Tips on Migrating Old Paper Records

Occupying vast quantities of space in your office are thick patient records containing years of office encounters, labs, studies, consults and various other sundry notes and paper artifacts.

While there are those that advocate scanning the entire paper chart into the electronic health record, the consensus of most offices that have been through implementation is that this is overly time-consuming and not necessary. There is actually no avoiding taking a somewhat fresh start with the electronic health record. Information such as problem list, social history, family history, allergies, past medical history and medications are discrete data that need to be entered into your electronic health record database to produce a useful record for the present and future.

With proper guidelines, most of this data can be entered by a non-physician in your office. However, many family physicians who have been through implementation find it useful to enter problem list, past medical history, procedures, referring physicians and medications themselves, getting a fresh look at the patient and accurate data.

If you have set up your implementation to provide you with sufficient, you should have time either before or during the office visit to do much of this. This is a significant amount of work and there is no sense sugar coating it --doing it properly the first time will pay enormous dividends for the second, third and 30th time the patient is seen in the future.

Certainly there are some things such as immunization history, EKG, recent cat scans or MRI scans and possibly recent important consultation reports which can be scanned into the record. The provider can flag these items either before, during or shortly after the first or second visit. It should definitely be a goal to "retire the paper chart" at or before the second visit. The chart can then be stored off-site for retrieval if necessary.

An EHR Email Discussion List post from Dr. Kelly Locke, Basalt, CO, admirably summarizes the various ways physicians have dealt with this issue. The links below represent his summation of the issue. Other opinions and contributions of experienced EHR users are included: