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Getting From Here to There

April 17, 2007
by Brad Arrington
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A sound roadmap can help executives migrate from papers to pixels.

Brad ArringtonHealthcare institutions of all sizes, locations and types — hospitals, long-term care facilities and small clinical offices — are reaping the benefits of their new electronic records systems, including increased efficiencies, reduced costs, HIPAA compliance and better patient care.

If you're one of the thousands of healthcare organizations on the verge of making the transition from paper to pixel, there are many elements to consider. Many healthcare institutions generate an overwhelming amount of data, including patient records, medical billing statements, insurance claims, reports, enrollment forms, handwritten notes, prescriptions and medical images. Thus, the first step in transitioning these items to electronic form is to assess the fundamental benefits you expect to receive and develop a plan to achieve them.

For some organizations, the primary driver of an electronic records system is HIPAA compliance, as relates to the privacy and security rules of the Administrative Simplification section. More specifically, healthcare organizations are looking to electronic record systems to help add security, audit trails, and authentication to their patient-related documents and medical information to aid compliance with those privacy and security mandates.

For others, the need to build provisions that will streamline and automate the billing process becomes a necessity. And of course, the ability to provide faster, streamlined clinical access to patient data, thereby improving patient care is often a primary driver for the transition.

With your priorities in mind, you will be better able to decide which projects should receive immediate action and funding.

The next step is to consider the workflow of your institution. Hospitals, long-term care providers and clinical offices all have different document workflows, creating entirely different digital document management needs. The size of your institution helps guide your selection of the appropriate technology, based on scalability.

Many healthcare organizations utilize a phased rollout of their electronic records systems, on a department-by-department basis, as each department will have unique workflows. Large institutions in particular have found that converting one department at a time can be a much more manageable and seamless endeavor than trying to embark on the entire facility simultaneously. This process will also enable you to be fully operational when bringing systems online for use with admitted patients.

Building a bridge

You will probably never get away from paper entirely. Some information, including transferred records, proof of insurance, and authorizations will continue to enter a hospital in print form for the foreseeable future. The trick is to quickly capture the paper-based information electronically so that it can be stored and managed efficiently.

Healthcare institutions of all sizes and types are finding that scanners are the ideal bridge between paper and electronic records. The price-performance and ease-of-use of modern scanners simplifies one of the more cumbersome aspects of the conversion — the transition of print records to pixels.

Healthcare organizations evaluating dedicated scanners are advised to choose one with a variety of image options, including the ability to process insurance cards, driver's licenses and patient signatures. Also important is the ability to process HIPAA acknowledgements — documents that healthcare providers present to patients describing their privacy practices and policies.

Whether signed by the patient acknowledging receipt of the information or signed by the provider indicating that the information was offered to the patient but that the patient refused to sign the document, the forms must then be retained by the provider according to HIPAA's retention rules. These HIPAA acknowledgement forms are also frequently used to capture other data and consents, such as whom the provider can speak to regarding the patient's treatment, what phone numbers to call, and if messages can be left on answering machines at those numbers.

It is also advised that decision-makers consider scanners with a staple detection feature both to protect the hardware and to maintain higher productivity levels. High-volume, batch-scanning jobs can take many more hours than necessary because forgotten or missed staples shut down the system or damaged the original documents or the scanner.

Bar coding

Formerly an extremely labor-intensive task, a significant number of institutions are incorporating bar codes that can — when combined with a software solution — route forms and other paperwork to their destinations. Using optical character recognition (OCR) software in conjunction with bar codes, printed words are converted into digital words, thereby making the data more useful in computer systems for quickly retrieving patient information and making it accessible to those who need it for patient care or business administration.

For example, each admitted patient is assigned an individual ID upon arrival, which can be expressed as a bar code. An adhesive bar code sticker is affixed to a designated area on all documents related to that patient. As those documents are later digitally scanned, the individual bar codes are recognized and the patient's forms are electronically routed to the proper filing and billing departments.

What about the ROI?

Medical records are one of the largest costs of healthcare administration. As the cost of digital storage decreases and the price of physical real estate increases, electronic archiving will help deliver immediate return on investment (ROI) by freeing up space.