Written by: Center for Care Innovations

Sometimes a relatively small technical adaptation can make a big difference to a clinic’s workflow, efficiency, and environmental impact — not to mention employee satisfaction and the bottom line.

Take the humble document scanner. Since its invention in 1957, and beginning with its widespread adaptation in the 1990s, document scanners have become the ubiquitous workhorse of modern offices, one of the digital devices designed to improve efficiency and accuracy and reduce labor and paperwork. Since 2009, when medical providers began a dramatic shift towards electronic health records, scanners have become a staple at health clinics, including their front offices.

But not those of the Monterey County Health Department Clinics. The clinics—now totaling 10 locations in Salinas, Seaside, and Marina—have used scanners in their billing department since 2010, when the healthcare providers converted from paper-based records to electronic health records. And they piloted using front office scanners around 2012, but that program was abandoned after about a year as the equipment proved too cumbersome and intrusive. “We just defaulted to old school paper gathering,” says Berenice Perez, a department information systems specialist at the Alisal Health Center in Salinas, home to farmworker families in the country’s “Salad Bowl,” so-called for its fertile soil and agricultural abundance from leafy greens to luscious berries.

For 25 years, Monterey County Department Health Clinics (MCDHC) have provided health services to a diverse demographic, including residents without health insurance, seniors, and immigrants. The clinics, which in pre-COVID times received 600-plus visits a day, provide primary, pediatric, internal medicine, and specialty care. MCDHC provides health care to the county’s most vulnerable populations—50,000 individuals who would otherwise fall through the cracks in the healthcare system. The ten-clinic healthcare provider serves a large Spanish-speaking client base, in addition to patients whose preferred language of communication is Vietnamese, Korean, Tagalog, and Russian.

Struggling with a paperwork backlog

These safety net clinics have a track record for smartly integrating new technology. (See our case study on its successful text messaging program.) Despite these successes, however, Monterey County Health Department Clinics had long struggled with a paperwork backlog that delayed key materials—such as consent forms and financial information—making their way from the front office care crew to the medical records department and back office billing team.

Billing staff frequently expressed frustration about such delays, which can prevent prompt reimbursement, recalls Perez. And, for their part, front office staff expressed frustration about the tedious, time-consuming task of making copies, attaching bar codes, and dropping paperwork to the medical record department for scanning, explains Perez. In addition to streamlining workflows, the clinics also wanted to reduce paper waste and eliminate a backlog of items that needed scanning.

And, given scanners widespread use in the healthcare field, the clinics’ IT team knew they did not need to reinvent the wheel.

Perez says she gathered a lot of useful information on integrating new technology into a healthcare system from previous CCI technology solutions case studies and participating in Tech Hub calls. “It made it much easier to use what we learned from others, it helped us get organized, ask the right questions, and move the implementation smoothly,” she says. As part of its Technology Hub program, CCI–with support from the California Health Care Foundation–partners with safety net clinics to vet, pilot, evaluate, and integrate innovative digital health solutions designed to benefit underserved communities.

“It made it much easier to use what we learned from others, it helped us get organized, ask the right questions, and move the implementation smoothly,” she says.