ------------------------------



  • 6.  RE: Point of Care Scanning

    Posted 05-18-2019 20:21
    We no longer have binders on the nursing units. When we migrated from Meditech Magic to 6.15 in 2018, the binders were removed from the floors. It was tough but our leadership stood firm and now they are used to accessing records completely via the EMR. All records are scanned by HIM within 24 hours, most sooner than that. HIM has a pick up schedule throughout the day and anything picked up is scanned and indexed within 1 hour of pickup. (We are a smaller facility, 49 acute beds, 51 long term care and 20 psych.)

    ---------------------------------
    Kathryn Wood, RHIA
    Assistant Director of Information Systems/Privacy
    War Memorial Hospital
    ---------------------------------





  • 7.  RE: Point of Care Scanning

    Posted 05-21-2019 15:33

    Kathryn

    If you don't have binders on the units and HIM has a pick up schedule, where are the paper documents that need to be scanned held on the unit until HIM retrieves?

    I am thinking of implementing a similar process but I thought that we would keep the documents in the patient record binders until HIM retrieved once each day.

     

    Deloris Farthing, RHIA, CHPS, CHDA, CHTS-TR| Director of Health Information Management

    HaysMed, part of The University of Kansas Health System
    785-623-5813 | FAX 785-623-5078 | 
    deloris.farthing@haysmed.com | PO BOX 8100, Hays, Kansas 67601








  • 8.  RE: Point of Care Scanning

    Posted 05-21-2019 16:50

    Hi Deloris,

    We actually have a couple of different styles of "collection bins" in our hospital. The binders were so precious to many of the end users that we thought we had to cut them off cold turkey or things would seep back into the binders that shouldn't be there. We decided that each unit could do what was best for them, in order to facilitate the removal of the binders. Our Med/Surg unit is the largest unit and they have a file box at the clerk's desk. The file box has tabs to organize the documents while they are still on the floor (consents, DPOA paperwork, POST forms, ROI forms, other, etc.) All patients go into the file box and the papers are sorted by category. Our ICU has a bin at the clerk desk and everything goes into the bin face down, every form and every patient. Our OB unit has a file box at the clerk desk, but the tabs are divided by room. All of forms for the patient in room 126 go to the 126 tab.

     

    I hope this helps a little. It's working for us.

     

    Katie Wood, RHIA

    Assistant Director of Information Systems/Privacy Officer

    War Memorial Hospital

    5oo Osborn Blvd

    Sault Ste. Marie, MI  47983

    p: 906-635-4663   khwood@wmhos.org

     


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  • 9.  RE: Point of Care Scanning

    Posted 05-21-2019 17:50

    Thanks

    This is something that I think I would like to implement but our HIM department is off site from the hospital so I need to find a "spot" for the HIM scan staff to work from or get mobile carts with the computer and scan machine on the cart and they work on the units.

     

    Deloris Farthing, RHIA, CHPS, CHDA, CHTS-TR| Director of Health Information Management

    HaysMed, part of The University of Kansas Health System
    785-623-5813 | FAX 785-623-5078 | 
    deloris.farthing@haysmed.com | PO BOX 8100, Hays, Kansas 67601








  • 10.  RE: Point of Care Scanning

    Posted 05-28-2019 12:34
    How many times a day are you picking up charts? Have you found that you need to round more often during certain times of the day? We are going to trial one of our floors in the next month.

    ------------------------------
    Chelsea Bemiss
    System Director of Him
    Ephraim McDowell Regional Medical Center
    ------------------------------



  • 11.  RE: Point of Care Scanning

    Posted 05-29-2019 08:31

    We perform Point of Care Scanning on the units - we round once a day to all units and scan documents that must be kept in the "blue backs" - these include consents, Baker Acts, Advance Directives and Blood Banks.  The other documents are taken off the charts and taken back to our concurrent scanning office where they are scanned within 2 hours. We make 2 rounds a day to the 4 EDs to pick up material and take back to the HIM Department for for scanning.  Everything that is scanned on the units is stamped "scanned by HIM" so it is easily identifiable as scanned at the next round.



    ------------------------------
    Lee Starling, BS, RHIT
    HIM Manager, UF Health Shands
    starll@shands.ufl.edu
    ------------------------------



  • 12.  RE: Point of Care Scanning

    Posted 05-29-2019 08:40
    This is good information. It sounds like there are no hard copy records on your units except just a few designated forms. Have you ever encountered a situation where you took something off a unit for scanning and there was a need for it prior to the document being available in the EMR? For us this will be our toughest selling point for eliminating the hard copy binders on all units when we take over POC scanning from the clerks.

    ------------------------------
    Kenneth Starkey
    Supervisor, Document Management
    UMass Memorial Healthcare
    Kenneth.Starkey1@umassmemorial.org
    ------------------------------