Point-Of-Care Scanning

Submitted by: Lee Starling, JM, RHIA, FHIMA Past President/AHIMA Delegate

Point-of-care scanning is defined as scanning documentation into the electronic health record during the time the patient is receiving care.  In order to meet HIMSS stage 7 status, the facility must scan the documentation within 24 hours of completion versus receipt. Organizations across the country have been working to figure out ways to make point-of-care scanning work for them.  There are a variety of ways that this can be accomplished.  Some facilities have chosen to fax their documents, directly from the nursing units, into a server where Health Information Management (HIM) staff members or a scanning vendor will index and quality check (QC) the incoming documents.  This is a great option if there are resources such as unit staff and fax machines on the hospital units.  Other facilities have chosen to have HIM staff perform this task.  This usually involves the HIM staff using portable equipment such as scanners, laptops and battery backups which is then taken to each unit daily.  In order for this to work, the facility would need to map out the hospital units, schedule staff appropriately and create a workflow that would ensure that the HIM staff would be able to scan the documents within 24 hours of creation.  Below is an example of an organization that decided to take the bull by the horns and perform POC inhouse.

Staffing: This organization has 3 hospital towers (1100 beds) and the scanning area is staffed 24/7 with 12 staff members.  Employee shifts were scheduled to ensure the facility meets the goal of scanning documents within 24 hours of creation and that the scanning equipment is available for each staff member. 

Equipment: The facility purchased two mobile carts with a scanner, laptop and battery backup on each.

Documents: HIM Administration worked with the nursing units and providers to determine which documents needed to be scanned on the units and which documents could be taken from the hospital chart.  The documents that could be taken out of the hospital chart are transported downstairs to the HIM home office and scanned on the high speed or desktop scanners.  This helps to limit the amount of time that the HIM staff is on the nursing units.

Workflow: The HIM staff assisted in the overall development of the workflow. They were flexible with their shifts, often working odd hours in an effort to figure out the best timing.  The workflow of the point-of-care scanning was created based on the needs of the nursing units.  For example, the newest hospital, which is a cardiology and neurosurgery centered facility, does not allow visitors or non-clinical staff on the units during physician rounding or nursing shift change. Therefore, the staff goes to the units in that tower before rounding and shift change to ensure that the documentation is scanned timely. 

Whether your facility chooses to outsource bits and pieces of the scanning or perform it inhouse, point-of-care scanning can be done. It takes teamwork, patience, and flexibility but most importantly, get your staff involved and you will have a successful outcome!