The short answer

To scan a document into your EMR from a ChromeOS, deploy the Citrix Workspace app for ChromeOS on the endpoint and connect a Works With Chromebook certified Ricoh scanner. ChromeOS auto-detects the scanner and downloads its SANE driver, and Citrix redirects the scan to your existing TWAIN application. Your legacy scanning software, EMR integration, and user workflow stay exactly as they are.

The guidance below comes from a live webinar hosted by Ricoh with Google, Citrix, and Hackensack Meridian Health. This article covers what was discussed; the full webinar, including the customer deployment story, is available at the end.

Definition: what is the SANE driver for ChromeOS?

SANE is the scanner interface ChromeOS uses, where Windows applications have long used TWAIN. Ricoh built a new SANE driver that includes PaperStream IP image processing and worked with Google to embed it directly into ChromeOS as a driver plugin. There is no package to build, stage, or push to each endpoint: connect the scanner, launch the app, and ChromeOS detects the connection and pulls the driver down on its own.

Citrix closes the remaining gap. Applications looking for a TWAIN data source find one — a Citrix data source — and the translation from SANE to TWAIN happens on the back end. The application never knows anything changed, which means no back-end change control and no rewrite of an EMR or document management integration.

Why healthcare endpoints are hard to modernize

When webinar attendees were asked which IT challenge most impacts their healthcare operations or patient outcomes, the responses spread across every option: 32% named IT hardware cost, 29% security issues, 21% system management, and 13% expensive software licensing.

Underneath all four sits change management. Healthcare runs 24/7, 365 days a year, which makes any change that touches a clinical workflow expensive to attempt. The conventional Windows model made this worse for scanning specifically: a model-specific application package had to reach the right endpoint, and because these scanners stay in service for years, organizations routinely ended up with leftover software from a scanner that had already been replaced.

Scanning itself remains essential even in largely digital environments. As noted during the session, if a ransomware event takes systems down, the ability to scan paper forms back into the system is a business continuity capability, not a legacy habit.

How the solution works end to end

1. Deploy the endpoint. Citrix Workspace app for ChromeOS runs on the ChromeOS device — new hardware, or existing hardware converted with ChromeOS Flex.
2. Connect the scanner. ChromeOS auto-detects a supported Ricoh scanner and downloads the SANE driver automatically.
3. Capture. PaperStream IP applies size detection, deskew, orientation correction, and thresholding as the pages feed.
4. Redirect. Citrix translates SANE to TWAIN and presents a Citrix data source to the application.
5. Deliver. The image lands in the existing TWAIN scanning application and its EMR or document management workflow, unchanged.

The functionality ships in Citrix Virtual Apps and Desktops 2503 as a default setting, with no special policy required.

What PaperStream IP handles automatically

Certified scanners

Four models carry Works With Chromebook certification: the fi-8040, the fi-8170, the fi-7160, and the fi-800R — the last of which handles cards, passports, and documents and fits easily on a medical cart.

Image quality matters beyond legibility. As scanning workflows begin feeding artificial intelligence, image quality drives recognition accuracy, which drives the quality of the AI result.

What this looked like at Hackensack Meridian Health

A 2019 cyber event affected a large number of Hackensack Meridian Health's Windows endpoints and led to a leadership decision to move to ChromeOS for better security. The scale: 18 hospitals, more than 500 patient care locations, and 45,000 computing endpoints.

The team began by cataloging use cases and peripherals to separate what could migrate immediately from what would need engineering help. The two easiest use cases turned out to be the largest — single-user office workers, and shared clinical devices used to access the EMR — together about two-thirds of the environment, or roughly 30,000 devices. That migration is complete; the organization now runs over 30,000 ChromeOS endpoints.

The harder workflows depended on specific USB peripherals: e-consent, dictation, and scanning and registration. For those, the team built a test lab covering every configuration of their Windows and ChromeOS devices, documented their real workflows for the vendors, and ran hundreds to thousands of scanning tests into their EMR, feeding bugs and logs back through early releases.

The scanning solution was finalized earlier this year. A production pilot has run for two months at one facility without significant operational issues, and the organization is now scheduling the replacement of another 4,000 Windows machines with ChromeOS in scanning and registration over the following six months.

On user reaction: they didn't have to change anything. ChromeOS devices were slid in and the workflow remained substantially unchanged from the clinician's perspective. The most useful feedback was about recovery — when something does go wrong anywhere in the stack, recovery is dramatically faster, with no driver configuration to untangle, and a rebooted device is back where the user left it within a minute.