The redevelopment of the Royal Victorian Eye and Ear Hospital (RVEEH) has resulted in a significant reduction in space for paper medical records to be kept on site. In 2014 there were 130,000 records on site and following two significant culls this has been reduced to 60,000. Further culling aims to ultimately reduce the number of paper medical records on site to less than 2,000. In order to achieve this, and still provide “old” patient information as per the clinicians’ request – back scanning would be necessary. Due to the interesting cohort of patients at the hospital being a mix of chronic and complex long term ‘frequent flyers’ as well as simple cataract patients, it was clear there needed to be different approaches to back scanning for different types of patients.
To determine a model for back scanning, the BOSSnet Project team consulted individually with all Heads of Clinic (i.e. clinical departments and specialties) and undertook a lot of analysis on patient cohorts to determine which types of patients and clinics would get the best ‘bang for buck’ from a back scanning perspective. A back scanning plan was then prepared and presented to Executive which included the budget required for Health Information Service clerks to scan. This plan was subsequently approved and implemented in June 2015. The plan included two types of back scanning, full and partial. Full scanning were those small and quick records, such as simple surgical, and partial scanning was for the chronic ‘frequent flyers’ which have over 100 pages. Extensive consultation with clinicians on partial scanning requirements resulted in clinicians agreeing to identify up to 6 documents in the patient’s existing hard copy record that if scanned, meant they would not need to retrieve the hard copy record when the patient represented to hospital to that specific clinic.
Back scanning is an integral part of the strategy to reduce the number of paper medical records on site to less than 2,000. The back scanning program is going much better than anticipated in terms of throughput. Health Information Service staff are indexing two key documents (Operation Notes and Medication Charts), then using generically prefixed doc types (e.g. Pt_Hx Outpatients – Corneal) for other doc types. Though this would normally be more time consuming, the process and workflow in BOSSnet facilitates this efficiently and effectively. It was felt that having a couple of specific old documents individually named rather than in a generic back scanning doc type would ensure clinicians could quickly and easily find the information they needed for patient care. The document types were also added into a back scanned (“Pt_Hx”) folder as well as being displayed in the relevant attendance folder and into each sub-specialty filter. Moving forward, it is expected that hardcopy record retrievals will reduce significantly resulting in cost savings to the hospital.
"The detailed planning that went into developing a back scanning model suitable for RVEEH should soon result in a significant reduction and therefore cost saving in retrieving hardcopy medical records."Bec Ziffer