This article examines the process of document scanning and conversion in HIM departments and how to address challenges involved.

1. Document
Scanning and
Conversion in
HIM
Department – an
Overview
This article examines
the process of
document scanning
and conversion in
HIM departments and
how to address
challenges involved.
Managed Outsource Solutions

2. www.managedoutsource.com 800-670-2809
With increasing use of the Internet on the global scene, document scanning and conversion of
paperwork in all business sectors became a massive trend. As companies merge or grow they
need to decide how to treat their document repositories. Corporations and entrepreneurs are
turning paper into electronic format not only to dispose of large volumes of hard copy
documentation that is taking up space but also to tremendously enhance their business
performance. Conversion of documents into digital format improves speed and efficiency and
also enables to perform different tasks using the internet that will allow much higher
productivity. However, paper records continue to be a major part of business documentation,
and in many business organizations digitization projects are under way.
The Need for Document Imaging Likely to Continue
In HIM (Health Information Management) departments, medical records still continue to be
partly paper documents. Most US hospitals continue operating in some form of a hybrid
medical record environment; part paper and part electronic. Recently, a survey was conducted
of over 200 healthcare information technology experts, out of which 172 experts considered it
helpful if an electronic health record contained scanned documents and images along with
discrete electronic data fields. EHR implementation can be improved if the patient’s earlier
paper medical records are scanned and made available along with the electronic system.
When physicians can easily access the scanned patient record, it contributes to increased
physician satisfaction and enables valuable time savings. This signifies that the need for
document scanning and imaging technology/document conversion as well as the human
resources to perform the job is likely to continue within HIM departments for the near future.
What Document Conversion in an HIM Department Involves
The process of converting paper documents into digital format begins when the records are
received in the HIM department. Typically, the document conversion process occurs in the
following sequence.
Quality Control Process
 The documents received are carefully monitored by the HIM department. They ensure
that there is a smooth flow in the processing of the record and also implement quality
control at each step of the conversion.
Receiving Prepping Scanning Indexing Transferring

3. www.managedoutsource.com 800-670-2809
 The HIM department takes note of the time taken for performing each step. This is
done in order to accurately measure and manage productivity, cost and staff
accountability.
 Using workforce management software that includes a well-organized set of document
conversion workflows and strong management reporting functions, HIM managers are
ensured the lucidity vital to maintain the pulse of the process.
 The stringent QA procedure provides HIM managers with the information necessary to
address and reassign work appropriately and ensure maximum productivity and
quality.
Challenges Faced in Document Conversion
There are certain typical challenges associated with the document conversion process, mainly
with regard to the four areas – Quality, Technology, Cost and Turnaround Time.
Effective Performance Measurement Vital in 3 Important Areas
Document conversion is all about quality, timeliness and cost. Out of the three areas, quality is
the most important one.
 Quality
o Quality control checkpoints are necessary at each step of the document
conversion process.
o In addition to these, a final and more detailed QA process is also necessary.
Quality
•Images of poor
quality
•Incorrect
identification and
indexing of
document
•Erratic entry of
patient name,
account number,
date of service, etc.
•Mixed patient
records
• All pages are not
captured
Technology
•Poor performance
stemming from
poor maintenance
•Improper handling
of scanners and
resultant damage
•Wrong type and
size of scanner
•Malfunction of
interface with
imaging systems
and EHR
Cost
•Increase in overall
staffing cost
•Rising hardware,
software and
maintenance costs
Turnaround Time
•Slow turnaround
time transitioning
from paper records
to images in EHR
•Employee turnover
•Staff burnout

4. www.managedoutsource.com 800-670-2809
o The entire paper record must be compared to each page of the related imaged
document. In this stage, there should be the capability of reporting to
categorize the errors into types such as high severity or low severity.
o It is important that staffs are held responsible for the errors they make, and a
corrective action plan must be implemented for any staff member that
continues to make the same error.
o A good workflow design should also have the feature to allow authorized HIM
staff to submit a request for correction/modification to the document
conversion area in case it becomes necessary to make a change after the record
is transferred to the EHR. The corrections should be made within specific
timeframes.
 Turnaround time
o Meeting a set turnaround time is an important objective of any HIM manager.
The medical records must be coded and distributed promptly without delay.
This is possible only if they can quickly find out where the document scanning
delay is occurring, via availability of reports that point out which unit has been
slow in delivering the records, the full chart as well as loose documentation.
o The staff concerned must be able to know issues such as accounts that are
nearing the imaging turnaround deadline, high priority documents that are
missing such as progress notes, physicians’ orders and so on, and high risk
accounts (multiple barcode values, mixed accounts and so on).
o Ideally, an effective document conversion workflow should include a daily
summary of the activity report that would provide HIM managers with
necessary information such as total number of accounts received each day,
total TAT (time of patient discharge to time when the imaged record is available
in the EHR), document conversion centre TAT (time the record is received by
the centre to the time when it is available in the EHR), details of QA performed,
and error rate percentages on the basis of error type.
 Cost
It refers to the cost per page to process, review and release the scanned documents to
EHR. For in-house document conversion, this would include the cost involved in
recruiting new staffs for the conversion process, and training them. Retaining and

5. www.managedoutsource.com 800-670-2809
managing the staff and purchasing hardware and software required for the conversion
process are all the components of the overall cost.
Hiring reliable document scanning and conversion services is the best way to ensure accuracy
and efficiency in EHR. Expert professionals can complete the project quickly and resourcefully.
Considering EHR implementation in healthcare facilities and physician practices, maintaining
onsite storage of archival records will not be cost effective any more. There should be a policy
in place to get rid of obsolete medical records, scan the frequently accessed paper records to
make them readily available and scan archival paper records as they are requested
subsequently.
Advantages of Document Conversion
Digital files
enhance
access.
information is
made
available in
the form of
indexable
files.
Information
can be shared.
Files can be
easily searched
and organized
after digitizing.
Digitized
documen
ts ensure
more
security
of
informati
on.
Prevents
loss of
important
records.
Saves
valuable
storage
space and
eliminates
the need
for file
cabinets.
Improved
care
provision
and
improved
level of
patient
satisfaction.