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Document Imaging System put to good use by Tamara Pomerantz Center for Computers and Information Technology  The medical record has taken on a new meaning for the Hollings Cancer Center and Hematology/Oncology staff and physicians.  In June, OmniVision, the Document Imaging System application from LanVision, was rolled out to the Hollings and Hem/Onc pilot areas.     The Document Imaging System, a component of MUSC's electronic medical record project, EMERALD, has been several years in the making.    The Document Imaging System bridges the gap between paper and direct electronic entry of patient information in the medical record. Last October, the Health Information Services (HIS) Imaging staff began scanning paper charts.     Once a page in a chart is scanned, it is stored as an electronic image viewable by an application called OmniVision.     Traditionally, when a clinician requires a chart, it is necessary to call the medical records department, request the chart and wait for its delivery, assuming that the chart can be located or isn't already checked out. Once the chart is received, the clinician must leaf through the paper forms searching for the document needed to answer a question or provide patient care.    The Document Imaging System eliminates these obstacles by providing instant simultaneous access for all appropriate care providers who require information concerning a patient.     Further, the Document Imaging System structures the patient chart in a logical, ordered manner, using categories and encounter dates that  allow for easy retrieval of pertinent information.   The Document Imaging pilot areas have been using OmniVision to view their scanned charts and provide feedback on how the system works in the patient care arena. During its development, the Medical Records Committee and pilot representatives worked diligently with the HIS imaging team to identify new procedures and policies and to provide input on how the Document Imaging System should be structured.    Pilot representatives include clinical coordinators Kathi Callahan and Peggy Anthony, business operations coordinator Audrey Smith, and registered nurse Laura Milligan.     Procedures continue to be improved upon, and regular usage continues to grow as everyone learns and gains from this experience. Lawrence Afrin, M.D., Hematology and Oncology physician, commented, “In these last two weeks while I've been on ward service on 8West, I've seen nurses, residents, and fellows making extensive use of the system.  Several of them have commented to me how useful it is, and one nurse exclaimed, ‘I love that system!’”      Linda Monroe, a nurse in Hollings Cancer Center provides another account of how the system can assist in patient care. Monroe needed to review prescriptions written for a patient and found that the paper chart was not available. The information needed could be reviewed, however, by accessing the scanned chart through OmniVision.    “This system saved me about 15 minutes of precious time—not only did it save me time, it also saved the person in Medical Records time since she didn't have to lookup the record and deliver it!!”  Monroe said.     Carol Sherman, M.D., relates how the OmniVision document imaging system successfully resolved a medical record dilemma commonly encountered in the Hollings' Chemotherapy Suite and the 8West inpatient unit... A patient—newly diagnosed with cancer—had begun chemotherapy as an inpatient on 8West and was subsequently discharged, to receive follow-up chemotherapy in Hollings.    When the patient returned for that follow-up, chemotherapy orders were ready, but no consent form could be found. Policy and practice standards dictate that a nurse should personally view the patient's signed consent form prior to initiating chemotherapy.  Previously, treatment delays may have resulted while an inpatient or outpatient record was called for and physically delivered to allow confirmation of a previously signed consent form.    In this recent occurrence, the Hollings nurses were about to do the same when Sherman suggested they check OmniVision first instead. As she put it, “A few clicks, and bingo, there it was”—the signed consent form was  immediately visible on the screen.    Such examples are just a few of the benefits already being seen with this system.    Among the greatest benefits yet to come from the Document Imaging System are gaining control of the tremendous mountain of paper generated in patient care and increasing clinicians' comfort and skill level when it comes to working directly from a computer.    Additionally, communication among outpatient clinics, inpatient units, ancillary services, health information services, and financial services will greatly improve because all patient information will be available in one location, providing a complete picture of the patient's care at MUSC.     The next step for the project will be to curtail delivery of the paper chart so that the electronic chart is the primary source for patient information. Plans are also in development to introduce the On-Line Chart Completion System (OCC) to the pilot areas, which will allow clinicians to complete their charts electronically.   Additionally, the HIS Imaging team and the Document Imaging Project Committee are working to identify the next departments to be slated for implementation roll out.