Eastmont Towers, a continuing care retirement community in Lincoln, NE, offers multiple levels of care and a range of services between five buildings on two campuses, which leads to multiple levels of information management challenges. Patients transferring from area hospitals bring electronic and paper medical records with them, creating distribution bottlenecks, logistics and the need for more and more filing cabinets—along with potential compliance and confidentiality concerns.

When Eastmont Towers’ Health Care Administrator Beth Nelsen RN, CHPN, began exploring enterprise content management systems, she soon discovered that “paperless” meant a lot more than just empty file cabinets. “First, we looked at outsourcing to a company that would scan our records onto disks,” remembers Nelsen, “but we were concerned about how we’d be able to use the information once it was digitally stored.”

Not to mention, outsourcing may have gotten rid of the paper—but it created an entirely new set of compliance concerns. Nelsen next began to explore solutions the agency could configure, use and administer in-house.

Quick Fields and Workflow: impressive possibilities

Kathy Gentile of Laserfiche reseller Bishop Business Equipment had worked with Eastmont Towers as an MFP hardware provider. Gentile, Bishop’s Laserfiche Document Management Specialist, invited Records Management staff from the agency to attend a workshop to see Laserfiche in action. Nelsen and her staff saw how Laserfiche Quick Fields could create files on the fly. Once files were created, Workflow could then notify decision makers of pending approvals and track those approvals throughout multiple business processes.

Nelsen was impressed. “We fell in love with Workflow,” she says, citing how it could help the agency:

• Transmit insurance information to the billing office.
• Send lab results to physicians.
• Route medication orders to the pharmacy.

“We’re a multidisciplinary team caring for people across a continuum, so that ability to share documents between departments, reduce paperwork and improve communication would greatly increase efficiency and positively impact patient care,” she adds.

Thus inspired, Nelsen and her team purchased a 30-user Laserfiche Rio pilot system and have spent the first half of this year preparing to roll it out. “Laserfiche Rio made the most sense in terms of meeting our immediate needs. It includes Workflow and the Records Management component to work with our EMR, as well as unlimited servers.

“As we progress, we can just add users to grow the system to meet our future needs and goals. Scalability was a big factor in choosing Laserfiche Rio,” Nelsen explains.

Goodbye filing cabinets, hello automated patient charting

Eastmont Towers’ medical records staff is now halfway through a backlog conversion process that Nelsen anticipates will eliminate at least four filing cabinets by the end of the year. Meanwhile, Nelsen and her staff have been analyzing business processes to guide the upcoming implementation. “After we had our initial training, we sat down to map out what exactly we do with our documents, where they are sent and why,” she says.

Initial focus has been on automating the patient charting process to compile and distribute client records and information as they enter Eastmont Towers from hospitals and other healthcare agencies. “We have several departments we need to route various information to, so we needed a way to streamline and simplify everything coming in and have it work with our EMR so staff could find everything in one place,” explains Nelsen.

Eastmont Towers is currently working with Gentile and Laserfiche consultants Our Support Services to automate and streamline the patient charting process:

• When a patient transfers to Eastmont’s Skilled Nursing facility, Quick Fields generates a chart by recognizing document types from an Excel spreadsheet.
• Quick Fields then populates metadata template fields according to patient name and ID number.
• Quick Fields then builds the folder structure out according to what documents fall under respective chart headings.
• Workflow then notifies the pharmacy and dietician according to document type (nutrition information, etc.).

Prior to implementing Laserfiche, paper files all had chart tab dividers. Every time a document was added to that tab, all documents had to be removed from the file so new information could be filed in the appropriate spot, then documents would be replaced in the folder and the folder refiled. A new feature in Laserfiche 8.2, dynamic fields, greatly simplifies this process, Gentile explains.

“When a ‘tab’ item is selected from the ‘Chart Tab’ field drop down, the ‘Chart Doc Type’ drop down list automatically populates to correspond with the documents that fall under that ‘Chart Tab’ category,” she says. “It’s saved staff a lot of time.”

Immediate practicalities, limitless possibilities

As Nelsen and her team continue to come up with ideas for future process automation, she sees even more potential for Laserfiche. “We wanted something that was would be fairly easy for the end user to learn but that also could streamline our processes better, and Laserfiche has met and exceeded our expectations,” she says.

Next up, she says, are integrations with the agency’s Keane clinical and financial software to support current EMR deployment and refine and automate processes in the Accounting Department. “We see a lot of value in having an ECM system that’s flexible and adaptable enough to meet clinical and non-clinical needs throughout our agency,” Nelsen adds.

“We have a lot of time and resources invested in our existing technology, so it’s important that Laserfiche enables us to build on the progress we’ve already made without interrupting the ways we’re used to working. Plus, the way Rio’s set up, we can keep building with it, which is very appealing to us. Technology’s always changing and Laserfiche is a great tool to adapt along with it.”

Screenshot of Eastmont Towers' table used to populate the template's dynamic fields by chart type.

The drop-down menu where users select Chart Doc Type to automatically populate the list with specific documents, instead of having to manually sort through tab dividers to find the paper file.

Hobey Echlin is a Writer/Researcher in the Laserfiche Marketing department and is active in the Laserfiche Luminaries program.

• Topic(s):
• continuing care,
• dynamic fields,
• Eastmont Towers,
• EMR,
• Healthcare,
• hospital,
• Keane software,
• Laserfiche Workflow,
• Lincoln Nebraska,
• Medical Records,
• nursing,
• Quick Fields,
• retirement community,
• Rio