Question #2: How have the clinics you support dealt with the hybrid environment of paper and electronic charts?

The plan is for charts to be retired 1 year after the first clinic visit that utilized the EHR. If the patient is not seen 3 years after the go live, then the chart will be retired.

We had established a suggested policy of having the chart pulled for the first 3 visits of a patient since the EHR go live, but many clinics have stopped pulling the charts prior to this limit. The providers were given the paper chart to see the patient for the first 3 visits so they could flag anything they would like the staff to scan for future use. There was also a template given to the staff to instruct them how to organize and name every scanned document. Variables which influenced this behavior included provider preference (which usually correlates with how well the provider can use the EHR) , time taken to pre-load or populate the chart with digitally irretrievable data, and patient complexity (a patient with multiple outside referrals for specialty consultations or tests will cause a chart to be pulled for the visit more often).