Going Paperless in the Pediatrics Clinic

Executive Summary 

In the pediatrics clinic, paper-associated inefficiencies have the potential to impede medical experts, delay returns and adversely affect medical care. Effective management of paper documents promises to ensure a smooth flow of work and minimize operational costs. Most importantly, the patient experience in the pediatrics clinic may greatly be improved. Digital technology is at the forefront of transforming several sectors of medical practice such medical records’ management. Nevertheless, it can be said that truly paperless practice remains are improbable especially for medical groups which are smaller in size due to lack of infrastructure and resources or incentives needed to implement far-reaching solutions. Contrary to popular belief, the transition to a paperless pediatrics clinic need not be an expensive or extravagant affair. By setting up affordable storage, scanning, and incorporating paper-to-digital uploading within the existing system, the pediatrics clinic can in a gradual manner switch to digital records and still have the alternative of producing key documents on paper. This paper explains the various issues associated with minimizing the dependence on paper in the pediatrics clinic and suggests ways in which the office can go paperless in the best interests of patients and the patients alike. 

1. Introduction 

A paperless pediatrics clinic refers to the desirable environment where all documents are in a digital form not just for the sake of it but also to enhance service where practitioner decision and patient information are highly secure, precise and available (Dixon, 2002). 

Some of the benefits of a paperless pediatrics clinic would include: 

Improved patient experience – Patients will be able to spend more time with their care providers, as opposed to spending more time at the intake stage in the queue waiting for the doctors. Furthermore, they would not need to deal with follow-up concerns as a result of poor documentation. The delays and errors linked with reimbursement, patient records, physician orders and prescriptions would be alleviated. 

High-Quality Care- Healthcare providers would be in a position to maintain high standards of patient care. The risk of duplicated treatments, mistakes and omissions would be greatly reduced through accurate and complete patient files. Moreover, pediatricians will be able to safely access files the hospital, other offices or at home hence the opportunity for greater continuity of care. 

Improved medical personnel productivity- Doctors together with other medical personnel would concentrate on personal care since the office workflow would be less disrupted by incomplete, misfiled and missing files. Pediatricians would be able to interact with more patients, have more time with them or even use the saved time to perform other productive duties. 

Enhanced office efficiency- The pediatrics clinic would be able to eradicate administrative delays and effort duplication. There would be less administrative staff space and time needed for management of records. Additionally, the risk of errors would be mitigated by the less manual entry of data. 

2. Drivers towards a Paperless Pediatrics Clinic 

Apart from the advantages, there is a host of market forces that support the transition to a paperless pediatrics clinic. First and foremost, computers are extensively used for various office applications, both back, and front. According to a survey of 30o0 doctors, 93 percent of them currently utilize a computer-based scheduling framework while around 95 percent of them use an electronic coding and billing system (Velte et al., 2008). Besides, there is a growing trend for electronic transactions among payment processes and insurance authorization. Electronic-based systems also allow for automated audit trails and security features are very instrumental when it comes to securing patient privacy regulations. The computer also provides for viewing and storage for digital output increasingly being generated by new diagnostic technology. 

Furthermore, mew generations of healthcare professionals, physicians and patients are quite at ease using digital technology in their personal lives and are more highly expected to embrace its use in the pediatrics clinic to advance medical care.Electronic Medical Record systems and practice management are evolving towards doctor-friendly interfaces yet integrating built-in defenses and expert systems that minimize the risk of medical errors. As per the survey, 23% of the doctors stated that they use electronic patient record system currently (Giles, 2012). 

Many healthcare organizations recognize the ability of computerized physician order entry systems, Web-based information systems, and Electronic Medical Record systems along with other Information Technology related solutions in fostering overall accuracy and diminish error frequency. 

3. Barriers to the Transition 

It is important to understand the various challenges facing the transition of the pediatrics clinic to a paperless working environment. 

3.1. Wide Preference for Paper 

In most organizations, paper remains to be the standard for record-keeping. The paper is both flexible and familiar to most people as they allow individual preferences for transcription and notation. There are a number of doctors who are not very comfortable with using new technology. Besides, there are others who prefer paper since it is apparently easier and faster to cross-reference or find information on paper compared to navigating through computer screens. 

