February 8, 2011

A couple weeks ago, we talked about some of the hurdles that the healthcare industry was trying to jump as it moved to electronic health records (EHRs), in our blog about “Managing Documents in HER Systems .”  But as more and more hospitals and medical offices move to EHR systems, they need to consider more than just how they’ll get their paper documents into the electronic records.

One major decision is in which format these electronic records should be saved.  There are many formats in use today, but perhaps the best one for ensuring accessibility of patient records for the entire lifetime of the patient is PDF/A.

Most people are familiar with PDF – one of the most popular formats in use today for being able to read documents with various components, such as text, pictures, graphics and other content.  PDF/A is an update of the PDF standard designed for long-term archiving because it will be able to be accessed and viewed regardless of hardware or software used by offices in the future.

PDF/A can offer the medical industry a number of benefits:

• Available for the life of the patient – The standardization of PDF/A guarantees that documents saved in this format can be accessed long into the future, regardless of new or enhanced applications that may be developed and adopted.
• Reduced file size – Scanned medical records can be compressed to be 100 times smaller (black and white documents compress up to 10 times smaller) within PDF/A than other outdated and less dependable file formats. This will help minimize storage requirements and costs, while allowing medical offices and hospitals to save digital documents in both color and black-and-white. The smaller file sizes also support ease of access and sharing by email for medical consultations.
• Use of Color – Because of the compression capabilities of PDF/A, medical records don’t have to be scanned in just black and white.  Hospitals and medical offices can scan documents in full color – to show where doctors or nurses have highlighted specific information, or handwritten notes in different color ink.
• Searchability – PDF/A can include hidden text, indexing and metadata. As a result, PDF/A supports OCR and full-text searching in the documents – a feature not incorporated into other formats.
• Digital Signature – The PDF/A format also allows digital signatures, enabling users to electronically sign-off to verify that the electronic document is an accurate representation of the original.
• Vendor independence – Because it is an ISO standard platform, users of PDF/A do not need to purchase proprietary software or applications to share or view PDF/A-based documents.  With PDF/A, documents can be rendered reliably and consistently without regard to the hardware or software platform.

If you’re interested in more information about implementing EHRs in PDF/A format, please e-mail me at m.mckinney(at)luratech.com.  

January 24, 2011

Over the last several months, there’s been a growing buzz about the use of a document archiving format by the federal government, including the U.S Federal Court system.  That format – called PDF/A – is designed to improve the ability to archive documents. While most of European governments have mandated its use, the U.S. government has not yet taken such a specific step.

Instead, various U.S. government agencies and groups are beginning to give recommendations that support use of PDF/A for documents, because it is an open, non-proprietary standard that will guarantee long-term accessibility and ensure the security and validity of documents. For example, requirements from the National Archive and Records Administration make a case for agencies to transition to PDF/A format for all documents that must be archived.

Some agencies are considering and recommending PDF/A. One is the Nuclear Regulatory Agency, which now accepts filings in PDF/A from the companies it regulates.  The nuclear companies have realized that they can adopt PDF/A, and gain the benefits of the format for their own electronic archiving needs, while still supporting the necessary regulatory guidelines.

Now momentum is growing for use of PDF/A in the U.S. Federal Court system. According to Public Access to Court Electronic Records – or PACER – the judiciary is planning to change the standard in use for filing documents in the Case Management and Electronic Case Filing (CM/ECF) system to PDF/A.  Courts currently accept PDF/A documents, but there has not been a specific date set that mandates when all new documents must be filed in PDF/A.

Stay tuned to the LuraTech blog, as we’ll be following the developments and deadlines the court system sets for implementing PDF/A across the board.  Also, in future blogs, we’ll dive into the nuances of how to implement PDF/A within your organization, particularly when dealing with born digital documents and the variety of content that can be included in a PDF/A file.

January 21, 2011

Electronic health record systems – or EHR as they’re commonly known – are a hot topic in hospitals and doctors’ offices around the country these days.  Many of these organizations are beginning to establish meaningful EHR systems within their practices, capitalizing on federal incentives in the process. But still those who have implemented complete EHR systems are few and far between.  Consider the latest stats from the medical industry trade association HIMSS: Less than half of 1 percent of all U.S. hospitals have a complete EHR system.

So, what’s the hold up?   What’s holding hospitals and medical practices from implementing something that seems so straight forward and beneficial to all involved?

