Digital imaging for document management

Susheel John, MD, Information Management, Asia Pacific Region, Kodak Alaris gives a rundown on applying digital imaging’s lessons to document management

Healthcare professionals worldwide have witnessed first-hand technology migration from radiology film and laser film printers to diagnostic digital imaging and communications in medicine (DICOM) digital devices and picture archiving and communications systems (PACS).

This transition has had an extensive impact on patient care, efficiencies and diagnoses. Healthcare organisations and professionals are facing a steep learning curve and the need to build network and IT infrastructure, along with external communication capabilities, ensuring interoperability and facilitating the efficient exchange of images for viewing and interpretation.

Initial adoption and migration to the electronic health information exchange negatively impacted clinical productivity. This caused resistance, frustration and financial challenges. Healthcare professionals were more focused on patient care than evolving technologies, especially dealing with hybrid environments of medical films and digital images.

Improvements with electronic healthcare processes

As India’s healthcare system continues its migration towards electronic health communication and interoperability, the objective is to encourage physician-wide adoption of electronic healthcare processes. This will help facilitate immediate access to information and reduce the instances of lost information. Examples of technology enabled process improvements include:

• Use of unilateral electronic health records (EHR), physician entries and information exchange between doctors, practices, facilities and patients
• Closed loop e-prescriptions to improve patient medication adherence
• Proactive patient engagement for wellness management and better patient outcomes

We can take advantage of lessons learned from the film-to-digital evolution to relate these lessons to the transition from paper-to-electronic health information exchange, some of which are already in practice today:

• Utilising upfront planning to choose systems that meet your needs and ensure a successful transition
• Managing user introduction through new systems and process implementations, since initial and on-going perception can make or break a project
• Identifying and accepting the gaps and realities upfront to be better prepared

Paper-to-electronic data transition

The thought of change to new electronic processes can cause much anxiety, especially due to the familiarity and comfort with current manual practices. Even in today’s culture, where nearly everyone uses digital communications in their everyday lives, there is still the dread of change, together with cost and implementation challenges.

Organisations need to identify a methodical migration plan before moving away from film – this includes a structured conversion plan for back file paper documents and charts. Options include outsourcing the complete conversion project, converting paper files and charts prior to the next patient visit, or to adopt a hybrid approach of scanning prior to visit, along with converting back file charts when on-site availability permits.

Determine a day-forward process of converting paper documents that may present themselves, from patient orders to test results received. Planning out whether the information would be stored as part of the EHR or in another system is critical to knowing where and how to access pertinent information.

Decide whether to store and manage documents as part of an EHR system, taking into account whether a dedicated, integrated and accessible document management solution is more appropriate for handling all document types – not just patient health information. Always check ease of use and compatibility.

Realise hybrid environments

The healthcare industry often looks for a single ‘fix’ to process issues, and EHRs were perceived to be that single ‘fix’. Healthcare organisations need to simultaneously research and compare current and new technology compatibility gaps and identify best practices that include effective ways to work in hybrid environments.

Healthcare has recognised that between providers, facilities, patients and associated businesses, there will always be:

• Some information in paper form
• Data in various formats (structured and unstructured)
• Technology integration and compatibility issues
• Information security concerns
• Communication and exchange challenges
• Care providers who will not implement electronic systems or electronic communication methods
• User adoption struggles

Looking forward

Once electronic information is interoperable and accessible, applied clinical and business intelligence and analytics will become important tools, enabling the next level of transformation in healthcare.

This added dimension of ‘intelligent’ information, which provides the ability to receive immediate clinical feedback and trigger treatment suggestions, will result in better outcomes. This will also ultimately aid in readmission reduction while optimising patient care and satisfaction, with expectations of assisting in population health management.

We will also see greater operational efficiencies related to staffing and resource allocation, coding and billing guidance and information process enhancements, which all lead to increased productivity and reduced costs.

Ultimately, if we learned well from previous technology migrations, there will be enormous opportunities for IT leaders and providers to make an impact on the healthcare industry.