Scanned is good enough for me and if an entire NHS Trust is using scanned documents it would be absurd to refuse to accept them. As long as patient identifiers are clear so you know what you are looking at, I doubt anyone would object to this. More than 10 years ago I was monitoring sites in Germany using electronic patient records and always used the scanned documents on the system as source. It would have been completely impractical to do anything else.

I think the key here is that the data is highly unlikely to have been manipulated during scanning. The worst that might happen is that a scanned document ends up in the wrong patients file. I think that is complete different to accepting an excel spreadsheet of data as source when in fact it has been entered onto the spreadsheet from an original paper source.

Hope that is helpful,

CTU