Although the doctors’ attention is devoted to delivering excellent patient care, they recognize that if the medical group’s finances aren’t in order, their ability to continue serving patients is compromised. Therefore, they’ve charged their business office with employing the best people, processes and technology to optimize the revenue cycle and ensure the profitability of the practice.

Recession Brings Reimbursement Challenges

“The tough economy and changing California regulations have made it more and more difficult to collect payment in a timely manner,” explains Sue Kruger, Office Manager at Tri City. “Medicare and Medi-Cal pay only a fraction of the fee for emergency services, people who’ve lost their jobs and their health insurance oftentimes can’t pay for their care and private payers sometimes drag their heels.”

She notes that the group’s physicians treat an average of 6,000-7,000 patients a month. In terms of Tri City’s revenue:

• 27% comes from Medicare patients.
• 17-18% comes from Medi-Cal.
• A little over half comes from private insurers and self-pay accounts.

“Our employees have to work much harder to collect the same percentage of payment they did three or four years ago,” says Kruger. “If we didn’t have a paperless system, we’d absolutely have had to hire more staff.”

Integrating Content Management with Practice Management

After transitioning to a new practice management system—CPU’s MED/FM—in 2003, Tri City began thinking about how to get even more value out of that system. When CPU introduced an integration with Laserfiche enterprise content management (ECM), Tri City jumped on board.

“Handling paper was a big expense that slowed our staff down,” says Kruger. “Our doctors recognized that purchasing Laserfiche would pay off in terms of staff productivity.”

J.R. Juiliano, Tri City’s IT Manager, explains, “We scan everything that’s related to patient encounters into Laserfiche. This includes demographic information, dictations, EOBs and correspondence from insurance companies.”

He notes that the hospital sends information to the medical group via an FTP site. “In the past, we just printed everything onsite.”

This, of course, was problematic on many levels:

• It was expensive.
• It was difficult to store.
• It was tough to retrieve in a timely manner.

“We have to keep patient information for seven years,” says Juiliano. “We used to rent four storage units at a facility that’s ten miles away. We kept a year’s worth of records onsite in a big filing room, but somebody had to go over to the storage units at least once a week.”

Kruger adds, “Efficient medical billing depends on keeping people in their seats so they can be productive. Manual tasks like retrieving paper records just aren’t the best use of employees’ time.”

Today, Tri City automates the document capture, indexing and filing processes with the following tools:

• Laserfiche Snapshot converts the electronic documents from the hospital’s FTP site into TIFF images and processes them using Laserfiche Quick Fields, a high-volume document capture and processing tool that automatically extracts metadata from the documents and files them in the Laserfiche repository—no printing or scanning required.
• Laserfiche Quick Fields also scans and processes paper EOBs and correspondence from insurance companies. Using optical character recognition (OCR), Quick Fields converts the scanned images into editable and searchable text, extracts metadata and files the documents in the repository.
• Laserfiche Import Agent captures and processes electronic faxes.

Verifiers, coders and payment entry staff work with dual screens, so they’re able to view a document on one screen while performing data entry into MED/FM on the other. With the MED/FM integration, documents are automatically attached to the appropriate patient records in the practice management system. When employees type a number into a specific field in MED/FM, Laserfiche opens the corresponding document. This ensures that employees don’t have to launch Laserfiche or toggle between screens to retrieve the documents they require.

Kruger explains that the integration keeps her staff in their seats. “Laserfiche makes our staff so efficient that we haven’t had to hire more people. In fact, we haven’t even replaced everyone who’s left.”

Visibility = Productivity

Documents—whether scanned or electronically imported—are time-stamped when they enter the Laserfiche repository so that the management team can measure staff productivity. Kruger explains, “If something comes in at eleven but doesn’t get finished until 4:30 pm, I can go to the person and ask, ‘What were you doing for those five and a half hours?’”

Juiliano appreciates how easy it is to run and store reports in Laserfiche. With Laserfiche Audit Trail, a monitoring and reporting tool, Tri City can create summaries of all actions taken on a particular document or record, making it much easier to prove compliance with HIPAA. “We can see who changed what when, where and why,” he explains.

In terms of other types of reports, Juliano says, “We run a lot of reports—collections reports, month-end reports, weekly reports. Even if we don’t run the report in Laserfiche, we store it there, which makes it easy to access and compare historical data with present trends.”

Lisa Newland, Tri City’s Assistant Manager, notes that the group’s RAC audits have gone smoothly thanks to Laserfiche’s instant search-and-retrieval capabilities. “Being able to instantly pull the information the RAC auditors want to see makes life so much easier than digging through filing cabinets or storage boxes.”

All in all, says Kruger, “Laserfiche is a great product. I don’t know how we ever got along without it.”

• Colorado Division of Forestry.
• Colorado Division of Parks and Wildlife.
• Colorado Division of Reclamation, Mining, and Safety.
• Colorado Division of Water Resources.
• Colorado Geological Survey.
• Colorado Oil and Gas Conservation Commission (COGCC).
• Colorado State Land Board.
• Colorado Water Conservation Board (CWCB).

According to Susan Lesovsky, Application Support Manager for the CWCB, the DNR purchased a Laserfiche enterprise content management (ECM) system in 2005 to replace a legacy IBM system that lacked an out-of-the box Web interface, optical character recognition (OCR) functionality and the ability to automate business processes. “Our old system was pretty much limited to search-and-retrieval,” she explains.

She notes that a top priority for implementing Laserfiche was making it easier for citizens to stay informed about government activities. “Ultimately, our customer is the public, and our success is measured on how we provide and process information for them,” Lesovsky says.

To that end, the DNR upgraded to Laserfiche Rio in 2009. According to Lesovsky, “Laserfiche Rio has allowed us to increase the transparency of information to the public, and it’s done it in such a way that we don’t have to worry about connections or cost.”

In particular, she describes the benefits of upgrading to Laserfiche Rio as:

• Greater public access to information through the WebLink Public Portal, which provides unlimited connections.
• Scalability through unlimited servers and volume discounts on user licenses to accommodate future growth.
• The bundled functionality of Web Access and Workflow.

Laserfiche Rio Enables Citizens to Cut through Red Tape

Lesovsky notes that Colorado Governor John Hickenlooper recently called for every department in state government to reduce red tape. Good government, he says, is characterized by “efficiency, effectiveness and elegance.”

“As one of only two recommended content management systems for the state, Laserfiche epitomizes all three E’s,” Lesovsky says.

