Term: Document Imaging


Document Imaging is an IT term that refers to systems designed to create digital copies of physical documents.

The idea of document imaging has been around for nearly 160 years, originally starting with the production of micronised pictures in the 1850's, and later Microfilm & Microfiche machines (1920's) designed to make copies of physical documents onto a more compact, longer lasting, and easier to store and retrieve physical media of film.

With the rise in digital computing in the 1980's and the creation of smaller, more affordable, and more powerful computers the possibility of storing important documents and other media digitally became a viable option.

Below is an example of how an organization's work flow would operate using a document imaging system:


Document Imaging has many applications in the healthcare field.

Due to the healthcare industry's total reliance on physical media (patient charts, x-ray, test results, etc.) since its inception it now is facing unbelievable storage requirements for the legacy physical documents and records that grows by the day as new records are created. Applying digital document imaging technology to these legacy documents can produce a reduction in storage requirements by eliminating the need to store all of the physical originals, aid in the finding and reproduction of records which currently must be done by hand if there is a request for medical records, and if used in conjunction with Optical Character Recognition technologies can produce full-text records that can be queried and used for data mining or other data intensive applications that would be impossible to do with physical records.

Document Imaging as a stepping stone to Electronic Health Records (EHR):

The current hot topic in healthcare is the push to move to the EHR, document imaging systems can be used to help ease the transition from paper-based records to fully electronic records by reproducing the currently existing physical records for use in EHR systems. This is a highly valuable approach to the transition to EHRs that eliminates the problem of data loss from existing records and the need to reproduce the records manually into new EHR systems.

Even before the introduction of complete EHR systems into healthcare institutions (which are currently struggling to gain a foot hold), Document Imaging as a way of preserving and aiding in the distribution of information has been widely accepted in the healthcare field and has been in use widely for several years.

Advantages of Document Imaging:

In general, Document Imaging technology has several advantages in a business environment over physical media.

  • Reduction of storage cost (via space reduction vs. physical media)
  • Increased preservation of records
  • Increased disaster recoverability of records (as long as the digital files are properly managed)
  • Increased portability of records
  • Increased searching capabilities
  • Increased manageability
  • Increased system efficiency & productivity

According to AHIMA there are several advantages of using document imaging that are most importantly immediately applicable to healthcare;

  • Improved Access to records for authorized non-HIM users

  • Elimination of Retrieval, Delivery Lag Times

  • HIM Work Flow; efficiency, productivity increases

  • Improved Coding/Accounts Receivable Processing Time

  • Improved HIM, Information Services Relationship, Collaboration

Disadvantages of Document Imaging:

There are of course some disadvantages that can be associated with document imaging;

  • Cost (while storage costs are reduced, upfront costs for implementing a complete document imaging system as well as the 'hidden costs' such as continued maintenance can be very large and hard for an organization fo see benefit in from the start)
  • Implementation & conversion time (the time required to fully implement ie. testing & training as well as complete the conversion of records can be quite large depending on the size of the organization and the extent to which they want to convert their records)
  • System interoperability (not every document imaging system implementation can be expected to work completely with the systems currently in place within the organization)
  • System obsolescence (is the system upgradeable? will future technology developments mean that the organization will be left with a new and more expensive legacy record system a few years from now?)
  • Security (now that all records are stored in a "single" location, are they properly secured against unauthorized access?)

Special Considerations for Document Imaging within HIT:

One particular area regarding Document Imaging that is of special concern to the healthcare field is that of Legality.

There are far more legal restrictions on data in healthcare due to the sensitive information of the data than on any other field that would implement susch a system. These restrictions add extra items of consideration for an organization that might be considering implementing a document imaging system in a healthcare environment.

Some specific items that may fall under this field;

  • HIPAA regulations
  • State laws regarding the legality of Electronic records (in some cases state laws either directly or indirectly prohibit the destruction of the original paper documents, essentially eliminating one of the greatest benefits of document imaging; the storage reductions)


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