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VistA Imaging Scanning. EHR & MU for HIM Professionals. Presenter. Jamie Furniss, RHIT , CCS-P Portland Area HIM Consultant. Training Objectives. Examine policy & guidelines for VistA Imaging Review processes for scanning documents Perform quality checks and correct errors.
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VistA Imaging Scanning EHR & MU for HIM Professionals
Presenter Jamie Furniss, RHIT , CCS-P Portland Area HIM Consultant
Training Objectives • Examine policy & guidelines for VistA Imaging • Review processes for scanning documents • Perform quality checks and correct errors
What is VistA Imaging • The VistA Imaging System (VI) is an extension to the RPMS information system • VI provide extensive support for imaging. • VI is a FDA Approved Medical Device and cannot be modified • It captures scanned documents and makes them part of the patient’s electronic medical record • Sites or Areas have the primary & long-term storage server
Preparation • Create a local Implementation Team • VistA Imaging Site Agreement – send to IHS VI Coordinator • Scanning Policy & Procedure • Equipment Purchase • Approved scanners with ergonomic work station • Stamps • Scanned By_________ & Date • Illegible • Intentionally Left Blank • Scanner locations – HIM & other locations • Uninterrupted & quiet area • Training – Scanning (capture) & Display • Individual • Group
Training IHS & VA provides training • Scanning Policy & Procedure is required • http://www.ihs.gov/CIO/EHR/index.cfm?module=listserv • 3 ½ days of hands on training • Post training competency test
National Policy can be found in: Indian Health Manual, Part 3 - Professional Services - Chapter 3 - Health Information Management EHR Policy & Procedure, HIM found on the FTP directory/pubs/EHR/ at ftp.ihs.gov IHS National Policy & Procedure
Develop Local Policy Sample local policies available on the IHS website under Vista Imaging in the FTP site documents: http://www.ihs.gov/vistaimaging/
Approved Documents • Categories • Clinical (Consent Forms, Advance Directives) • Administrative (Certificate of Degree of Indian Blood (CDIB), Insurance Card) • Refer to national policy & procedure for list of approved documents and create local policy including list of approved documents
Refer to Forms Approval Committee for approval or denial, or Refer to HIM Director for approval or denial Non-Approved Documents
Open the EHR Open Vista Imaging CaptureAlways select the patient in EHR
Documents may be scanned as an addendum to provider’s note or scanned as a new note
Choosing your Format Color Settings • True Color JPG scans color documents one page at a time. • TGIFF 4Fax scans multi-page black and white documents. • 265 Color scan multipage color documents. Warning: If scanning photographs use True Color JPG. 256 Color will give your photograph a water washed appearance.
Quality Check Con’t The Reviewing technician will initial and date next to the Scanning technician as shown below
Multiple Pages Any sequential documents that are blank, stamp the documents BEFORE scanning • “Intentionally Blank” or • “Intentionally Left Blank”
Outside Sources PHI on various media (CDs, disc,) • Accept medium from patient • Forward to primary provider for review of information to be included in the patient record • May enter the information as a chart review in the EHR NOTE: It is recommended that IT scan all outside electronic data sources before forwarding to provider.
Errors • Contact HIM Director • HIM director deletes the image(s) and enters the reason for deletion • HIM Director will attach an addendum to the TIU note indicating the reason for deletion • HIM Director will delete the TIU note of the error
Errors Errors should be entered into a Quality Assessment Log
Enhancements • Enhancement requests are submitted through Catherine Moore, IHS National VistA Imaging Coordinator, to the VA • The VA Index Term Review Board reviews and approves items to be added to the index terms (image type)