She explains how easy it is for citizens to access documents such as the CWCB’s meeting documents:

• The current year’s materials are available on the Board’s Website in a table that provides direct links to PDFs stored in Laserfiche.
• Archived materials are accessible through a custom search box (created using the WebLink Designer) on the lower right side of same page or through this link.
• The custom search box is limited to three fields (title, date range and document type) to streamline access and reduce user confusion. (Custom search components have been included throughout the CWCB’s Website to help direct the public’s search for Board-related documents.)

Colorado’s Decision Support Systems Website also includes custom search boxes throughout its Website, such as the one at the top of this page that searches according to document type and a few other parameters, while a set of “Google-like” search results based on document type displays below thanks to an encoded URL string.

“We used the WebLink Designer to create custom searches because we noticed that our users would get overwhelmed when presented with a long list of templates and fields,” says Lesovsky. “Each custom search focuses on a particular program area or topic and uses a limited set of search criteria within the associated template.”

Quick, easy and efficient searches support Hickenlooper’s goal of driving the “three E’s” into government operations. Lesovsky explains, “In the past, people had to come to our offices to request information. Laserfiche WebLink provides a simple and elegant way for the public to get immediate access to the information they need whenever they need it.”

Integrations Make ECM “Mission-Critical”

By integrating Laserfiche WebLink with other software applications, the DNR has been able to make information even more accessible. For example, by integrating Laserfiche with ESRI ArcGIS, staff can click on a stream and retrieve associated court documents, while public users can quickly access information associated with flooding and flood hazards in the state.

To see the public-facing integration in action:

• Visit Colorado’s Flood Decision Support System page.
• Click on the Flood DSS Map Viewer.
• Agree to the disclaimer.
• Click the Documents tab in the top menu.
• Enter your search criteria in the pop-up window. For example, select:
  • Group: Historical Flooding.
  • Document: Historical flood photographs.
  • Type: Photographs.
• Hit the search button.
• A new window displays the results (produced on-the-fly by an encoded URL string) in a grid format.

It’s the integrations with applications like ESRI ArcGIS that make Laserfiche “mission-critical.” According to Lesovsky, “When you integrate Laserfiche with business-specific systems, you embed it into your existing workflow processes and it becomes integral to how you operate.”

ECM Enables Electronic Forms Processing

Laserfiche Rio has been a particularly effective ECM solution for the DNR because different divisions can configure it to meet their unique needs. For example, the Oil and Gas Conservation Commission (COGCC) uses Laserfiche to enable an eForm application that provides an interface for oil and gas operators to enter and submit permit forms and supporting documents. There are currently six active forms and three in development.

According to Ken Robertson, Application Developer for the COGCC, “Uploaded files are stored in our production Web server. Once the operators submit the form to our internal server, we export the attachments to Laserfiche.”

He explains that the public can view the files directly from the production Web server or wait until the files are imported to Laserfiche and use WebLink to access them. Furthermore, he outlines how the COGCC has used the Laserfiche SDK to create customized Laserfiche scripts and programs.

Robertson says, “For those attachments still sitting in our production Web server, we created a Windows service to check queued files in the Web server every 15 minutes and use the Laserfiche Toolkit [SDK] for .NET to import files to the Laserfiche repository server. In the meantime, we also collect the Laserfiche reference numbers in our attachment table so that system (eForm) can provide a WebLink download page for users to view the attachments.”

He notes that there is a separate application that allows oil and gas operators to upload well logs, which are imported into Laserfiche using Laserfiche Import Agent, a tool that captures and processes electronic documents. Scanning staff members use Laserfiche Quick Fields to index other types of electronic documents.

The biggest benefit of processing permits and well logs with Laserfiche is time. Robertson says, “We used to shuffle files from one person to another until they were approved, and then we scanned everything into the system. Having the operators upload their attachments to their documents saves an average of 15 minutes of scanning and indexing time for our staff, not to mention the time saved on data entry.”

He goes on to explain that having everything available electronically at the beginning of the process allows multiple people to work on the same forms simultaneously, further reducing processing time.

“Not only do we save time,” Robertson says, “but the approval process is now more transparent for the public.”

Lesovsky adds, “Laserfiche is powerful, flexible and easy to work with. Even though all our divisions use the same system, we can all use it a little differently.”

Looking Ahead

Lesovsky is particularly excited to use Laserfiche to harvest data across organizations. She explains that the CWCB has already conducted a feasibility study and has a grant in place to make it happen.

“Colorado State University has an ECM solution other than Laserfiche but a healthy collection of water information. The Colorado Water Resources Development & Power Authority and the Colorado River Water Conservation District currently use Laserfiche, with repositories of useful water documents. By hooking our systems together and using common metadata, we’ll be able to search for information across all four entities and gain a more complete picture of accessible water information in the state.”

She says that the DNR is also working on integrating Laserfiche and SharePoint. “Most of our divisions use SharePoint for their external Websites. Right now, people have to conduct separate searches if they want to find content stored in both Laserfiche and SharePoint. What we’re looking to do is enable searches that return results from both systems at the same time.”

All in all, she says, “Laserfiche Rio is a great tool. The bottleneck now is just finding the time to make it do everything we want it to do.”

Although both Arkansas’ supreme court and court of appeals have recently begun broadcasting—and archiving—live oral arguments on their Website, it is the courts’ use of enterprise content management (ECM) technology that has caught the Supreme Court’s eye.

“We’d had a document imaging system in place for several years, but it hadn’t been used much,” says Frederick. “Only a few techs even knew how to access it, and the search and retrieval capability for records wasn’t particularly useful. We had to ask ourselves, ‘Why scan anything if you can’t use the system?’”

He continues, “Our principal selection criteria for an ECM solution included the ability to manage content, automate processes, enable easy access to records and raise visibility for the legal community and the public.”

He notes that, ultimately, it was the unlimited servers included with Laserfiche Rio that won over the courts’ IT Department. “Both courts issue opinions of high interest that are heavily accessed, so we wanted to make sure we had failovers and test servers in place to accommodate that.”

Laserfiche Enables Electronic Opinions

In 2009, Arkansas became the first state to establish electronic reporting as the official medium for appellate court opinions. Substantial cost savings resulting from the transition provided the opportunity to implement Laserfiche.

“Before that, the appellate court opinions had always been officially reported in bound volumes,” says Frederick. “However, the volumes were produced and distributed approximately four times a year, which meant there was significant lag time between issuance of an opinion and its appearance in its official format.”

