Walk through the modern new document depository in Medley, and one thing becomes clear: Paper can be a hard habit to break.
Opened 16 months ago, the facility owned by an Atlanta company employs a team dedicated to digitizing records and storing them in secure computerized archives that can scan millions of files in a moment. But that part of the business occupies a tiny portion of Recall’s Medley operation, which remains dominated by old-fashioned paperwork.
The warehouse now contains roughly 10 million files and 500 million pieces of paper. They fill 90 rows of shelves 30 feet tall, running the length of two football fields. The warehouse purchased 193,000 labels to set up the shelving system.
“Everyone wants to push digital,’’ said Ruben Garcia, Recall’s top Florida executive. “I’ve been in the business 15 years. Paper doesn’t go away.”
Documents — and the digitizing of them — have been big news in recent years. President Barack Obama’s stimulus program included $30 billion for medical offices to convert their records to digital data. America’s foreclosure crisis took a pause in 2011 thanks to disputes over questionable paperwork by banks as they sought to repossess homes — the so-called “robo-signing” scandal.
And as environmentalists push a “green” approach to corporate paperwork, Apple, Google and countless tech start-ups see massive profits in off-site digital storage — the so-called “cloud.”
The Recall facility off 115th Avenue stands at the crossroads of this evolution, offering a full menu of digital options: high-speed “Optical Character Recognition” scanning, a patented web-based inventory-management tool for recalling the computerized records, and servers scattered across the country designed to protect against calamities like fire, hurricanes and even terrorist attacks.
Before entering the facility, Recall employees must press the top of their hands to a scanner that identifies them by the vein patterns in their upper wrists. Then they walk past another secure room with glass walls, where four employees unload files from battered cardboard boxes and scan them one-by-one into a digital archive.
The warehouse stands ready to destroy paper records that clients no longer want to keep. But parting with paper can be hard to do..
In the loading bay, a red sign reading “DESTROY” hangs over a cluster of about 100 boxes. Those documents will be shredded. Another 2,000 cardboard boxes stretch from near the discard area to the far end of the warehouse, stacked five or six high.
“This all came in Friday,’’ Garcia explained on a recent Monday morning. “We need to put it up today.”
That’s roughly a 20-to-1 ratio of new paper records to destroyed ones. “It keeps coming,’’ said Garcia, who got his start climbing document racks as a temporary hire in another warehouse in the 1990s. “Who is going to stop it?”
Recall runs 300 document warehouses across the country. Medical records occupy most of the shelves in Medley, with banking records a distance second, Garcia said.
A January study by the Bipartisan Policy Center found that 5 percent of the eligible doctors received federal money for digitizing records, though about a third had registered for the incentive program. Hospitals seem to be farther along the digital evolution: a third had received the federal money, and two-thirds had applied for it.
Healthcare Data Solutions, a Miami company, estimates it has converted more than 1 million pages of medical records into digital files for doctors throughout the region. The $30 billion stimulus program gave a big boost to the firm, said CEO Chad Novitski, prompting medical offices to invest in a process bound to save money over the long-term.
“We’ve seen chart rooms that are 250 or 300 square feet,’’ Novitski said. “They can take that space and reallocate it to another examination room or use it for other procedures. It actually goes from a cost center — a money pit — to a revenue-generating space.”
Going digital and maintaining paper records aren’t mutually exclusive — just expensive. Garcia estimated turning a box of 200 documents into a digital record will cost $100. Storing the box costs about $15 a year. Why do both?
Digitizing records can be slow and expensive, so some facilities simply haven’t caught up with what technology offers. Many providers opt to start fresh with digital records with new patients, and don’t bother converting old files. Florida law requires providers to maintain records for seven years, so storage is a must.
But there also is the anxiety factor for people of a certain age adjusting to the digital age. Dr. George Muñoz, a 58-year-old rheumatologist in Aventura, converted his practice to all-digital records in 2003. But he waited a full seven years before destroying his old paper files, even though he was legally free to shred them once they were in the digital archives.
“It’s a process — it’s both a practical process, and an emotional process,’’ said Muñoz, owner of the Arthritis and Osteoporosis Treatment and Research Center in Aventura. “A physician who is starting out who is 28 or 30 is going to be a lot more comfortable with all sorts of software. In college and medical school, I didn’t use it.”
In Medley, Garcia also cited digital anxiety in explaining the crush of paper inside the Recall facility. He said some companies require the CFO’s signature before destroying records, and executives often hesitate to take such a final step even if digital duplicates exist.
“They’ve been doing it for so many years,’’ Garcia said of shipping paper files off to warehouses like his. “It’s hard for someone to make that decision.”