The Bridge to EMR... Document Management

Each week in my work, I either meet or speak with physicians who are just starting to warm up to the idea of electronic medical records.  They're feeling the push from the folks at OntarioMD and Infoway Canada , or they're watching some of their "forward-thinking" colleagues take the leap.  Or perhaps, like so many, they're simply up to the gills in paper and realize that they either have to consider a bigger space to accommodate the accumulated boxes of inactive records they must still retain, or start thinking about the bigger picture of how the records are managed.

Technology has a way of eventually breaking down your front door if you wait too long to graciously invite it in.  It eventually starts to feel like being the only one at the dance without a date.

In the meantime, the latest statistics in Canada indicate that the uptake to EMR is still slower and far lower than expected.   

Unquestionably, the leap to EMR from a paper-based practice is a quantum one. 

But there is an interim step out there that is often overlooked.  This bridge to EMR, not only rids the physician practice of all new paper, it also affords the physician some additional time to better weigh the EMR options out there.  The bridge is called Document Management.

A Document Management System might be
the perfect bridge and interim step to EMR.

In its simplest form, a Document Management System (DMS) is a software application which tracks, stores and allows for immediate retrieval of electronic documents or images.  It is not specific to medical offices, but lends itself beautifully to one.

In the case of a medical practice, the DMS will store each patient record digitally and allow for instantaneous retrieval of that record through its search capabilities.  Once retrieved, the record is similar to the paper record in that you can flip through the record one page at a time by using the arrow button or "next page" button, just as you would use your finger to flip through a paper record.  Any paper coming into the office, be it through fax, mail or even handwritten notes, can be scanned in to the DMS at the end of the day, with each new page appended to the top of the existing digital record for that patient.  Plain and simple.

Document Management Systems vary greatly and usually offer additional functionality such as: annotation tools (highlight, circle, redact, etc.), ability to zoom in and out, rotate an image, print, share, etc.  When set up for it, the DMS can be accessed via any secure internet connection (ie. the home, or hospital).  It can be fully secured, and there's an audit log showing the date and time and username for each activity that takes place within the record.

Compared to its big brother EMR system, the DMS is inexpensive (imagine a $1400 one-time fee per concurrent user license).  It gets rid of all paper going forward.  It prepares everyone for a paperless office environment.  It buys you time to figure out which EMR system is really right for you, while letting the EMR market mature a little more.  And when you do finally make the move to EMR, it will not be quantum leap, but rather a small footstep.

For a solid DMS with a great track record in the medical sector, RSRS recommends Digitech's PaperVision Enterprise, which can accommodate small to very robust requirements.   Here are case studies where PaperVision was implemented in a Single Physician Practice, A Large Clinic, and a Hospital.

EMR is not the only way to do away with paper in a medical environment.  DMS is a very viable option, both as an interim step to EMR and even, dare I say, as an alternative to it.