With declining subscription rates, higher production costs and advancing technology, the court determined that its current method of publication was no longer acceptable. “Although court systems in general have been slow to enter the digital age, we have to remember that we work for the public, and they’re used to finding information quickly on the Internet,” explains Frederick.

“One of the driving forces that led to the implementation of Laserfiche was to provide the official version of the opinions to everyone free of cost. The substantial savings realized by terminating the bound volume method was also a considerable advantage,” he says.

Using Laserfiche WebLink, a Web portal that provides instant, read-only access to documents over the Internet, the Arkansas Supreme Court and Arkansas Court of Appeals publish their latest opinions in PDF format on their Website.

“Most court records and paper copies of opinions are retained indefinitely,” notes Frederick. “In addition, we are required by statute to keep three copies of each bound volume; the final published volume count was 375 when we made the transition. From that standpoint, the storage of electronic records is far more efficient.”

In terms of search and retrieval, “metadata is a gift,” Frederick says. The Reporter of Decisions established the courts’ file structure, templates and fields, which allow anyone to access the opinions using one or more of the following criteria:

• Date.
• Court.
• Order number.
• Justice/Judge.
• Session.
• Session term.

Current Integrations, Future Plans

After enabling live video streaming by implementing a Granicus software solution, the court integrated it with Laserfiche to enable the public and legal community to access archived video footage along with a copy of the opinion tied to the case in question. “We’ve made great efforts to become more transparent,” says Frederick. “By integrating Granicus with Laserfiche, we’ve created a comprehensive digital public record that’s accessible to anyone over the Web.”

The court is currently working on integrating Laserfiche with its court management system (CMS) so that court personnel can access documents stored in Laserfiche when they’re viewing a particular case in the CMS.

Although the courts haven’t yet taken full advantage of Laserfiche Workflow, a business process management tool included with Laserfiche Rio, they may use Workflow to route drafts of their opinions to:

• The deciding panel (court of appeals, typically three judges) for review and annotations.
• The Reporter of Decisions for editing, publication and retention.

“Flow is a big buzzword right now, so knowing that we can use Laserfiche to automate more of our processes presents tremendous possibilities,” says Frederick.

Change Management Methodology for Curing “Parchment Disorder”

“One thing I’ve noticed after working in IT across a variety of industries is that the public sector is a little more cautious when it comes to adopting new technology,” says Frederick. “Some people still get comfort in being able to touch a piece of paper, so educating and training everyone on the value of Laserfiche has been interesting.”

In terms of change management, Frederick’s philosophy is that history always denotes the future. “As we were moving to electronic publication, we focused on the input from the Reporter of Decisions and the parameters set by the supreme court. Full integration would have been more easily put in place had we also gotten input from the court about the opinion writing process upfront.”

As Frederick and his team prepare to use Laserfiche to enable attorneys to e-file briefs and other documents that make up the appellate court record, they are training the judges, judicial clerks and administrative assistants first. “The better we understand what each court needs, the more successful the transition will be,” he says.

Frederick explains that e-filing will eliminate the need for lawyers to bring 16 copies of their briefs to court. More importantly, it will allow both courts to quickly find specific pieces of information contained within those briefs, thanks to chapter and marker breaks within electronic briefs, as well as Laserfiche’s sophisticated search capabilities.

“Digitizing will lower our costs and increase our clearance rates,” says Frederick. “Training people ahead of time is a key factor for recognizing the value that Laserfiche has to offer.”

Located just outside of Los Angeles, CA, the City of Long Beach turned to technology to cut costs—and create innovative ways to improve citizen service delivery. In fact, Long Beach has been so successful at leveraging technology that it has just been named one of the top ten digital cities in the U.S. with a population of 250,000 or more by the Center for Digital Government.

“The City of Long Beach takes great pride in our use of technology to be more efficient and make City Hall more accessible and responsive to the community,” says Mayor Bob Foster.

According to Curtis Tani, Director of Technology Services, the effort to reduce costs without compromising service delivery has been three-pronged:

• Consolidate information and communication technology (ICT) services.
• Increase transparency and collaboration across the enterprise.
• Digitize processes, forms and workflow.

“The Mayor, the City Council and City staff understood the value that technology could bring the city and were open to change at the foundational level to allow Long Beach to become a technology leader,” says Tani. “They understood that the shortfalls in our budget challenged operational efficiencies and gave the Technology Services Department the freedom to lead initiatives to make Long Beach a digital community.”

IT’s Strategy: Consolidate and Standardize

Long Beach has worked hard to consolidate technology functions to create budget efficiencies while still providing enough flexibility for each department to run efficiently. “By bringing our IT staff into one office and centralizing IT oversight, we’ve been able to decrease overall staffing costs as well as the number of overlapping technology investments,” Tani explains.

For example, in 2009, Long Beach chose to replace its existing IBM FileNet system in various departments with a Laserfiche enterprise content management (ECM) system that could be used across the city. “We selected Laserfiche to create more consistency, efficiency and transparency, while saving the city many thousands of dollars in equipment and maintenance fees,” Tani says.

In fact, by implementing a single Laserfiche system, the city cut its annual ECM support costs by 50%. “Our strategy is to implement shared services to capitalize on existing funding and consolidate services,” explains Tani. “Our ECM system is just one example of this.”

Other cost-saving IT consolidation efforts include:

• A new, enterprise-wide Internet-based phone system expected to generate $165,000 in annual savings.
• Virtual servers and workstations expected to generate $100,000 in energy and hardware savings over three years.
• Cluster databases that have reduced licensing and hardware fees.

ECM and Open Government

In April 2011, the Long Beach City Council adopted an open government policy identifying transparency as a core function of local government. To that end, making information more accessible by staff and citizens alike has been a top priority.

“Long Beach is dedicated to fostering and promoting open and transparent government where everyone in our community can easily participate and be engaged,” explains Long Beach City Clerk Larry Herrera. “As one of the largest cities in California, we are committed to exploring best practices, adopting new technologies that simplify and speed up all work processes and providing a level of customer service that is unmatched.”

Herrera notes that the City Clerk’s office uses Laserfiche to streamline paperwork and processes, helping the city deliver higher service at a lower cost. “In 2002, we needed 28 people to provide the public with quick, accurate and effective answers to their questions about our community. Today, with a staff of 17, our level of customer service is better than ever before.”

