When the average person thinks about the employees who keep a hospital running, it is doctors and nurses who immediately come to mind. But what the average person doesn’t realize is how much work it takes to provide those doctors and nurses with the information they need to provide high-quality care. This task, of course, falls to health information management (HIM) professionals, and when a hospital relies on paper records, it is no easy feat.

“I’ve been in HIM since 1986,” explains Patty Hall, privacy officer and director of HIM at Wythe County Community Hospital, a 100-bed facility located in the Blue Ridge Mountains of southwest Virginia, “and I have to tell you that having an electronic solution makes things so much easier.”

A transplant from a hospital in Illinois, where she had worked with electronic health records for years, Hall was determined to decrease Wythe’s dependence on paper and improve the ease with which clinical, clerical and billing staff could access the patient information they need.

“I had a very specific idea of what I wanted in a content management solution,” she says, “and I worked very closely with the team at EMI Imaging [a Laserfiche reseller] to make sure that they could accommodate my requirements.”

Convincing Corporate

Hall was quickly sold on Laserfiche due to its rich functionality and affordable cost, but convincing Wythe’s parent company of the system’s merits was a tougher nut to crack. “LifePoint Hospitals uses a different content management solution, and they were fairly adamant at first that we should go with the system they had in place,” she says.

According to Hall, EMI made the difference by designing a very detailed, highly customized demo for the representatives from LifePoint. “After the demo, the lady from corporate headquarters told me that she’d come out to Virginia with the intention of nixing the Laserfiche proposal, but after the demo, she just didn’t see a way to say no; it was such a perfect fit for our needs.”

Wythe purchased its Laserfiche system in August 2009. In less than a year, the hospital’s repository has grown to manage more than 2,152,886 pages of records. “Working with EMI, we were able to deploy Laserfiche very quickly,” explains Hall. “Today, nearly 100 of our 415 employees use Laserfiche to some extent.”

Leaving the Paper World Behind

In 2009, Wythe had a total of 7,200 inpatients and 37,300 outpatients, performing 3,300 same-day surgeries and treating 15,000 people in the ER. With so many patients coming through the doors, digitizing medical records has been a huge time saver. “Many of our ER patients, in particular, come back more than once,” says Hall. “When you’re living in a paper world, it takes time to track down their records. Laserfiche makes it instantaneous.”

Although some technology solutions require intensive staff training, the HIM director notes that Laserfiche is pretty much the exact opposite. “Laserfiche is very user friendly. If you know how to use Microsoft Windows, you can use this system. For some of the less tech-savvy staff, we conducted 15-minute training sessions. That’s really all anybody needed to get up and running.”

Laserfiche delivers a number of benefits on the clinical side, including:

• Electronic EKGs. Physicians log directly into Laserfiche, where they can view labs, radiology reports, EKGs and ER reports for outpatients and ER visitors. (Inpatient charts are not yet being managed by Laserfiche.) “Having the EKGs in Laserfiche is a big benefit for our doctors,” Hall explains. “While our Meditech system makes labs and radiology reports available electronically, the EKGs don’t have a place in any other software application. To have them accessible through Laserfiche, in a crisp image, is fantastic.”
• Centralized Charts. Hall also acknowledges that having a centralized digital chart available through one interface (Laserfiche) makes it easier and faster to access all of the information relevant to any given patient. Labs, EKGs and radiology reports are batch scanned and captured electronically using Laserfiche Quick Fields, a high-volume capture tool that automatically sorts, stores and creates folder paths for these documents in Wythe’s Laserfiche repository. Charts are tabbed and separated into sections that make it fast and easy for doctors to locate the type of information they need.
• Quick Digital Searches. Kim Newman, the HIM department’s lead operations technician, notes that the optical character recognition (OCR) process available through Laserfiche translates printed words into alphanumeric characters that the system indexes for full-text search, giving Wythe the opportunity to search for specific documents using a keyword or phrase. This capability has come in particularly handy when radiology reports were misfiled. “Searching by the patient’s medical record number enabled me to quickly find the missing report and save it to the correct chart. If this had happened before we implemented Laserfiche, we may have had to spend hours and hours searching through every chart processed on a particular day of service, and even then we may never have found the misfiled report. Laserfiche OCR is a real timesaving tool!”
• Easy-to-Access Advance Directives. In addition to the patient charts, the hospital’s HIM department has created a folder for Advance Directives, organized by patient name. Having these important documents in Laserfiche is particularly useful in the case of emergencies. In the past, paper copies may not have been discovered quickly enough to make an emergency patient’s wishes known to medical staff. With Laserfiche, a simple search rapidly reveals whether or not a patient has an Advance Directive on file; if such a document exists, the patient’s preferences are immediately identified and honored.

Back-Office Benefits

But it’s not just the clinical staff that benefits from Laserfiche; the patient access (registration) department, the business (finance) office and the lab director (who is in charge of compliance), all use Laserfiche, too.

“Before Laserfiche, Patient Access made four copies of each patient’s records; now they make none,” says Hall. She also notes that the hospital now sends its ER billing information to its outside billing company electronically, adding to the cost savings Wythe realizes on printing, storing and mailing paper documents.

Facilitating Compliance

As the hospital’s privacy officer, Hall is responsible for investigating HIPAA complaints. Laserfiche Audit Trail, which tracks repository activity and provides a Web-based interface for running detailed reports on the tracked information, allows her to monitor all system activity—who looked at various records, what time records were viewed, whether any changes were made, etc.

However, Hall notes that the security controls in Laserfiche make it virtually impossible for unauthorized people to view information they are not allowed to access. “We limit access to the content in our repository based on folders,” she says. “For example, the patient access department doesn’t see the same things our physicians do.”

Corporate audits conducted by LifePoint are also much simpler now that Laserfiche is in place. With Laserfiche, the hospital is able to grant auditors secure access to a folder containing all of the documentation that needs to be reviewed. “Laserfiche allows us to prepare for audits on very short notice,” explains Hall. “It’s a lot easier than finding and copying paper documents and putting them in the mail.”

What’s Next

Wythe is currently in the process of implementing Laserfiche in the physical therapy department, and it hopes to tackle inpatient records before too long. Hall is also interested in adding electronic signature functionality to Laserfiche. Although her department doesn’t currently have the budget for it, she’s hoping to get money approved for it next year.

Overall, though, Hall sees Laserfiche as “a much larger solution for the hospital. This isn’t just something that the HIM department can benefit from; it would be a great thing for departments like HR and credentialing, and for the hospital as a whole.”

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Tags: advanced directives, audit preparation, auditing, digital charting, EKG storage, ER records management, finance, HIPAA, LifePoint, Meditech, registration, remote auditing

Posted on Tuesday, May 25th, 2010 at 4:02 pm under Customer Stories, Healthcare, Healthcare Newsletter, Newsletters, Run Smarter, 2010. You can comment on this post.