Key Considerations For Digitizing Hospital Records

• Slow: With information being exchanged mainly through calls, fax, or mail, the process of information transfer is prolonged, leading to loss of time, sometimes life for critical patients.
• Lack of unified view: Patient information is scattered across departments like doctor, lab, pharmacy, and hospital, making it difficult to access across departments and doctors. Hence, often doctors and hospitals missed out on relevant information like drug allergies.
• Storage: With a paper-based system, storing all the data is a challenge both in terms of space and cost. Moreover, patients need to carry a physical copy of reports, prescriptions, and their medical history, which is not feasible in case of emergencies.

Thanks to technological advancement, hospitals, and doctors are resorting to maintaining records electronically, which can be accessed both by doctors and patients across any device anytime.

Medical record management involves maintaining all records of a patient throughout their lifecycle from creation, receipt, maintenance, and use to disposal. Medical records include a patient’s history, clinical findings, diagnostic test results, pre- and postoperative care, patient progress, and medications.

While the benefits of maintaining medical records electronically are many, we have listed some of them below:

• Access and storage: Storing documents is cumbersome, both in terms of space and sorting. Electronic medical records not only save space but also makes sorting and search easy with tags and meta tags.
• Cost saving: Setting up the system is costly and involve resources. However, once set up, hospitals and health professionals will need less support to manage, less security to protect, and less space to save – contributing to cost saving.
• Security: Electronic documents are backed up onto multiple systems. Hence the loss of a document is not irreversible like paper documents. Moreover, the files are encrypted, and security access can be set to prevent unauthorized access, making the records more secure.

While it is convenient to maintain health records electronically, doctors and hospitals should consider the following[1] while transferring from paper-based reports to electronic reports:

• Which historical patient information should be available for patient visits during and after the transition?
• What are the best methods of converting this information to the EHR?
• What is the best way to ensure that the converted data and information is of sufficient quality?
• How long should the paper record be available after the conversion?
• How long do paper records need to be kept after the transition to the EHR?
• What is the role of printing and should it be allowed during the transition?