Much of the problem may stem from the complexities involved in getting reams of paper documents from historical patient records into the EHR system.  As they are designed, EHR systems are primarily databases – not document management systems – which make it a challenge for those operating them to input paper or scanned documents and ensure the right data is being captured.

Typically medical office or hospital administrative staff doesn’t have the level of document management expertise that may be needed to ensure proper entry of scanned paper records into the EHR system. They’ll need to make sure that the patient for each document can be easily identified, that color capture is done so that they can read hand-written notes on the scanned document, and they’ll need to make sure that documents are adequately compressed so the electronic files don’t burden their digital storage space and are easy to transfer via email for collaboration purposes.

What can make the process easier for the medical staff is finding a partner with document management expertise and establishing a process that will meet their unique needs for capturing paper-based and born digital medical records for the EHR system.  This process can be the development of what’s called a “production environment,” much like we’re doing here at LuraTech with DocYard, that helps simplify the workflow and ensures that all types of paper and electronic records can be easily integrated into an EHR system.  DocYard can also include a module for conversion to PDF/A that will ensure long-term accessibility and preservation of documents.

If you’re interested in learning about how to find an effective document management solution, and the simple steps it takes to build a customized production environment for the healthcare industry, please give me a call or email me at m.mckinney(at)luratech.com.  I’d also encourage you to take a look at an article I wrote last October for ADVANCE for Health Information Professionals magazine called “The Prescription for EHRs: Consider These Five Tips for Integrating Paper and Digital Documents into the EHR”.  The article offers some helpful hints that may be useful for medical professionals embarking on the launch of an EHR system.

November 23, 2010

It seems that PDF/A – a standard that’s in common and widespread use throughout Europe – is starting to make waves on U.S. shores. At least, we noticed a lot more buzz about this standard at the recent ARMA 2010 – the 55th Annual Conference & EXPO hosted by ARMA International, this year in San Francisco.

We were at ARMA earlier this month, as part of the PDF/A Competence Center booth, and there we had the chance to talk to record managers and other attendees. Compared to the ARMA event in 2009,  we found that more of the people we talked to knew about PDF/A in general, and were interested in learning more about how used of this format could benefit them.

The attendees interested in PDF/A, too, were a varied bunch – from those working for small city governments to individuals who managed substantial archives for large energy companies. They visited the PDF/A Competence Center booth to discover how PDF/A will be vital to implement in the future of their digital records, and what they need to do to prepare for it.

We were excited to see the growing interest for PDF/A, because we believe that the standard offers a tremendous amount of benefits for organizations of any size that are digitizing their records and maintaining these files for many years to come.

If you missed ARMA and the chance to visit with us at the PDF/A Competence Center’s booth and you have questions about why your organization may want to adopt PDF/A for its archives, please e-mail me at m.mckinney(at)luratech.com and I’m happy to answer your questions.  I can also tell you more about how a number of federal, state and local government agencies have begun to adopt the PDF/A standard, and what’s the best way to optimize your processes for PDF/A.

November 17, 2010

Did you know that PDF/A is being updated? Let us tell you a bit more about the changes taking place, and how you could benefit from this new version of the standard. 

The new version is called PDF/A-2.  Technical work on it was completed this past summer and the standard is set to be published in early 2011.

PDF/A-2 is an internationally approved ISO standard (ISO 19005-2) based on Adobe PDF 1.7 as defined in ISO 32000-1. It extends the functionality of PDF/A-1 without compromising the goal of long term reproducibility. 

Some PDF/A-2 features that may be of interest include:

• JPEG2000 – Higher compression ratios with better image quality is delivered with JPEG2000 compression technology when working with digital archival images and scanned documents.  For example, JPEG2000 supports lossless compression (or visually lossless), which can prove important for higher-end archival images, such as maps, art or historic documents.  Additionally, JPEG2000 can be applied to color layers of scanned documents optimized with mixed raster content (MRC) compression.  These attributes enable it to achieve greater compression with higher image quality for color and grayscale scanned documents. 
• Layers / Optional Content – PDF/A-2 will allow switching between two or more versions of the same content within one PDF document. This feature is particularly useful for multilingual documents where different languages can be displayed, for example toggling between English and Spanish.  It also can be used within construction industries, for hiding or displaying specific aspects of detailed design drawings.
• Transparency – PDF/A -2 will support transparent objects. Transparency can affect images, graphics and text.  Transparent objects are not 100 percent opaque; instead content behind these objects can be seen providing interesting effects, like highlighting and shading of select content.
• OpenType Fonts – Because of their versatility and comprehensive Unicode support, OpenType fonts are more frequently used today than ever before. With PDF/A-2, OpenType fonts can be embedded.
• Collections – Also known as portfolios in Acrobat, collections refers to merging several documents into one PDF container, such as groups of e-mails or e-mail attachments.  Each collection of PDFs can still be identified individually within the PDF container.
• Conformance Levels – As with PDF/A-1, PDF/A-2 defines conformance levels targeting different audiences. For example, PDF/A-1a and -2a require creators to manually tag documents, in most cases, to maintain the semantic reading order and meaning of the content.  This allows PDF/A content to be displayed accurately on smaller display devices or read aloud with audible readers.  This tagging is not required in PDF/A-1b and-2b, which therefore is more widely used since maintaining only the visual static representation is sufficient for many users. With PDF/A-2, there is a new level of compliance, PDF/A-2u.  This new level leverages the benefits of Unicode fonts without needing to tag each Unicode character’s corresponding glyph.