Over the past year and a half, the city has spent approximately $120,000 for offsite record storage. Staff had to manually retrieve paper records to answer requests, leading to delays in service and extra costs. As more and more records are added to Laserfiche, information access is improved and storage costs are expected to decrease.

On a daily basis, the City Clerk’s office scans thousands of records into Laserfiche. Just a few of the document types available in Laserfiche include:

• City contracts.
• Campaign finance reports.
• Statements of economic interest.
• Council agendas and staff reports.
• Election ballots.
• Sample ballots.
• Voted returns.

Last spring, the city made all city contracts executed as of the first of the year available to the public through Laserfiche WebLink, a read-only public portal. With 24/7 online viewing access, city residents, contractors and employees no longer have to submit public records act (PRA) requests for these items, simplifying access and saving time for both requestors and the City Clerk’s staff.

ECM across the Enterprise

In addition to the City Clerk’s office, the Long Beach Police Department (LBPD) relies heavily on Laserfiche, using the ECM system to make information such as gang injunctions, citations, restraining orders, field interview cards and accident reports available to officers in their patrol cars.

LBPD Police Chief Jim McDonnell notes that since implementing an improved gang injunction system using Laserfiche, gang violence in Long Beach has decreased. In 2010, the first year of using the new gang injunction system, gang-related murders dropped by 53.8%. “By pairing technology with optimized policies and procedures, we’ve been able to reduce violent crime in the face of severe budget constraints. Our officers were able to spend less time on administrative tasks and reinvest this time to keeping the streets safe.”

According to Jonathan Stafford, Administrator of LBPD’s Records and Technology Division, “We were delighted when the city decided to standardize on Laserfiche. We were confident that the simplicity and flexibility of the system would enable us to be more efficient by streamlining our processes.”

Other departments that have undergone concerted efforts to digitize paper processes include:

• Financial Management.
• Human Resources.
• Development Services.

For example, in 2011 the city expanded the types of permits and licenses that can be obtained online via the Website to include garage sale permits, temporary preferential parking permits, oversized vehicle parking permits and pet licenses. Technology Services also developed an interactive Fees and Charges Web application that allows the public to easily search for fees based on department, activity or keyword.

Long Beach began streamlining its accounting processes by integrating Laserfiche with its business intelligence (BI) system. Through the integration, images of the accounts payable invoices managed in Laserfiche are available to authorized users through the BI interface. This streamlines the process of researching expenditures by eliminating the need to manually pull the physical copies of the invoices.

Long Beach City Manager Pat West explains, “Our goal is to virtualize and streamline the access and flow of records and information within the city, while ensuring security. We have been pleased with the Laserfiche system, because it easily expands and adapts to the technological and human factor needs of various departments while providing central control that is needed to ensure accountability.”

Elements of Success

According to Tani, “All the right elements were aligned for the success of our technology initiatives. City leadership, staff and citizens were onboard with the transition and willing to go above and beyond to make our efforts to centralize and standardize Long Beach’s approach to technology successful.”

In addition to the Laserfiche projects outlined above, a few of the innovative ways the citizens of Long Beach can now use technology include:

• Submitting service requests for sidewalk, graffiti and pothole repair through Long Beach’s Website or via the city’s iPhone and Android apps.
• Watching live and archived City Council meetings on the Internet, iPhone or iPad.
• Obtaining time-sensitive information such as road closures or missing persons from the police via Web, social media, live text and/or e-mail alerts.
• Using social media to access enhanced content including traffic and construction alerts, videos, news, pictures and other information.

Tani also notes that having buy-in from the community was essential to the city’s IT transformation. “We had overwhelmingly positive responses to different application launches—both from the media and end users.” He explains that the media provided ample coverage of different applications and technology tools for both public safety and general city services, and that the community was willing to try the new applications and processes and provide their feedback.

“Ultimately, increasing the dialogue between city officials and the community is what has given the city’s technology initiatives energy and poised them for success and sustainability,” he says.

As a result of the collaboration between city leadership, staff and citizens, Long Beach has used technology to position itself as a leader for the future.

With approximately 150,000 residents, Franklin County comprises 52 different departments, including the Commissioners’ Office, Human Resources, Human Services and Risk Management, to name just a few. Yonker notes that these departments “operate like 52 separate businesses under the same umbrella.”

In this kind of environment, it’s especially important to establish enterprise-wide IT standards to promote consistency and cross-departmental collaboration, Yonker says. However, it’s often difficult to find technology that’s agile enough to meet the needs of many different departments and flexible enough to adapt quickly and cost-effectively to changing conditions.

“It’s hard to convince all the different departments that they can all use the same system,” says Yonker. “Because of that, we didn’t start out thinking Laserfiche was going to be enterprise technology. But after the enterprise content management seed was planted in one department, suddenly all our departments wanted to know more.”

The Beginning

Franklin County first purchased Laserfiche back in 2001. “We had some younger Commissioners come in, and they were more familiar with technology and the benefits it could have for Franklin County than previous Commissions had been,” explains Jean Byers, deputy chief clerk in the Commissioners’ Office. “They selected Laserfiche for its instant search capabilities, as well as the fact that we could install it directly on the computers already in use.”

She continues, “We immediately realized tremendous benefits from Laserfiche. Documents that used to take days to find became available with the click of a button. It used to take hours to find specific text within meeting minutes that were hundreds of pages long, but with Laserfiche it only took seconds.”

The new technology also made it easy to share documents with colleagues, and due to a similar look and feel as Windows, Laserfiche quickly became popular with both management and staff.

The Evolution of an Enterprise Standard

As Laserfiche took root in the Commissioners’ Office, other departments began to take notice. With their focus on compliance and prudent financial management, both the Fiscal Office and the Controller’s Office deployed Laserfiche in 2004.

“Laserfiche is great for accounts payable (A/P) functions and auditing,” says Yonker. “For A/P, instant document retrieval speeds and simplifies the review and approval of invoices. And with electronically stored documents, employees can quickly and easily pull the files needed to satisfy an auditor’s request, with no need to spend hours digging through file cabinets. That’s a pretty impressive efficiency boost right there.”

Yonker notes that rolling Laserfiche out to additional departments was an easier sell than other system expansions because there was buy-in from the top right from the start.

“Whenever County purchases exceed a certain amount, they need to be approved by the Commissioners,” he explains. “Because the Commissioners were already very familiar with the value of using Laserfiche, they never hesitated to give the go-ahead when other departments wanted to get on board.”

