As I travel and speak with physician practices and hospital execs about health IT, I often hear questions about how practices can become paperless as they transition from manual to electronic processes. For those of you that have installed EHRs, you know that going digital does not mean that you’ll be paperless and you’ve probably had to buy more scanners and printers than you originally planned. For those of you that haven’t installed your EHR you’re probably puzzled so let me take a moment to explain why you shouldn’t believe vendors that tell you that you can be completely document-free or paperless in your environment.
- Patient communications are on paper. The first reason paper does not go away is that almost everything you do with your patients is still document-driven (not data driven). Think about the new patient registration process, the change of address form, the disclosure forms, referral forms, and the myriad other documents that you give to patients to fill out. Once they’re filled out you will enter some of the document’s information into structured fields within your EHR and other hospital information systems but they still need to scanned and otherwise managed for historical and audit purposes because there’s always more information in the paper version than the structure system can store. Making sure you have the right amount of equipment will ensure that the paper is captured appropriately and then discarded or recycled.
- Practice, Facility, and Physician communications are on paper. Even though we’ve spent billions of dollars working on health information exchanges (HIEs) and Meaningful Use compliance, most of the communication between hospitals and physicians or between physicians is still done via documents or paper. Even if both sides of the communications originate in EHRs or other digital techniques, the documents are often faxed, mailed, or at best sent by e-mail. Just because you’re using e-mail doesn’t mean that documents don’t need to be managed (because the documents sent via e-mails are separate from your EHR).
- Release of Information (ROI) remains paper-based. When you communicate patient data to law firms or other organizations for use cases such as workman’s comp care most ROI is done on paper.
- Payers and insurers are on paper. Except for electronic remittances (such as claims or payments), a great deal of communications with payers such as insurance companies and Medicare are done via paper and old fashioned snail mail. When rules or contract terms change there is a great deal of paperwork and documentation exchanged. All of those documents need to be managed appropriately.
- Government communications and compliance is done on paper. This one is obvious but a good chunk of government communications remains paper-based. Even if it’s faxed or e-mailed, though, don’t forget that you need a good document management approach to ensure compliance.
As you can see, most EHR vendor promises of taking you paperless are far-fetched at best unless they have a solid document management capability built in.