Document Imaging and EMR: Medical Industry Considerations

I was turned on to an article from Health Leaders Media this past week (thanks to @eMichaelPower) that turned into a conversation with @Tevora. Electronic medical records (EMR) are the rage in operational efficiency – but at what cost?

It’s put out there by the article that the biggest breeches in security (and ensuing HIPAA violations) are unencrypted laptops and portable file sharing devices like flash drives. Once confidential patient information is passed to these unencrypted devices, you may as well have written everything on a sticky note and taped it to the hospital break room refrigerator. Not necessarily what health organizations are looking for in an audit situation.

If your organization is considering EMR, I wanted to share some issues for your team to discuss over the boardroom conference table. These are from my perspective – “the guy” who works with organizations like yours every day. Maybe these questions will help you ask better questions and set your organization on a track towards all of the operational efficiencies that accompany an EMR solution as well as compliance.

• Indexing: The indexing system you choose will be one of the key factors that determines the overall success of your EMR initiative. If files are hard to find and your indexing system unintuitive, employees and staff will have a hard time converting.  Lets face it, your job is to Help patients, not look for them.
• Conversion Costs: EMRs mean not only increased access, no document loss and a faster share rate of important health information but conversion costs. Your file room becomes laptops and the necessary accoutrements. Look beyond the indexing and cost of scanning and don’t forget to factor in the hardware and software required to make your EMR solution a success.
• Security: File rooms have keys. File cabinets have keys. Electronic devices need keys as well. Password protection and data encryption should be a part of every EMR initiative. Sure – doctors like to use their own laptops, but tell us what’s more important: a physician with a penchant for his Mac or HIPAA compliance and the upholding of everything on that piece of paper people sign regarding patient confidentiality?  Security and encryption is not difficult, rather, it’s something that’s either forgotten or ignored  to due to laziness.  The “it won’t happen to me” mentality is simply unacceptable in this scenario.  Two simple things to do right now:

1.  Set BIOS Password:  Most laptops come with a very strong BIOS password capability that locks up the hardware and makes the laptop completely unusable. This is the password that has to be entered before the operating system loads, usually on a black screen a few seconds after the laptop is started.  Now, this will not protect the hard drive if its removed, but it’s the first line of defense.  This takes under a minute to set up.

2. Use a program like TrueCrypt: This open source program works.  Take a look at the site and make it part of your Electronic Health Record strategy.  On their website, when talking about hacking the program they say  “…it could take thousands or millions of years, depending on the length and quality of the password….”.  Enough said.

The ideal scenario for any organization, from a single-physician practice to a national health care organization is this:

Indexing + Budgeted Conversion + Security = EMR program success

If you’re missing a component, something’s not going to add up. If you have questions, feel free to pick my brain here in the comments section or drop me a line at jcushman [at] solany [dot] com. Happy to share what I know with you and help you through the EMR planning, execution and implementation process. Who knows – words from someone who’s done this before might help!

Posted by: John Cushman on May 21st, 2010 // View Comments
Posted in: Document Imaging, Document Management and Storage, Industries, Medical
Tags: Document Imaging, Document Management, Document Scanning, electronic medical records, EMR
You can leave a response, or trackback from your own site.