The next departments to raise their hands and ask for Laserfiche were Human Services, which was particularly excited about Laserfiche from a disaster recovery standpoint, and Human Resources. Both departments implemented the software in 2006.

Human Resources

The first thing the HR department did after implementing Laserfiche was to start scanning personnel files into the system. It took some time to develop an appropriate folder structure that separated employees’ employment records from their confidential medical records and discipline files, and then it took about a year to get everything scanned in.

“We probably spent between 4-6 months in the planning phase, but getting those personnel files into Laserfiche properly has had an enormous payback for us,” says John Aguirre, Director of HR at Franklin County.

A few of the benefits include:

• Reduced paper consumption. “We used to photocopy 100,000s of pages of job applications a year for review by our elected officials,” says Aguirre. “We almost never make hard copies of documents anymore since our officials have access to everything they need in Laserfiche.”
• Instant search and retrieval. “The ability to locate documents quickly is great for me,” explains Aguirre. “Not a day goes by that I don’t get a request from one of our directors for material from an employee’s personnel file for various purposes. Laserfiche makes it easy for me to satisfy their requests and quickly e-mail them exactly what they need to see.”
• Higher staff productivity. “With Laserfiche, we can do more with less and accomplish more functions with the remaining staff, which is important in this economy. When one of our part-time HR reps left the County, we didn’t need to find a replacement because Laserfiche makes everybody more efficient. Retrieving documents is as easy as opening a Web page.”
• Reduced need for document storage. “Prior to implementing Laserfiche, we had a large ‘Electreiver’ file cabinet in the office that stored approximately 1,500 files and rotated them on chains. It was always breaking down and causing us headaches. Once we started digitizing our documents, we were able to get rid of that monster, along with five standing file cabinets. We now use that space for our receptionist’s desk and our Laserfiche scanner, so our office is much less cramped,” says Aguirre.
• Easier audits. “Auditors love Laserfiche because it’s so fast and easy to use. It’s also clear to them that we’re meeting compliance mandates with regards to our folder structure and the security surrounding confidential medical records, etc. In addition, my department no longer has to stop working in order to organize for the audits.”

Aguirre notes that in addition to managing personnel files in Laserfiche, his department has also added recruitment documentation and union and arbitration files to the system, which has led to quicker resolution of some grievances. In addition, HR is currently most of the way through scanning employees’ benefits files and leave of absence documents into the repository, and it has recently started on payroll documentation.

“Laserfiche is so secure in terms of access rights and privileges that we’re comfortable using it for everything we’ve got,” Aguirre says. “For example, I’m the only person in the HR Department who can view the union files, and I’m also the only one with deletion rights. I know that unauthorized staff can’t see confidential information, and I know that no one’s going to tamper with our files. The role-based security provides real peace of mind.”

Laserfiche Rolls across the Enterprise

With some technologies, organizations hit a tipping point for enterprise adoption. For Franklin County, that tipping point for Laserfiche was the implementation in HR.

“After HR deployed Laserfiche, everybody started to ask for it,” Yonker recounts. “People saw how successful the HR implementation was, and they began to talk about what the benefits for their departments could be.”

As Laserfiche was adopted by more and more departments, the types of content stored in the system grew more and more diverse:

• Emergency Services uses Laserfiche to manage notes from its 911 calls and cases.
• Franklin County Jail stores inmate records and requests in the Laserfiche repository.
• Planning, which is tasked with fostering the proper growth of communities within Franklin County, manages new development records with Laserfiche.
• Open Records, with its goal of making government transparent to County citizens, makes plans, drafts and studies stored in Laserfiche available to the public.
• Real Estate manages audit reports and past voting results using the ECM system. It is also able to respond to 13,000 queries a week in a fast and efficient manner thanks to Laserfiche’s ability to e-mail digital documents.

With 26 departments already using Laserfiche, Franklin County recently upgraded to Laserfiche Rio to bring 24 additional departments onto the system. According to Yonker, “Court Administration will be the last big department to make the transition, and we’re going to integrate Laserfiche with the state’s case management system for them.”

Although the IT Department had not initially planned to implement Laserfiche as the county-wide standard for ECM, it’s now grateful to have that consistency in place. “We got rid of a couple departments’ antiquated imaging systems in order to move them onto Laserfiche, which makes my staff more efficient because it only has to administer the one ECM system. It’s also easier from a user training perspective, since everybody’s using the same thing,” Yonker says.

According to Rochelle Waldoch, Compliance and Records Manager at Ramsey County, the need for more efficient paper-based business processes drove the county to investigate enterprise content management (ECM). “The Human Services Department had always been a paper-heavy department, but as caseloads grew, we started having difficulty with sharing paper files. In addition, client information was siloed, so employees had to collect the same data over and over again. It wasn’t an efficient process, and it needed to change.”

She notes, however, that the county wasn’t interested in deploying a departmental ECM solution. “If the Information Services Department was going to invest the time and resources in implementing ECM, the solution we chose needed to provide a standard systems architecture and methodology for managing all types of documents across the county—not just in one department.”

Needs Analysis and Selection Process

To that end, Waldoch and Toyia Arvin, EDMS Business Analyst, worked with county staff to analyze business processes and document needs in every department. This analysis included:

• Interviews with more than 500 county employees.
• Document inventories completed by each department.
• A review of each department’s network shared folder directory structures.
• An inventory of software applications used by each department.

Armed with the results of the needs analysis, Waldoch and Arvin authored the county’s RFP. “Prior to implementing Laserfiche, we were using the DocuWare system to store a variety of document types, but it didn’t have the advanced workflow or capture functionality necessary to streamline business processes enterprise-wide,” explains Waldoch.

In terms of the selection process, Arvin says, “Laserfiche was beyond impressive when we were doing our RFP. Laserfiche Rio offered a familiar, Windows-like interface for our users; included all of the components we needed to achieve ECM success across the county, including Workflow, Records Management and unlimited servers; and received excellent recommendations when we did our reference checks.”

