One of Deborah Kohn's recent consulting assignments epitomizes the most pressing issue concerning healthcare document imaging and management systems.
A large teaching hospital asked Kohn, principal with Dak Systems Consulting, San Mateo, Calif., to help it pare down its document management systems from six to one. "They bought solutions departmentally and didn't start off with a strategy, but as they embrace document management, they see the need for an enterprise-wide strategic perspective," Kohn says.
While there have been evolutionary improvements in optical character recognition, integration with enterprise resource planning (ERP) applications and new workflow features, perhaps the biggest change regarding document management has been in healthcare executives' perceptions.
"What's new is that customers are thinking about how to tie it all together in one enterprise approach," says Brian Patsy president and CEO of Streamline Health Solutions Inc., Cincinnati. "You might use Siemens in billing and Cerner in clinical, but you want one document management system to work with all of it," he adds.
Although document management is playing an increasingly important role in clinical settings, its value in back-office operations has been clear for several years: It can eliminate obstacles caused by accessing, filing and faxing tons of paper. For instance, a healthcare system might have 20 locations using different financial applications and handling invoices separately. Document imaging allows all of the invoices to be tracked from one central location.
Originally, Kohn says, ERP vendors developed their own document management modules, but customers found those to be the weak link in their systems because it wasn't their forte. The ERP vendors were forced to partner with document management companies, many of which have products designed to match the healthcare workflow.
"This eliminates all the printing, carrying and faxing to insurers, hoping they get it"
For instance, Streamline Health's Coding Workflow module can prioritize and push work to coders on or off-site, Patsy says. Another Streamline module can change how a hospital deals with requests for releases of information. Instead of pulling, copying and sending paper forms, hospitals can give approved third-party requestors online access to scanned documents.
Beth Fox likes the enhancements to imaging systems, such as improved scanning capability and the ability to attach notes or highlight an item in a document. But, she says it's the workflow features that make the investment in Perceptive Software Inc.'s ImageNow system valuable for Genesis Health System's human resources and accounts payable groups.
Fox, senior business analyst in information technology for Davenport, Iowa-based Genesis, says when a Genesis employee fills out an application for a new health insurance plan, ImageNow can route that form to the proper work queue in human resources and send it to the insurer using the secure e-mail system. "This eliminates all the printing, carrying and faxing to insurers, hoping they get it," Fox says. On top of that, then there is the paper copy storage.
David Lintz, sales director for Perceptive Software (Shawnee, Kan.), says Web access and acceptance of digital signatures are some of the new features. Another development, he says, is enhanced configuration. If an organization merges with another hospital, the accounts payable manager can add that hospital to the document management work flow without the costly and time-consuming process of getting IT or the vendor to help. "That's a big change from four or five years ago," Lintz says.
As hospitals and health systems begin to see document management systems as more than quick solutions to painfully slow departmental processes, they still must cope with multiple legacy systems and adopt a unified approach.
Steve Tobin, a healthcare information technology research analyst for Frost & Sullivan, a Palo Alto, Calif., global consulting firm, says it often comes down to who's purchasing the system and how it's being deployed. "If the CIO is purchasing everything on an enterprise basis, that has a huge effect on how well integrated the solutions are."
David Raths is a contributing writer based in Philadelphia.