Last review date 03/02/2023
Scanning rules created in SystmOne can be extremely useful and an aid to help make scanning more efficient. Care needs to be taken when creating and using rules though otherwise it can cause a few issues. There are two categories of scanning rules that can be configured, 'Letter Type' and 'Coding' .
1. Pros & Cons of Scanning Rules
1.1 Letter Type
Pros
- Good at automating selection of letter types & speeds up the scanning process.
- Increased accuracy of labelling letters in the record for easy access, reduces the tendency to save a scanned letter as a 'Clinic Letter'.
Cons
- Occasionally if you have many letter type rules the OCR software will pick up more than one letter type.
- Hospitals and departments regularly change the wording and layout of their clinical letters which has an impact on the usefulness of the scanning rules until adjusted.
1.2 Coding
Pros
- Coding repetitive batches of letters for example diabetic retinal screening results, pharmacy influenza vaccination notifications.
- Picking out QOF items such as smoking status, height / weight / BMI.
Cons
- If staff are not careful when scanning you can easily add an inappropriate read code to the record. For this reason we do not suggest using this functionality to offer diagnosis codes.
- Hospitals and departments regularly change the wording and layout of their clinical letters which has an impact on the usefulness of the scanning rules until adjusted.
Examples of coding issues
1. If you set up breast cancer as a coded scanning rule and if a letter says ‘mother has breast cancer’, it will suggest adding a ‘breast cancer read code’ to the patient’s record. This is obviously incorrect as would be referring to a personal history of breast cancer, rather than a family history of breast cancer.
2. Scanning rules for codes can be useful for identifying who a letter is from, e.g. ‘From Rheumatology Department’ will suggest ‘Seen in rheumatology read code’. This is very dependent though upon how local hospitals and clinics write and structure there clinic letters. Again, there are issues with this as the letter maybe from the Rheumatology department but the patient may not have been seen by Rheumatology at all, in could just be a letter for information.
Because of the above reasons and the risk of incorrect coding, Ardens do not therefore offer any pre-set OCR scanning rules.
2. Creating Scanning Rules
Scanning rules cannot be shared across an organisational group and are not provided by Ardens because of the above coding issues. If you wish to setup your own scanning rule, please follow the instructions below.
2.1 Creating Letter Type Rules
Go to 'Setup >Referrals & letters >Scanning Rules >New
Give it a sensible name and select 'letter type' as the category, be specific with your 'Sub-category'. Once again it is better to have multiple key phrases that are all required to be picked up by the scanning. Pick your letter type from the pick list.
Once you have created a scanning rule it is sensible to try it out. If you don't get the results that you expected you can see the text the OCR software has detected by right clicking on the document in the Scanning Document Update (as below) and select 'Show OCR Text'. This will then open in a Word document what the OCR software has found which may give you a clue how to resolve a rule that isn't working.
Letter types and read codes should now be found by the scanning rules. You can see in the example below that only two of the four re-codes offered are ticked. On this window, if you are not sure why a code has been offered if you click on it you will see in the letter on the right highlighted in blue showing what the scanning OCR software has found. In this example you can see blood pressure management was mentioned in the letter but no blood pressure readings, the words blood pressure is only one of multiple key phrases set on this particular scanning rule therefore SystmOne wont automatically select it by ticking it.
2.2 Creating Coding Rules
Go to 'Setup >Referrals & letters >Scanning Rules >New
In this example for retinal screening you will see that two phrases have been selected from the document and added as 'Key Phrases'. These are unique phrases particular to that document. Sometimes it isn't enough to have just one phrase and to be more accurate you can setup multiple key phrases and tick 'Require all phrases'.
Give it a sensible name and if you setup 'coding' or 'letter type' as categories be specific with your 'Sub-category' it will help you to find rules at a later date when you have many rules.
In this example the scanning rule is looking for any of the key phrases and because there are three read codes listed the person who is scanning will be prompted to select which ever code is most appropriate.