Central Control, Departmental Flexibility

Ramsey County implemented a 2,000-user Laserfiche Rio system in the summer of 2010. It is supported centrally by a four-person team within the IS Department. To date, the team has transferred more than eight million documents stored in the old DocuWare system to Laserfiche and brought a variety of departments onboard, including:

• Administrative
  o Boards and Committees. Documents such as agendas, ordinances and proclamations are OCRed and stored in Laserfiche, streamlining search.
  o Budgeting and Accounting. Using DataNOW Affinity, Laserfiche is integrated with ASPEN (PeopleSoft) accounting software. Users can locate transactions in ASPEN and then automatically index, store and/or retrieve associated documents.
  o Human Resources. Personnel files are managed in Laserfiche. Laserfiche security restricts file access to authorized users.
• Elections. Laserfiche allows the department to save staff time and money on tasks such as making copies, redacting private information and responding to public data requests.
• Human Services. Laserfiche streamlines case management for divisions such as Child Care, Financial Assistance Services and Workforce Solutions.

Waldoch and Arvin note that the Elections and Administrative implementations have gone smoothly. “Because there was an election recount coming up, Elections employees did their homework before their initial meeting with us. They brought a lot of document samples and mapped out what kind of folder structure they wanted, which documents would need to be barcoded, what information would need to be redacted and so on,” says Arvin.

“Because of that, we were able to get them up and running in a week,” she adds. “Working with Crabtree, we’d do a build, show it to them that day, and then tweak it based on their feedback. They’d been thorough upfront with their planning, so there weren’t a lot of changes that needed to be made.”

Efficient Case Management Commences

Implementation in Human Services, which started out with a 75-user pilot project (including 28 case managers), has taken a little more time. “Elections is a small department with a limited number of document types,” explains Waldoch. “Human Services, on the other hand, is a huge department with hundreds of users and hundreds of forms—and a heavy need for Workflow.”

To determine how to configure the Client repository that Human Services uses, Arvin sat down with key Human Services employees to better understand their processes. “Subject matter experts in each of the three areas of the pilot analyzed their current folder structure by reviewing case files. Together, we analyzed the tabs contained in the paper files and came up with a nine-sided file structure that could meet the needs of all the various Human Services divisions,” she says.

“The goal of implementing Laserfiche within Human Services is to allow case workers to collect information from clients once and share it electronically throughout all program areas,” explains Waldoch. “Electronic client files decrease delays in processing benefits since case workers have, via Workflow, near-immediate knowledge of document receipt.

“In addition, supervisors have greater visibility into the workload and productivity of their employees. With Laserfiche, they’re able to run queries showing them what’s being processed and what’s still waiting in the queue.”

Also adding to the department’s increased efficiency is an integration using LincWare’s LincDoc to create a Case Creation Form for the Client repository. “LincDoc makes two calls—one to a State system (SMI) and one to a County system (CAFÉ) —to pull the information needed to create a new case in Laserfiche,” Arvin says. “Automating this process saves staff time.”

After a case is created, it goes through the following steps:

• The case receives “Appointment Pending” status in Laserfiche. When the client arrives for the appointment, CAFÉ alerts the worker to the arrival. An intake worker assigns the case to him- or herself by changing a template field, and Workflow routes the file to that person’s New Cases Queue.
• The intake worker meets with the client to collect additional information. Once the information has been captured into Laserfiche, Workflow routes the case to Case Assignment, where a clerk assigns the case to the ongoing case worker.
• Workflow sends a New Case Notification to the ongoing worker, who “acknowledges” the case by changing a template field. The case is then visible in the worker’s Active Cases queue. The worker then manages the case for ongoing benefits.
• Once a case is closed, its status is changed from “Active” to “Closed,” and the case is routed to the Records Department for long-term retention.

Arvin notes that creating workflows for Human Services wasn’t as simple as she’d first imagined. “The biggest lesson I learned is that you shouldn’t try to replicate paper processes in an electronic workflow. We built a workflow this way only to find out that a chunk of it was unnecessary, so we had to ask the Laserfiche engineers to go back and build it again.”

In terms of additional functionality, the IS team is currently in the process of enabling electronic signatures, electronic forms and barcoding, all of which will simplify working with Human Services clients.

In terms of additional Human Services divisions, the team is working to:

• Transition 340 Financial Assistance Services employees from read-only to full-client users, allowing them to expand their use of the system beyond search and retrieval.
• Integrate Laserfiche (via DataNOW Affinity) with MAXIS, the state-based case management system.
• Integrate Laserfiche with vxVista, the Mental Health Center’s electronic health system, so that users can automatically retrieve information from Laserfiche while looking at patient cases in vxVista.

“Although we have a long way to go before we’d consider Human Services a mature Laserfiche implementation, we’re definitely on the right track,” Waldoch says.

Change Management Methodology

“A lot of counties have to force content management into their departments, but we don’t have that problem here, due in large part to our extensive training program,” Arvin explains.

For the Human Services Department, the Laserfiche team involved all pilot participants in the project from early on. “The more involved people are in designing their own solutions, the more bought-in they’ll be when it comes time to use it,” she says. “We also had some strong advocates who’d previously worked in other counties that use ECM, so that was certainly a stroke in our favor.”

Once the Laserfiche pilot had been implemented, non-pilot employees started receiving information from Laserfiche on disk so that they’d become familiar with the way information was organized and presented. The team also created a lot of training documentation (available online), including videos of how to perform tasks in Laserfiche featuring the cast of The Flintstones. “Just because something is technical doesn’t mean you can’t have fun with it,” Waldoch says. “If people are laughing, they’re paying attention.”

In-person training classes are conducted by unit, so that employees see the information and steps that are relevant to them. When needed, the Laserfiche team conducts individual training sessions as well. The Laserfiche team also plans to create a county-wide Laserfiche User Group to facilitate knowledge sharing between departments in the future.

Future Plans

Although Laserfiche is currently being used by several departments to enhance internal productivity, in the future, Ramsey County wants to use Laserfiche to directly help its citizens as well. It plans to do this by making information available to its constituents via a public portal, increasing transparency, and also by giving constituents the ability to complete and submit forms online. “We’re here to serve the public,” Waldoch explains. “We want them to get as much benefit from Laserfiche as our staff does.”

In conclusion, Waldoch says, “Laserfiche is a powerful enterprise system that’s already having a great impact in a number of departments.”

“Rodney recognized that although SharePoint could do many great things for our organization, DoD 5015.2-certified records management wasn’t one of them,” says Ellis, who today is a senior web analyst for the Port Authority.

“SharePoint,” she explains, “with all of its many features is so much more robust than a network drive. In particular, the Port Authority uses document workspaces heavily, because they make it easy to collaborate on works in progress such as contracts. However, once you go beyond about 10,000 documents, you’ve got a real mess on your hands.”