3.2. Greater Document Complexity among Primary Care Groups 

The pediatric clinic deals with quite a large number of patients. The clinic tends to have a long-spanning relationship with patients. The higher the number of active patients with extensive document retention requirements, the more complex the issue of transitioning to paperless office becomes. It is clear that the pediatrics clinic should only look to switch to a new system if the benefits outweigh the risks. 

3.3. The Use of Various Formats for Documents 

These comprise of documents meant to be included in the patient file from treatment centers, specialists, diagnostic centers and laboratories and doctors. They also encompass remittance forms and Explanation of Benefits that have to be fed into the billing system for the reconciliation of accounts (Vezyridis et al., 2011). Such records originate from both electronic formats and paper. Once they are gathered, the necessary information from the paper documents is entered into an information or billing system. In many respects, the systems operate independently and fail to incorporate data assets across the healthcare continuum. This leads to more inefficiencies and relegates the efforts of healthcare providers in the pediatrics clinic to retrieving, filings and entering information. Due to inefficiencies, the risk of administrative errors and reimbursement delays for staff and their physician's increases. 

Incompatibility of Paperless Solutions with Workflow 

Even though they are familiar with the advantages of a digital record, a majority of nurses and doctors will neglect any solution that does not resonate with the current workflow. For instance, 13 percent to 15 percent of hospitals and clinics, despite having some type of computer-based medication order entry installed, doctors in these firms enter less than 25 percent of their orders via the electronic system (Shaw, 2001). The reason is plain simple – Although the solution promises enhanced productivity, it is incompatible with the prevailing workflow. 

3.4. Inadequacy 

Electronic record systems call for solid backup systems and maintenance by IT experts , particularly in the case of an emergency. The challenges of file location in a paper-based office derails the doctor/patient interaction and promotes downstream delays such as for payment, claims processing, and subsequent patients. A solution dependent on IT, o the other hand, may cause the collapse of all the operations of the pediatrics clinic. Introducing digital document management is bound to create a clash with the current technology but since the pediatrics clinic uses a combination of paper and digital systems, it will not need to undertake a complete transformation to a comprehensive electronic system; rather, it will simply the use of existing infrastructure. However, irreparable disparities among systems may occur and the source of challenges is quite difficult to identify. A point in case, is it the fault of the user, network, hardware, software, or the printer if an electronic file fails to print? 

3.5. Resistance to Change 

Given that the current pediatric environment is at the moment non-linear and highly interrupted, doctors are not willing to make changes that are likely to compound their distractions or prompt them to use computers at the expense of giving medical care. That said, solutions that involve altering the doctor’s perception of individual productivity or entails staff training is bound to generate a great deal of resistance. 

3.6. Attitude 

In many medical offices, the staffs have access to paper documents such as receptionists, assistants, nurses and doctors without the same degree of experience or accountability with the filing system. The physical transportation of paper files between the laboratory and the office, a specialist’s office, an offsite storage center, or a medical imaging facility increase the chances for misfiling, delay, and error. 

4. Solutions 

The pediatrics clinic can go paperless by employing the one or a combination of the following affordable digital technology solutions: 

4.1. Automated storage and retrieval systems 

The implementation of EMR technology may be very expensive for the pediatrics clinic. However, automated storage and retrieval systems can allow the clinic to achieve many of the benefits of EMR for a relatively lower cost. It may also complement an Electronic Medical Record system by supporting the electronic storage of a huge volume of delicate paper files including safeguarded health data. Essentially, the solution comprises software and hardware that provide retrieval of medical documents, electronic storage, and scanning, printing and secure capture. The hardware components may consist of the following: a secure retrieval and electronic filing system, a digital multifunction product capable of faxing, copying, scanning and printing and a steadfast backup server to cushion against the loss of data (Selvidge & Phillips, 2000). The software components may embrace applications for retrieving and indexing documents as well as for producing liability reports. 