So now what?

If you or your organization is using PDF/A-1, you don’t have to migrate to PDF/A-2 since the earlier version will continue to be a valid standard and compatibility is ensured. However, if the new functions we talked about above could be a benefit to your organization or a specific project, it may be a good idea to switch to PDF/A-2, irrespective of the other tools you’re using.

October 19, 1010

If you’re a scan service provider, you know that the business these days is defined by stiff competition and increasingly slimmer margins.  A fraction of a cent can mean the difference in winning a big job and being a perpetual runner-up.  That fraction of a cent also could be the difference between making money on a project and barely making ends meet.

The eternal question is:  How can I win in a competitive bidding war and still make a profit?

To answer that question, you need to be able to glean insight into the processes you’ll be using for a job, the efficiency of the people you employ and the technical steps required. But doing so can be very difficult for scan service providers that use disparate systems with no centralized management capabilities, and often find themselves dealing with errors or ineffective processes once that new job begins.

With a centrally managed platform that can control and monitor workflows, our DocYard solution can provide the management data scan service providers need to accurately estimate their internal costs for processing jobs, and what components will be needed to successfully do so.  And once a job has been won, DocYard can help you quickly build conversion workflows, improve efficiency by minimizing errors, and reduce processing costs.

With more and better data as a result of using DocYard, you can gain a competitive edge in the scan service market.

October 10, 2010

If you’re a company that has to manage millions of pages of scanned paper and digital documents, you probably always have an uneasy feeling about whether your document conversion process is running as smoothly as it could.

For most companies, there hasn’t been a real, practical way to make sure that the automated processes are running as smoothly as possible without errors, nor can you track your employees’ progress to ensure they are being efficient or need more training. The reason, the various pieces in the conversion process were disparate or too complex, resulting in a lack of oversight and control.  Therefore, any step in the process could be the weakest link that diminishes your already-slim margins or introduces time-consuming mistakes into the conversion job.

With our DocYard platform, we’re hoping to give scan service providers and other companies dealing with massive amounts of documents the muscle to overcome those weak links.  DocYard is a production level document conversion environment that can give you a view into the process. And through its centralized management capabilities, lets you have a clear picture of where your workflow could use improvement. 

Question:
LuraTech's new DocYard product is an integration platform - how does
my scan service bureau benefit from such a product?

Answer:
DocYard focuses on production-level document conversion
workflows. And this platform really focuses on integration - you
can keep existing tools and integrate them into DocYard in the shape
of DocYard Modules. In particular, this means that you do not have to
unleash a huge migration project, plan an enterprise-wide rollout
top-down and then turn your whole organization inside out.

Instead you can start small, implementing one workflow or even a part
of one workflow and then expand over time in a stepwise
approach. Still, you immediately benefit from DocYard's unified
management and reporting and its parallel processing support. Plus
you can avoid unecessary manual or script-based copying of files
- the DocYard infrastructure moves the data around for you.

Finally, DocYard offers menas of integrating manual processes with
automated ones. This lets you seamlessly combine e.g. manual indexing
or QC tasks with fully automated processes, such as compression or OCR.

Question:
I have been told that there is a new version of the PDF/A standard coming soon. What does this mean for me?  