According to Ellis, the Port Authority didn’t want to lose the collaboration features inherent in SharePoint, nor did it want to take a familiar interface away from the staff, so it needed to make sure that the ECM solution it selected had a seamless SharePoint integration. “I was the lead on the team that built our RFP,” Ellis says. “In the end, we had more than 400 requirements and 24 vendors vying for our business. The SharePoint integration was our top concern.”

Other important selection criteria included:

• Robust records management functionality.
• The ability to electronically store a wide range of file types, including AutoCAD drawings.
• Open architecture allowing integration with line-of-business applications such as CRM.
• Availability of workflow functionality for process improvements—and a reduced paper flow.

“Before we implemented Laserfiche, our records management plan was very inefficient,” Ellis explains. “We’d print out documents, process them by hand and then file them in cabinets. We had a whole warehouse dedicated to file storage, containing all kinds of old documents in Bankers Boxes stacked nearly to the ceiling that we didn’t have time to properly manage.”

Laserfiche + SharePoint = Transparency

By integrating Laserfiche with SharePoint, the Port Authority now has the ability to collaborate on documents, retain them electronically, and efficiently manage and dispose of digital records—all while giving users access to content through the SharePoint interface.

“Laserfiche has dramatically reduced the flow of paper throughout the organization,” says Ellis. “It’s opened up space for new offices and enabled us to tear down an entire warehouse for profitable use!”

But the cost and space savings aren’t the most significant benefits the Port Authority has realized as a result of its Laserfiche implementation. By acting as integrative middleware, Laserfiche allows users at the organization to access information in the environment with which they’re already familiar: SharePoint.

“The Port Authority’s had SharePoint for close to ten years, so people are pretty familiar with it,” says Ellis. “Most of our users won’t even know they’re using Laserfiche. With the integration, our content is searchable on an enterprise level, and the results are returned to users transparently through SharePoint. It enables us to access all our information from one central location without having to train our users on a new system.”

Laserfiche + SharePoint = Operational Efficiency

With Laserfiche in place, the Port Authority has started using it to streamline business processes. First on the list? The RFP and vendor selection process.

The Port Authority was established in 1952 as a political subdivision of the Commonwealth of Virginia for the purpose of stimulating commerce in the ports of the Commonwealth, promoting the shipment of goods and cargoes through the ports, improving the navigable tidal waters within the Commonwealth, and in general to perform any act or function which may be useful in developing, improving or increasing the commerce of the ports of the Commonwealth. As such, it contracts with dozens of vendors each year.

In the past, the RFP and vendor selection process was manual and paper-based:

• Proposals were submitted in hard copy and photocopies for each member of the selection committee.
• After a contract had been finalized, paper copies were made for the Contracts and Finance Departments, and also distributed to the contract administrators.
• Because copies of the contracts documents weren’t centralized, it was difficult to locate the most current version of any given contract or amendment.

With the help of Unity ECM, the Port Authority’s Laserfiche reseller, the organization has transformed the entire process as follows:

• Proposals are submitted electronically and automatically routed into SharePoint.
• Proposals are posted to a workspace in SharePoint for contract evaluation, scoring, changes and selection.
• Once the collaboration phase is finished and the contract is finalized, it is automatically pulled into Laserfiche, where it is retained according to contract retention schedules.
• From SharePoint, users can access the contract by clicking on a URL that takes them directly to the document stored in Laserfiche. The URL placeholder in SharePoint ensures that the data is synchronized between the two systems, simplifying version control.
• When searching for a contract, users run a search in SharePoint that seamlessly provides results from both the Laserfiche and SharePoint repositories.

“Even employees who aren’t technologically inclined appreciate the efficiency of our new process,” says Ellis. “In general, having real-time information available in a central location has been one of the most important process improvements our organization has received as a benefit of this project.”

Overcoming Implementation Hurdles

One implementation hurdle that Ellis hopes to help other people avoid when integrating Laserfiche with SharePoint has to do with Kerberos, a network authentication protocol that, according to Ellis, is “widely used but poorly documented.”

The Laserfiche/SharePoint integration tools are optimally designed for a single-server deployment, but according to Ellis, the Port Authority “has Laserfiche and SharePoint set up on a multi-server farm that consists of five different servers: the Laserfiche Application Server, Laserfiche SQL Server, SharePoint (MOSS) Server, SharePoint SQL Server and a server for Laserfiche Web Access. Prior to implementing Laserfiche, we didn’t realize that—because we have multiple servers—the integration wouldn’t work without a great deal of manual configuration and without using Kerberos. We had a few frustrating days before we figured that out.

“In the end,” she adds, “we had to enlist a senior network administrator to assist us by adding the SPNs on the domain controllers, since adding them to the Laserfiche or SharePoint servers doesn’t solve the issue.

“My two big pieces of advice for other organizations that want to deploy the Laserfiche/SharePoint integration are to get to know your Active Directory and SharePoint experts really well (if you’re not either one) and use the Laserfiche Support Site. Read those Knowledge Base articles!”

Even the hassle surrounding the Kerberos issue, however, didn’t dampen Ellis’ enthusiasm for Laserfiche. “If I had to do it all over again the same way, I’d do it all over again, hands-down,” she says. “Both our users and our executives are impressed with the efficiency and effectiveness the Laserfiche/SharePoint integration affords the organization. Putting a secure, centralized and powerful Laserfiche repository behind SharePoint has given everybody much better access to the information they need to do their jobs well.”

She ticks off a few of the benefits that give Laserfiche a leg up on the competition: “First, Laserfiche is easy to use, because it looks and functions like Windows and Google. Second, it’s stable and easy for the IT Department to maintain. Third, it has an open API that makes it easy to integrate with our other applications.”

These benefits, Duckett notes, are vital to Shakopee, which has a two-person IT Department supporting approximately 125 city staff in nine different departments. In fact, if Laserfiche wasn’t easy to use, maintain and integrate, the city wouldn’t have considered shaking up its approach to enterprise content management (ECM) by upgrading from four concurrent users to a 50-user Avante system.

Leading Up to the Upgrade

“We first implemented Laserfiche in 2005, using it to manage building permits through an integration with our PIMS building permit software,” Duckett explains, outlining how the process works:

- “We print barcoded permits that our records clerk scans into Laserfiche Quick Fields, which is an automated data capture solution.
- “Within Quick Fields we have an ODBC connection that connects to the PIMS database.
- “Quick Fields pattern matches the permit address, permit type and permit ID and automatically archives the document in the Laserfiche repository.”