4.2. Paper-to-digital uploading applications 

The challenge of obsolete data entry from paper to digital form is overcome via these applications. Hitherto, firms were compelled to perform manual entry of information from paper documents into digital medical records systems or practice management. This method required a great deal of personnel time and was prone to the inclusion of errors. In contemporary times, there are a variety of easy and effective solutions including the uploading of paper information through a single scanning operation. 

Some of the benefits of translating information from paper form to digital form are as follows: minimal training and supervision is required for use, tracking of use and security of important records is achieved through built-in security, works well with a variety of information systems, can be incorporated easily into the existing workflow, uses readily available office technology (scanner/copier) and provides for easy turning of paper documents into digital form hence reduction of redundant filing of electronic documents and paper. 

4.3. Indexing applications 

These applications serve to secure each transaction’s “metadata” for example the time and data, the number of copies produced, the name of the individuals doing the file retrieval and tat of the individual requesting the file. The data is automatically captured to facilitate reporting, creation of a certifiable audit check that helps safeguard and adhere to HIPAA privacy regulations (Vezyridis et al., 2011). The pediatrics clinic is able to minimize cases of misplaced or lost files through the use of sole, searchable and reliable location for necessary documents. The automated storage and retrieval system fundamentally eradicates the possibility of health care professionals returning files or document t to the incorrect location. Additionally, they boost efficiency and precision as they supersede the manual process. Despite being electronic, the automated process suits the existing workflow as far as file capturing and retrieval is concerned. 

4.4. Networking scanning and routing 

Since email is used in the pediatrics clinic for the distribution of health documents, this method may prove vital. Network scanning software enables one to transfer documents to other caregivers or doctors via email attachments instantly from a digital multifunction product. The attachments may be sent in various easily transferable file formats such as PDF OR TIFF. The technique allows security through login authentication and encrypted transmission where a specific user is linked to a specific transaction. 

4.5. Web-based management and storage 

This allows for a single access point for healthcare-related documents devoid of any significant investment in technology. This method employs a digital multifunction product capable of scanning and transmitting data straight to a protected Internet site in which they are recorded in distinct folders fielding all the correlated files such as doctor’s test results, notes among other records (Beato et al., 2011). Authorized users are then able to access the files by using and a device that is Web-connected. For extra security, the data transmission is encrypted and access is password protected. Web-based storage will ensure the pediatrics clinic does not have to transport or transfer files through the fax machine, courier or mail. More so, web-based storage may be used to manage retrieval and storage of paper-based records. It may also be of great assistance when the employees are situated in different offices. Last but not least, an authentic audit trail is established through the use of web-based storage. Information regarding the identity of the person who has accessed a particular file or if any adjustments have been made in the folder can be shown easily. 

5. Conclusion 

Switching from a paper-based office to the digital format does not necessarily have to be as expensive as many people think it is. By integrating lower-risk and lower-cost digital technology such as paper-to-digital uploading alternatives, storage, and scanning into the current system, the pediatrics clinic can gradually adopt more secure and efficient digital records. Through a number of strategies, practices may realize a smooth flow of work, enhanced productivity and an environment where the staff is more focused on offering patients medical care rather than looking for paper. 

References 

Beato, B., Pisek, A., White, J., Grever, T., Engel, B., Pugh, M., & Shoup, R. (2011). Going paperless: implementing an electronic laboratory notebook in a bio analytical laboratory. Bioanalysis , 3 (13), 1457-1470. 

Dixon, J. F. (2002). Going paperless with custom-built Web-based patient occurrence reporting. The Joint Commission Journal on Quality and Patient Safety , 28 (7), 387-395. 

Giles, J. (2012). Going paperless: The digital lab. Nature , 481 (7382), 430-431. 

Selvidge, P., & Phillips, C. (2000). E-books: Are We Going Paperless? Usability News . 

Shaw, N. (2001). Going paperless: a guide to computerization in primary care . Radcliffe Publishing. 

Velte, T., Velte, A., & Elsenpeter, R. C. (2008). Green IT: reduce your information system's environmental impact while adding to the bottom line . McGraw-Hill, Inc.. 

Vezyridis, P., Timmons, S., & Wharrad, H. (2011). Going paperless at the emergency department: A socio-technical study of an information system for patient tracking. International journal of medical informatics , 80 (7), 455-465.