August 18th, 2011
Paperless and Purposeful
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- Hobey Echlin
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Northern Michigan’s Muskegon County Community Mental Health Services (MCCMHS) implemented its Avatar practice management system back in 2003 to automate electronic health records (EHR). Although the Avatar system had a document imaging module that could digitize the patient histories, lab reports and documents that would always require doctor and patient signatures, several of the county’s non-clinical departments—including HR and Finance—were also contending with overflowing file cabinets and rising storage and handling costs.
Rather than implementing separate solutions for the clinical and non-clinical sides of the house, MCCMHS officials recognized that enterprise content management (ECM) would be the most efficient and cost-effective way to answer its document-related challenges.
ECM Supports EHR
MCCMHS’ search brought the organization to Jeff Nelson of Bolt Document Management, a Laserfiche reseller based in Elkhart, IN. “Initially the objective was for the Laserfiche system to act as a bridge between legacy information and future digital content,” Nelson remembers. “At the same time, implementation of Laserfiche allowed MCCMHS to address areas where working with paper was simply inefficient.”
In 2003 Pat Latimer, the former project manager, led the effort to implement a 118-user Laserfiche system in the agency’s centralized scanning bureau. Staff began migrating and adding patient histories and signature forms for use in conjunction with patient records, which were being generated from Avatar by Crystal Reports and then scanned into Laserfiche.
Dave McElfish, Director of Technology, says that although the original idea was for clinical staff to simultaneously access patient information from Laserfiche and the practice management system, “the reality was, even though we purchased Avatar with the idea of integrating it with Laserfiche, when we explored it further, it was going to be cost prohibitive on the Avatar side of the project.”
In the meantime, Laserfiche deployment had been extended to MCCMHS’s HR and finance departments, which likewise began migrating backfiles to ease storage costs and give staff the ability to retrieve information on command. System use has since grown to the point that the Laserfiche repository now houses over 800,000 documents.
More recently, McElfish says clinical staff have once again expressed interest in being able to access to information from Avatar and Laserfiche at the same time, even going so far as to revisit the idea of using Avatar’s add-on imaging module. “After much consideration, our clinical staff felt that would put us no further ahead in our goal for a true, single database to model our EHR from,” McElfish says. “The reality is that Laserfiche is designed to manage unstructured data, so in that respect it’s closer to that single database because we are able to include unstructured data, such as lab reports and doctor’s notes.”
Going Mobile
McElfish adds that MCCMHS has been speaking with Nelson and Bolt to explore ways to simplify and streamline how data is entered and accessed between Avatar and Laserfiche. McElfish says staff is especially encouraged by the release of Laserfiche Mobile, which could be used to grant clinical staff in the field comprehensive access to patient data via Web Access. He says several options are being considered, including taking advantage of the Laserfiche Q3 Promotion to upgrade the agency’s current system to Laserfiche Avante and receive Web Access (which is required to use the Laserfiche Mobile app) for free.
“We know that allowing staff to access information from Laserfiche on iPads in the field would be a huge boost in our productivity,” says McElfish.
An Avante upgrade would provide lot of potential for automation as well. McElfish notes that Nelson and Bolt have recently been discussing implementing distributed capture processes for paperless faxes and digital signatures via virtual rubberstamps, all routed by Workflow through the agency’s central scanning office for oversight.
Looking ahead, he is understandably pragmatic. “Although Laserfiche is not our primary practice management system, it represents a critical and necessary content management tool that complements Avatar.
“We’ll continue to have paper and documents that need signatures, and the simplest, most cost-effective way to incorporate them into our EMR strategy is to use Laserfiche. There are digital signature solutions and other options, but Laserfiche lets us use what we already have,” McElfish adds. “Our goal was and is to have a single database to model our EHR from, and Laserfiche has provided us with the portability and flexibility to move forward with that goal from a solid foundation.”