EHR Trifecta: Document Scanning, CLU and Integration Standards

David McKanna
David McKanna

Guest post by David McKanna, Nuance.

CIOs in healthcare face the constant challenge of doing more with less. Most are being asked to dramatically cut costs while continually tackling an ambitious list of responsibilities, including maintaining their organizations’ ability to demonstrate meaningful use, making the transition to ICD-10, sharing information through healthcare information exchanges (HIEs) and maintaining stringent patient privacy and HIPAA compliance programs.

Three key and often overlooked elements can help to address these tasks: document scanning, clinical language understanding and integration standards. Mastery of this electronic health record (EHR) trifecta can significantly simplify the healthcare CIO’s challenge.

Document scanning

Electronic health record adoption levels are steadily increasing, but ongoing interoperability issues result in high volumes of paper-based communications between providers. In fact, a survey conducted by the Bipartisan Policy Center in Washington, D.C., found that 71 percent of physicians identified lack of EHR interoperability and exchange infrastructure as major barriers to HIE.


This leads to incomplete or missing records from outside providers, delays in accessing paper-based patient information, and a prevalence of unstructured records (which are of limited use). However, enhanced document scanning software can enable automated paper workflows and turn distributed capture devices in a hospital into secure on ramps that accelerate access to locked, paper-based patient information within an EHR or enterprise content management (ECM) system.

Clinical language understanding (CLU)

Approximately 60 percent of the 1.2 billion clinical documents produced each year in the US are in unstructured form (i.e. dictated notes or paper records) and require manual processing to make the data accessible. CLU technology is a clinical-specific form of natural language processing that leverages one of the most comprehensive medical ontologies and state-of-the-art language processing algorithms. Combined with document scanning software, CLU enables you to analyze free text from scanned documents and tag the most important data elements to populate EHRs and support a wide range of applications requiring access to structured data.

Integration standards

Integration standards are fundamental to information sharing and continuity of care. Technology that complies with integration standards can facilitate increased compatibility and help healthcare organizations meet key challenges.  For instance, software leveraging global IHE Integration Profiles such as XDS and XDR can create “intelligent documents” from paper records using the HL7 CDA format. Additionally, software that supports the Patient Demographic Query (PDQ) Profile can conduct dynamic patient look-ups directly from point-of-care scanning devices and enable accelerated and secure distributed scanning to the correct patient records in an EHR, ECM, or HIE platform.

Technology that meets “Content Creator” requirements for HL7 Consolidated Clinical Document Architecture  (C-CDA) can convert scanned documents and extract discrete data with CLU technology to generate conforming structured C-CDAs which can be consumed by “Content Consumers” (such as EHRs or ECMs). The Integrating the Healthcare Enterprise (IHE) North American Connectathon is the industry’s largest IT interoperability testing event, and is an ideal indicator of how integration standards enable interoperability.

The 2014 event will take place on January 27 through 31 , and tens of thousands of tests will be run to demonstrate the most advanced technologies that meet industry standards for interoperability. It is vital for healthcare organizations to take advantage of the increased compatibility offerings demonstrated at this event.

What this all means for healthcare organizations and practices

Leveraging scanning technology and CLU can help healthcare organizations meet key challenges related to:

One comment on “EHR Trifecta: Document Scanning, CLU and Integration Standards”

I believe that adding ECM and Capture to your EHR software is the Trifecta needed to meet todays standards. The challenge for the small practices is cost. I believe cloud based ECM providers are going to be the best option for small practices. We at Systems & Solutions Inc. Have created what we believe will be the trifecta that will help small practices get the trifecta at a cost they can afford. Systems & Solutions Inc Hosted Package for $300.00 monthly is the best way small practice can achieve the Trifecta.

We believe that Capture Software for document scanning is essential to creating the first part of the Trifecta. Capture software will give document scanning tools needed for Capture.

Production scanning of virtually any volume of documents, distributed or centralized
Capture documents from a variety of sources (scanned paper, faxes, Emails, multi-function devices, electronically created documents and more…)
Thumbnail Document Viewing
Automated document cleanup (image enhancement – de-skew, de-speckle, border removal and blank page deletion)
Automated Page Separation to burst mixed batches into individual documents
Barcode Recognition
Machine Printed Character Recognition (OCR) capabilities (Zonal or full-page recognition)
Hand Printed Character Recognition (ICR) capabilities
Optical Mark Recognition (OMR) capabilities
Document recognition and classification capabilities
Database Lookup and Query Tools
Field Input Masks and Validation
Standard and Searchable .PDF Creation (including PDF/A)

Automatically upload the documents and viable information captured to our preferred Enterprise Content Management System. M-Files is the ECM software that uses Metadata. M-Files is built from the ground up with metadata in mind, the central concept that it is easier to describe “what” something is rather than guess “where” it is stored. This metadata-driven approach is comprehensive, from navigation (or browsing and search), to access permissions, workflow and replication.Metadata-driven navigation solves an intractable shortcoming of traditional folder-based approaches that are limited to allowing a file to exist in only one location, or having copies of the file (or links to the file) reside in other folders. In M-Files, unique information shows up dynamically wherever and whenever it is needed without duplication, thereby eliminating a host of traditional ECM and workflow issues. M-Files Cloud Vault looks and acts like a standard hard drive, so it supports literally every Windows application. Simply use the standard Save and Open commands to save to and open from the vault. Every file type is supported, including Word documents, Excel spreadsheets, PowerPoint presentations, PDF files, Emails, CAD files, QuickBooks files, images and pictures and more.

Storage Of Documents And Files With 50 gigs of Storage in S & S Inc Solution

Manage your organization’s documents without investing in server setup and maintenance – and make it easier than ever to access files anywhere, even from mobile devices

With M-Files Cloud Vault, you won’t waste time searching for a document, recreating information or using the wrong version. Instead, you can just tag your documents and save them in your vault – and they’ll automatically be saved in the cloud and made available to anyone with access, anywhere they are.

Plus, M-Files Cloud Vault is the first professional document management solution running on the Windows Azure platform, so you can take advantage of Microsoft’s highly scalable and reliable cloud-based platform and geographically distributed data centers to rapidly deploy solutions.

Systems & Solutions Inc. Offers Even More…

Workflow Improves Quality and Processes while Ensuring Regulatory Compliance

Systems & Solutions Hosting Package offers M-Files and McAfee with an easy and practical solution that helps manufacturing organizations and related businesses fulfill the documentation requirements associated with quality regulations and standards. Standards and regulations, such as ISO 9001, FDA 21 CFR Part 11, EU GMP Annex 11, HIPAA and Sarbanes-Oxley, set certain requirements for document management that can be easily met with the Sands Hosted Package. With the versatile and powerful M-Files workflow features, routine company tasks can be automated and task assignments can be given to the right persons at the right time – with no programming required. Work flows within M-Files can be instituted for approval of contracts, circulation of purchase invoices, processing job applications and for myriad of other use cases that require the review, edit and/or approval by several entities. McAfee is used to ensure data protection and integrity on the workstations, while Microsoft Azure ensure data protection and integrity in the cloud.

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