The centralized health information management department at the University of Pittsburgh Medical Center is a very busy place-as in 24/7/365 busy. There, some 75 staff members are devoted to one primary function-keeping the patient records from UPMC's 20-hospital empire up to date.

And while many of UPMC's hospitals are highly automated (seven are at HIMSS Analytics Stage 6; one is at Stage 7, the highest rank), UPMC must contend with an array of information residing on paper. Those documents must be scanned by the HIM staff and then linked to the core EHR. "We scan about 2 million pages a month," says Nancy Soso, executive director of HIM. "It's an enormous orchestration task."

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