For Southern Virginia Regional Medical Center, a small community hospital that serves a population of 19,500 in Emporia, VA, keeping patient records secure yet accessible once required a balancing act of limited staff time, large paper volumes and never-ending information requests.
The medical center’s health information management (HIM) department maintains all of the medical records produced by the hospital. A group of seven employees led by HIM Director Margaret Bass works to service requests for records from the organization’s business office, quality control department and emergency room. In all, Bass estimates that her group handles about 350,000 pages a year.
“We’re the guardian of records,” explains Bass. “However, the manual processes of retrieving records, pulling the relevant information and copying and distributing the information delayed our response time to information requests.”
These inefficiencies led to major backlogs in the center’s medical billing cycle and impeded the hospital’s ability to meet weekly benchmarks set by its parent company, Community Health Systems (CHS). CHS operates 130 small hospitals around the nation and monitors the outstanding accounts each hospital accrues.
It also enforces a three-day allowance for sending bills to patients from a hospital’s accounts receivable department. If unbilled accounts remain after three days, the hospital enters what Bass calls the “red zone” for AR billing. Due to the HIM department’s inability to quickly access paper patient records, transferring documents to the hospital’s AR department used to take weeks. The hospital frequently reported up to $3 million in unbilled amounts per week to CHS and often reached the unfavorable red zone.
“We Were Sold on the Solution Immediately”
Before implementing Laserfiche, Southern Virginia Regional Medical Center was also paying a third-party company to host its emergency room (ER) records on an outside server. Several days after records were sent to the company for scanning, staff could access and print records from the company’s secure Web portal—at the cost of $1,000 a month.
As Bass sent the company more and more records to be scanned and hosted, she was inundated with growing retrieval and storage bills. The result was a cumbersome, costly process that consumed staff time and restricted the hospital’s bottom line.
When EMI Imaging, a Laserfiche reseller, approached the medical center about replacing its hosted storage server with an in-house Laserfiche Avante enterprise content management (ECM) system, Bass and the hospital’s CFO didn’t need much convincing. “When EMI showed us that you can just scan in the record and it appears immediately to read and manage, we were blown away,” says Bass. “The CFO turned to me on the spot and told me we should do it. We were sold on the solution immediately.”
Bass said the ease-of-use of the Laserfiche product suite convinced her that the system could dramatically reduce the time that her staff spends retrieving and printing records. Plus, at a price tag that eliminated 75% of the department’s scanning and storage costs, Laserfiche offered clear financial appeal on top of its functionality.
Kim Spencer and Adam Wright from EMI helped the organization set up security rights to patient records that ensured document control would stay within the HIM department and business unit, while providing read-only records access to the quality control department. For ER records, Laserfiche provides a streamlined process that reduces bottlenecks and makes the records instantly available to Bass and her colleagues:
- Every weekday morning, staff retrieves paper records from the ER and scans them into the Laserfiche repository.
- Laserfiche Quick Fields, a high-volume capture and processing tool, automatically recognizes the patient account number on a certain record, uses that number to pull other identifying patient information (like date of service and date of birth) from the Master Patient Index and applies the extracted information to the incoming document’s digital record.
- Laserfiche Workflow, a business process management tool, then routes copies of the digital records to the HIM department and the business unit.
- From the Laserfiche repository, HIM staff can instantly retrieve a record with the click of a button.
- Using redaction tools available in Laserfiche Avante, the department is able to block out confidential patient information when sending records for insurance and billing requests.
By switching to Laserfiche, the HIM department has cut the time that staff spends retrieving and relaying records by about 90%. In fact, the HIM department gained so much extra time with Laserfiche that Bass is actually lending her staff to other area hospitals to help them manage their paper coding processes.
Centralizing Security and Compliance
As HIM Director, Bass wears many hats, juggling security and HIPAA compliance in addition to the constant information requests. From an administrative perspective, having one technology system that can provide straightforward security features also cuts down on the time she spends monitoring the security of patient information during those requests. “On a daily basis, I’m the compliance officer, the privacy officer and the health information management director,” she emphasizes. “Having one tool that can handle all three functions is a major plus for me.”
Using Laserfiche Audit Trail, an enterprise risk management tool that tracks user activity, the department can configure strict parameters for document sharing that align with HIPAA compliance standards and can monitor which employees in the medical center have accessed particular records.
Bass says the system amazed her when it automatically detected and prevented a HIPAA violation. When the hospital’s risk manager attempted to forward an ER report from the Laserfiche repository to a department head, Laserfiche blocked the attachment because it would have broken compliance regulations outlined in the established Laserfiche access rights. “We’re the only department that has the rights to send documents to outside individuals, and Laserfiche caught the error. I called EMI and told them that the system was smarter than me!”
Spencer adds, “The system is helping to prevent the hospital from incurring possible lawsuits relating to patient confidentiality. That’s a huge benefit for a small hospital.”
Setting a Document Management Standard for Community Hospitals
HIM’s improved efficiency translated into benefits for other areas of the hospital, too. No department has profited more from HIM’s improved efficiency than Accounts Receivable: When documents are scanned into the Laserfiche repository, the AR department can now retrieve the records immediately, reducing the medical center’s weekly unbilled amounts by $1.5 million.
“CHS wants us to work smarter, not harder, and it was clear to us that Laserfiche could help us reach the goals that CHS sets for our operations,” says Bass, noting, “We haven’t been in the red zone for our AR activities in over a year!”
This reduction of unbilled accounts has helped Southern Virginia Regional Medical Center pave the way for other regional medical groups to improve their operations, too. When Bass told a colleague at Springs Memorial Hospital the amount of unbilled payments that the AR department had eliminated with Laserfiche, Springs Memorial immediately purchased its own Laserfiche system.
Bass emphasizes that her organization’s success can be attributed to cultivating a relationship with the right ECM reseller. “I’ve gotten so much help from Kim and EMI Imaging,” she says. “Whenever I have a question, they are very helpful in figuring out what’s going on.”
The medical center plans to rely on EMI’s expertise as it expands Laserfiche to other departments. Registration staff will use Laserfiche to scan patient consent forms, which the department regularly provides to both internal and external units. As the hospital prepares to phase into a new electronic medical records system, it looks to integrate Laserfiche with the system to attach the consent forms to patient records already scanned into the Laserfiche system. Bass hopes that the medical center’s case management and human resources groups will also begin taking advantage of Laserfiche.
“We’ve just been so thrilled with what we’ve been able to accomplish. I can’t wait to help other departments benefit from Laserfiche,” says Bass.