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Hospital Chain's Digital Conversion Takes Patience, Time

Exempla Healthcare uses launch of e-medical record system to rethink how it stores paper and film records.

When a hospital transitions to an electronic medical record system, it doesn't get to throw out the tons of paper and film records it has collected over the years. In fact, most healthcare providers that go digital find they must retain a lot of paper and film for quite awhile.

Record retention regulations prevent hospitals from dumping patient information. These rules, which vary from state to state, force hospitals to keep patient charts and images for anywhere from seven years to the life of the patient and beyond.

That can translate into a lot of paper and film that has to be either physically saved or electronically scanned and stored.

For older hospitals making the electronic switch, that means coming up with a plan to hold onto existing paper-based patient data even if their future is digital.

Many healthcare organizations have multiple rooms storing paper charts and others for radiology films. On top of that, most have off-site facilities storing older records that aren't likely to be used anytime soon but must be retained for legal, regulatory, and other reasons. Even if a hospital is going electronic moving forward, it's not likely to digitize all its paper-based records.

Exempla Healthcare in Denver is tackling this issue as it migrates two older hospitals onto a new Epic EMR system. A third newer hospital, Good Samaritan, opened in 2004 with e-medical records and other computerized clinical systems, but it wasn't 100% paperless from the start so it also has some physical record storage needs.

Last month, Exempla's St. Joseph Hospital, which has 565 beds, went live with its Epic EMR system, and by November, its 400-bed Lutheran Medical Center will go live. Prior to the EMR move, the hospitals had multiple rooms storing charts that were less than six months old, plus a number of other rooms storing radiology film. A third-party company stored and managed records offsite that were older than six months old.

The hospitals just didn't have enough space for anything older than six months old to be stored in-house, said Barbara Manor, Exempla director of information management. When a patient returned after six months, their records had to be moved out of storage.

Every day hundreds of records had to be pulled by the third-party storage company, and only half to doctors needing them got them the same day, Manor said. That meant doctors had to look in multiple places to find what they were looking for or wait for charts and X-rays to be delivered, she said.

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