Answer:
The first important message is that the new part PDF/A-2 will not substitute or ‘fix’ the current one. PDF/A-1 will remain available as an independent, valid standard. All existing PDF/A-1 documents and those that will be created in future are perfectly well suited for long-term archiving. That said, why do we need a part of the standard then? The PDF format is constantly being enhanced and improved. The current version of PDF/A is based on the PDF specification 1.4. But in the meantime the PDF specification reached version 1.7 and has even been published as an ISO standard itself (ISO 32000-1).  Since PDF 1.4 there were added numbers of new features to the PDF format, and some of these are also useful for long-term archiving. So PDF/A-2 will be based on the new PDF standard. The new features in PDF/A-2 cover document collections, metadata, image formats, transparency, among other things. The most important aspect for LuraTech customers will be the new support for JPEG 2000 in PDF/A-2. Now highly compressed PDF/A documents will be possible with the same great visual quality and small file size as it could so far only be gained for standard PDF output. LuraTech is actively involved in the development of the PDF/A standard. So our customers will always be among the first who can benefit from the new possibilities.

With the increasing spread of PDF/A as the ISO standard for long-term archiving, unfortunately a few misunderstandings have been popularized as well. After nearly four years, some DMS providers still seem intent on “riding out” the PDF wave. But as I see it, the saying applies that “you snooze, you lose!”

Myth #1: TIFF is secured against tampering, PDF and PDF/A are not

This assertion is clearly incorrect. There is no document format which is inherently secured against alteration and compliant with auditing requirements. A TIFF-file can be modified with simple tools just like a PDF/A document or any other format. “Inalterability” of documents can only be achieved using a signature. If files must be archived in compliance with auditing requirements, then a system or process is necessary to ensure protection against changes.

Myth #2: PDF is a standard from one provider, TIFF is a disclosed standard

Yes and no.  TIFF is a de facto industry “standard”, but it has never been standardized by an international standards organization such as ISO or DIN. Both PDF itself (ISO 32000) and PDF/A (ISO 19005) are disclosed ISO standards and are thus not only de facto but also de jure standards.

Myth #3: PDF/A does not support signatures

On the contrary.  PDF/A even permits embedded signatures – including qualified electronic signatures. To do this, the signature provider must simply apply the product in a PDF/A-compliant manner, but there are still some signature providers who have not yet accomplished this with their products.

Myth #4: PDF/A does not support compression

Wrong. PDF/A permits all common compression methods to be used, such as JBIG2, JPEG, etc. The exception is LZW, where at the time of the standardization patents were still in force. For these reasons of time, JPEG2000 was not incorporated in the PDF/A-1 standard, but it will be covered in the new version (PDF/A-2).

Myth #5: PDF/A does not allow OCR for scanned documents

Wrong. OCR is possible in both PDF/A-1b as well as PDF/A-1a, of course. A minor point – perhaps the cause of the confusion - is the exception that this invisible font does not have to be embedded.

Myth #6: PDF/A files are too large due to font embedding

Yes and no.  It is true that fonts (except for OCR) must be embedded. Based on practical experience, this is only a problem in the particular application area for bulk outgoing mail. In this regard, one can apply font reduction and subsetting or pragmatically omit font embedding in a solution tailored to individual company needs. These files are then no longer PDF/A-compliant in a strict sense. However, except for the deliberate exception they retain all the advantages of PDF/A.

Myth #7: PDF/A does not support metadata

On the contrary. XMP particularly facilitates standardized metadata in PDF/A. Metadata can be managed in the surrounding systems as before. An advantage of PDF/A is that these data can also be embedded inseparably in the document.

Myth #8: PDF/A is not supported by DMS systems

Yes and no.  Simply put, an ECM system which can handle PDF can also support PDF/A well. However, (unfortunately) there are still a number of DMS providers wedded to their outmoded TIFF viewers, and that can sometimes be a stumbling block in practice.

Myth #9: PDF/A is only supported by a small group of local German providers

Not at all! It is certainly true that PDF/A was first accepted in German-speaking countries – and that the PDF/A Competence Center originated in Germany. However, in the meantime many countries and industries recommend PDF/A or even require it by statute. Moreover, the PDF/A Competence Center now has over 100 members from about 20 countries!

Myth #10 PDF/A is expensive!

Yes and no.  Of course the deployment of PDF/A tools requires an initial investment. Sometimes the ROI from highly compressed PDF/A files can be calculated within a few months even without an Excel spreadsheet, for example with the Sparkasse savings banks.  But that is perhaps more of an exception. The problem here is assessing the benefits: how much is it worth if unifying formats saves training time and expense as well as viewer license fees. And when fewer migrations are necessary in the future? And last but not least, how do you place a value on a “good” archive thanks to standardized PDF/A files?

Thomas Zellmann is an executive board member of the PDF/A Competence Center