For Iredell Memorial Hospital, lost records meant enormous losses in revenues. But keeping critical information available to those professionals who need it is also a tremendous challenge at the facility, which delivers outstanding, cutting-edge care. With 135 physicians on staff, several specialized treatment centers and nearly 5000 emergency room visits per month, Iredell staff found their workflow and productivity hampered by their records system, which involved assembling, distributing, storing, and retrieving volumes of paper.

The effort of managing paper meant the hospital wasn’t making effective use of its 1700-member staff. Using Laserfiche®, Iredell succeeded not only in cutting revenue loss in the ER and improving its patient record management, but it also greatly improved the efficiency of its own staff and the physicians the hospital works with.

The Situation

With as many as 300 ER visits on a single weekend night, lost and misplaced records forced the hospital to write off about $40,000 per month, with no way to properly code and bill for the visits. To solve the problem, management looked at a number of products over several months. After viewing several presentations, Iredell chose Laserfiche.

The Solution

“Laserfiche gave us what we needed and it was very user-friendly,” says Medical Records Director Marsha Hunter. “And we could develop the different templates and have a direct interface with the Keane Patient Management System®, which runs our patient accounting system. We manage patient charts electronically instead of on paper. The interfaces were easily written using the HL7 protocol and created index fields that allow authorized staff throughout the hospital to quickly search for any records”

The ER staff scans the records into Laserfiche, which reads the bar code and pulls relevant patient information and date of service from the Keane application. Staff no longer needs to manually input the data so labor time greatly reduced. Quick access to patient information from anywhere in the hospital is an added benefit.

Up and running in two weeks

“At the end of just two weeks we had scanned all the records from the previous month,” notes Hunter. “We had a fully functional system and the coders were coding remotely. Getting this kind of technology solution in place normally takes months.” Lambert worked with two members from Iredell’s HIS department to install the product and develop the integration with Keane.

Training was equally seamless, recalls Hunter, who wrote the policies to guide use of the system. “We had a lot of people to train and the ER is 24/7. We had to make sure all the clerks understood the processes and how to get records into the system according to the policies.” Each training session, first for 15 ER staff and then for 10 file room staff in medical records, took about a half hour “and they were very comfortable with the system.”

Seamless storage and retrieval without paper

Switching to Laserfiche produced dramatic results in streamlining workflow and hospital processes. Previously, the records system had been 100 percent paper, with the average ER chart composed of about 15 pages. In addition, the ER reception clerk routinely made and distributed four copies, one for hospital billing, one for physician billing, one for the quality department and one for the nursing staff.

Now the ER staff scans in records after the patient leaves, and anyone who needs to can view them-even simultaneously. “We’ve reduced paper in the copying process by 80 percent,” says Ron Gobble, Emergency Room Coordinator. “We scan all through the day, which is great. If there’s a patient that left two hours ago and calls back, all that information is already in Laserfiche and the nurse can just pull it up and look at it. We’re very pleased on our end.”

Using Laserfiche means that staff no longer has to track down a physical chart-they can access all the records in the Laserfiche repository. “Now we can give access to anyone who needs it,” says Gobble. “We don’t have to wait for the chart to pass around.” Most importantly, once a clerk scans in a record it can’t be lost. “We haven’t lost a single record,” says Hunter.

But the ER uses Laserfiche for more than charts. Staff scans in prior years’ correspondence and old memos, so they don’t have to physically store them. “It’s great to get them out of the office,” says Gobble. “If you need it, you can just pull it up-you don’t need to go searching through a bunch of files.”

Remote access and distribution

Hunter also appreciates the increased space Laserfiche has brought to the hospital through remote access and elimination of physical storage space. “In health care, real estate is probably the most expensive thing we have. So if I can free up office space or move my employees home, we’re thrilled.”

Laserfiche has greatly improved access to patient records by off-site physicians as well, allowing staff to email records to the doctors. “It really helps with our physicians group that’s in a town nearby. Before, we’d have to send them a record by courier. Now we can just encrypt it and send it right out-it really saves us a lot of time here, and frees up some of our personnel for other duties.” It also saves the physicians a good deal of money on courier fees.

Gobble also sees a vast improvement in handling physicians’ addenda, when they’ve missed something on their physician’s order sheets. “We can highlight it using the annotation functionality, fax it to them and they can send it back and it’s done. We used to have to get the physical record to the department when the physician was here. Now they make their changes and we just rescan it in.” Eventually, Gobble hopes to make the Laserfiche fax feature available, so staff can automatically fax records to doctors from within the application.

Beyond the ER

According to Hunter, “As soon as we went live with the ER system, the outpatient laboratory came on board. They were getting orders and requests and didn’t have a way to store them except for manual file folders-we couldn’t review them when we were coding the lab records. Now we scan all outpatient lab requests so we can code more effectively.”

Hunter has strong praise for Laserfiche. “We were able to accomplish everything we wanted to and more. Our physicians are able to get the records the next day. We have a program that automatically emails the charts over from the day before and it’s been a wonderful elimination of work for them and for us. They’ve been able to do their billing much more quickly.”

Today, the hospital uses Laserfiche in its rehabilitation center, cancer center, radiation therapy center, medical records department, quality department and in administration. To further improve communications and workflow, the hospital is about to integrate Laserfiche with its own physician’s Web portal. Doctors will soon be able to review not only ER records, but documents such as stop-med orders.

Hunter anticipates using Laserfiche for Microsoft® Word and Adobe® PDF documents and directly link to SoftMed®, Iredell’s dictation transcription product, so that eventually staff will need to scan only handwritten documents. And as Iredell continues to explore electronic document management, Hunter looks forward to using Laserfiche as the cornerstone of an electronic medical records (EMR) system. “I want to make Laserfiche the document management system for the entire hospital,” she says.

Compliance

Like any medical facility, Iredell faces a host of regulatory and auditing issues when dealing with patients, their safety and their records. Laserfiche has not only helped with business process management, but also eased security and record integrity compliance for the JCAHO-certified hospital.

“We’re able to set security levels for each department. We can control access to the system, chart, and document level. We are able to run audits on what records are accessed, view any problems and make sure records aren’t being printed out by people who shouldn’t have access to them,” says Hunter. “The security levels are great because we give a lot of people read-only access and that helps us know that records are secure.”

Hunter notes that Laserfiche helps Iredell with disaster preparedness, enabling the hospital to securely store its records with a completely redundant system offsite. “If one system goes down, we can easily do a complete recovery.”

According to Hunter, Iredell Memorial relies on Laserfiche to “make records available in electronic format, streamline functionality and save money on the back end by not losing revenues to misplaced records. The very act of moving from paper to electronic records is one of the best practices we’ve implemented.”

Tags: bar code, Healthcare, hospitals, medical billing

Posted on Sunday, October 28th, 2007 at 5:41 pm under Customer Stories, Healthcare. You can comment on this article. trackback from your own site.