With the passage of the Patient Protection and Affordable Care Act (PPACA), and the ruling by the United States Supreme Court upholding it in June 28, 2012, Electronic Health Records (EHR) became a reality that every healthcare organization had to deal with. This is a major change to a business that has relied on paper records since the very beginning. Everyone is faced with digital transformation of their business to keep up with the new regulatory restrictions. Fortunately, technology has also advanced to the point that cloud-based systems have stepped up to fulfill the needs of reduced cost combined with increased security and accessibility over traditional on-premise systems.

Most organizations are already moving into these systems because they are easy to get into, cheaper to maintain and infinitely scalable with minimum ramp up time. These systems are an easy decision from an Information Governance (IG) perspective because cloud-based EHR systems generally have greater resources focused on security and maintenance which in turn protects file privacy and identity theft than most organizations can afford on site.

Another big advantage to these systems is accessibility for both the healthcare professional and the patient. From the healthcare professional’s perspective, they have found the use of mobile applications for medical references, prescription ordering and patient communications makes their jobs easier and faster. Patients appear to like this trend as well with access to all of their records and direct communication with their doctors via email as an added value to the healthcare experience.

From the business perspective cloud-based systems also deploy faster with shorter timeframes for maintenance cycles than a self-managed on premise system. This is a critical piece of the puzzle that cannot be ignored. However a successful implementation is not how quickly the new system is deployed to all the computers and devices throughout the organization, but how effectively users can interact with it once the new system goes ‘live’.

Ensuring this type of success means a lot of advanced planning around the user experience (UX). Optimizing the user experience is a key factor in any digital transformation because if people cannot use the system it’s a failure. There are a multitude of little things that make up the user experience component of digital transformation but two of the most critical are creating an environment that is easy to understand and the migration of existing data into the new environment so that it is easily recognizable to the user.

Once you have those nailed down then you must have a solid training plan in place. I always recommend that training exercises mimic actual real world examples for each department with hands on activities as much as possible. Regardless of the learning style of the individual the truth is any training has a limited effect because it is the repetition of performing a daily business routine that re-enforces what was learned in the training session.

This is not to say that all that paper magically goes away. The mountains of paperwork will still be around, but the rate of growth is drastically reduced. The decision on when all that warehouse space can go away dependent on the organization’s retention schedule. There are certainly some document types that should be scanned into the new electronic system. Those should be reviewed and a determination to scan made based on the retention date and the cost for the process.

A good example is a document type that is scheduled to be destroyed within five years may not be the best candidate for scanning. Another good practice is scanning on demand. Documents stored as hardcopy that are needed for some business process can be requested of the storage vendor who in turn scans and uploads them into the system and destroys the original.

Regardless of a regulatory mandate or a business goal, digital transformation is here to stay in the healthcare industry. There are many challenges ahead, but they are certainly manageable with a cooperative team of business and information technology professionals coming together to solve these issues. That is what Information Governance is all about.


Robin Woolen currently serves on several committees for ARMA International, including the Industry Expert Taskforce responsible for developing the Information Governance Book of Knowledge. A regular speaker on Information Governance with appearances across the nation to his credit, he maintains an ever-growing social media presence, The Records Guru®, focused on Information Governance.