A little over a year ago, Deaconess Health System in Evansville, Ind., obtained a lofty perch on the digital health I.T. rung-the six-hospital system was named as a HIMSS Stage 7 organization, representing the pinnacle of electronic health record accomplishments. And indeed Deaconess is highly automated, running an Epic suite across both its inpatient and ambulatory areas. Epic even stands as the hospital's "legal record," or its official repository in case of lawsuits. It wasn't always that way though.

Prior to 2009, Deaconess's document management system, Hyland Software's OnBase, which houses scanned images of paper records, served as the official record. Despite its demotion, the OnBase system is not going away anytime soon. "You'd think you would scan less as you move up the HIMSS ladder," says Pam Smith, application analysts. "But we're still scanning a lot."

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