Question #2: Hybrid environment

All NGHN customers are implementing Electronic Health Records by rolling out clinic by clinic over a period of time. This means that they are all addressing the challenge of being in a hybrid environment of both paper and electronic for a period of time. Our customers have addressed this challenge in several ways.

If an electronic record is created on a patient and the patient then goes to another clinic for services that is still on paper, that paper chart will be sent to the home clinic and scanned in so that the medical record is complete in the EHR. Some affiliates have allowed staff at non-EHR clinics to have read only access so that they can view and print the summary of previous electronic encounters a patient has had at EMR clinics.

Paper charts are only pulled and reviewed one time before they are retired. Then the chart is marked as “Abstracted” and is put away to be sent to off site storage. It will be kept off site for the required number of years. Clinic staff abstracts the relevant information onto an Abstraction template in the EMR during the first visit documented in the EMR. They also scan any relevant visit forms at this time, although scanning is kept to a minimum due to the time and effort it takes. Some affiliates give the patient a status of “EMR patient” in the practice management side of NextGen so that check in staff knows whether or not there is a paper chart that needs to be pulled.