Can Practices Scan in Old Paper Records and then make room by getting rid of the old ones?
The guidance below is taken from: The Good Practice Guidelines for GP electronic patient records, Version 4, 2011.
9.7.9 Document Management
An essential part of paper-light working requires the practice to utilise a Document Management System (DMS) to handle correspondence. This is often referred to as ‘Document Scanning’ and will consist of a document scanner and associated software, which stores the scanned images and allows them to be viewed on the computer monitor.
Once backed up, the original documents may then be shredded, within some safety and legal constraints, saving space and removing the need to file the paper into a patient record. There are two main types of document scanning: concurrent scanning, where documents are scanned to the record as they arrive thus, over time, reducing the need to refer to archived paper correspondence in the paper notes; and archive scanning, or ‘back scanning’, where the paper notes are scanned to the DMS to make the full historical paper record available from the computer.
9.7.9.6 Scanning Historical Records “back-scanning”
This process has been undertaken by some practices that wish to have the entire historical primary care record stored on their DMS. This may be of value where the practice wishes to be able to archive the paper records, perhaps returning them to the Health Authority, thus freeing up space in the practice. It can help with paper-light working by removing the requirement to refer to the paper records for old correspondence. It may improve clinical safety, by making the records more accessible, and in some instances may be cheaper than establishing a paper records filing store.
Practices should examine the business advantages to this process against the financial cost. Various companies offer this process as a service, and practices should examine what is offered and consider if the methods used will increase the utility of the record. In general it is good practice to scan archived documents into the DMS using some type of filing structure, to distinguish between the various sections of the medical record. Scanning the entire record to a single, multipage image file may risk losing some of the inherent structure and utility of the paper notes and should be avoided (See also 9.7.5.1 above).
Comprehensive advice on scanning historical records is available from the SCIMP website.
9.7.9.7 Shredding
Paper-light practices employing scanning should establish safe processes for the subsequent destruction of the original documents (see also Chapter 10 Electronic Document Attachments). In general this applies to documents attached to the record rather than the original record itself (e.g. Lloyd George envelope contents).
Documents can be shredded after they have been scanned, confirmed as legible, backed up, and that backup has been verified (confirmed local tape read-back). Practices should ideally employ a crosscut shredder, although there is no NHS required standard. In some areas PCOs provide a secure document destruction service, and commercial operators also exist.
So essentially there are ways of doing this. You can shred scanned documents but you may consider returning old paper notes to the SHA as suggested above.
DW Jan 2012 | 