She also notes that the city has long used Laserfiche to manage council agenda packets and other miscellaneous items, some of which are made available to the public through Laserfiche WebLink, a Web browser-based thin client that provides read-only access to public information.

The desire to upgrade the system came last year, when the Police Department hopped on the Laserfiche bandwagon. “In October 2010,” Duckett says, “the Police Department started using Laserfiche for evidence photos, and we integrated Laserfiche with New World, the PD’s case management system, to enable officers to automatically open photos that pertain to specific cases.”

The integration works as follows:

- Officers access an incident report in New World.
- By right-clicking on the New World screen, a box with a “Search Laserfiche” button pops up.
- Clicking the button launches Laserfiche and automatically takes the user directly to the right case folder, where he can view the evidence photos.

Jennifer Boudreau, Shakopee’s Police Records Technician, explains that one way the PD leverages the integration is to track graffiti, making it easier for officers to identify all instances of a tagger’s work so the city can recoup clean-up costs.

She also notes that Laserfiche allows officers to access photos in the field from their squad cars, which is something they couldn’t do in the past. “It’s an officer safety issue,” she says. “For example, if the officers come across a tagger with a known gang affiliation, they can treat that individual with more caution.”

Boudreau notes that in the past, search options were limited. With Laserfiche, officers can search photos by case number, but they can also search based on the metadata associated with each photo. This makes it easier to discern patterns that might not have otherwise been apparent.

Now that Shakopee has upgraded to Laserfiche Avante, the Police Department is looking forward to scanning all case files into the system. “Right now, case documents are contained in a paper file, which eliminates collaboration and the ability to work on the case at the same time as someone else,” says Boudreau. “As a result, we end up doing a lot of photocopying, which wastes paper. It can also get confusing to have so many copies of the same document floating around, because you never know which is the most current, complete version.”

Further, she explains that Laserfiche will be able to store more than copies of paper documents; where applicable, electronic case files will also contain audio files, squad car video and so on.

Since the Upgrade

Less than a month after implementing its 50-user Avante system, Shakopee has already brought the Finance Department onboard. It now uses Laserfiche Quick Fields to scan barcoded accounts payable documents into the repository, where they’re instantly searchable from the desktop.

“With the upgrade to Avante, which for us included the ‘Barcode and Validation’ and ‘Real Time Lookup and Validation’ packages, we can now use the pattern matching feature in Quick Fields, which automatically creates the folder structure in Laserfiche,” explains Duckett. “This creates a more efficient and seamless process for the users who scan documents into the system.”

She adds that once the Police Department starts using Laserfiche for its case files, it will use Quick Fields for its scanning, as well.

The next department to start using Laserfiche will likely be HR, which wants to use the system to digitize employee records and automate the hiring process using Laserfiche Workflow, a business process management tool that automatically performs specified actions (such as document routing) based on organizations’ unique business rules.

According to Duckett, this is just the beginning. “We hope to have every department using Laserfiche by this time next year.”

Additional Integrations

With the New World integration well underway, and the integration with the city’s PIMS building permit software already in place, Shakopee has big plans for linking Laserfiche to additional city applications. “Next, we plan to integrate Laserfiche with GeoLink, our GIS/mapping application,” says Duckett. “When you click on a land parcel, you’ll be able to launch Laserfiche and pull up all the documents associated with that particular piece of land.”

This functionality will be useful for multiple departments, including:

• The Police Department, which will use it for crime mapping.
• The Fire Department, which will be able to quickly retrieve building plans during emergencies.
• The Public Works Department, which will gain easy access to sewer information.

She goes on to explain that the city is also looking to integrate Laserfiche with JDE, Shakopee’s finance, payroll and HR software. “By integrating these two systems—and taking advantage of Laserfiche Workflow—we’ll be able to simplify the payment cycle with electronic invoices and purchase orders that can be automatically routed through the approval process. Once we digitize our HR records, we’ll be able to automate the hiring process as well.”

From Duckett’s perspective as an IT professional, the best thing about the planned integrations is how easy they’ll be to set up. “Because Laserfiche is used across so many cities and government entities, there are a lot of proven, pre-built integrations available to us at no additional cost.”

Avante = Affordability

In terms of cost-effectiveness, Duckett also appreciates how affordable it was to upgrade to Avante. “If we’d stayed with a concurrent user system and simply purchased the additional functionality and users we needed, it would have cost us $40,000 more than the upgrade to Avante,” she explains. “Plus, our named users now have 24/7 access to information, which is important from a productivity standpoint.”

She concludes, “Although it’s early in the implementation process, we’re starting to see financial and efficiency savings in the Finance, Building and Police Departments. Once we extend Laserfiche to all city departments and start creating workflows, we expect to save a lot more on paper and printing costs, and we also expect to greatly enhance employee efficiency.

“It’s our goal to have Laserfiche installed on every desktop in the city. We envision that it’ll be used as often as our e-mail client, providing instant access to records, streamlining business processes and allowing us to move data across multiple platforms.”

“Technical innovation and efficiency are important to our citizens,” says Steve Barden, Systems Development Supervisor for Durham County, “and they’re a top priority for the IT Department as well.”

Over the past year and a half, one of the major strategic projects for Durham County’s IT Department has been upgrading and standardizing its enterprise content management (ECM) infrastructure. “In the past, ECM was viewed as a departmental application,” explains Barden. “We came to realize, however, that this is an inefficient and resource-intensive approach, so I stepped in as project manager to coordinate the various installations and get everyone on the same page.”

With Laserfiche already in place in four county departments, the choice of systems upon which to standardize was simple.

“We have 32 different departments across the county,” says Barden. “DSS, HR, Public Health and Legal were already using Laserfiche, so it made sense to stick with the system they were already familiar with. It was more a question of getting them all onto the same version of Laserfiche before rolling it out to additional departments like IT and Purchasing.”

Laserfiche Rio, with its unlimited servers and ability to give IT central control over the system while still allowing each department to customize it to their own unique needs, made the most sense from an enterprise standpoint. Today, Durham County has a 605-user Rio system, along with Quick Fields and Laserfiche Records Management Edition.

In the Beginning

Durham County’s first purchase of Laserfiche occurred back in 2006, when DSS decided that case management would be easier if files could be saved in an electronic, rather than a paper, format. To date, DSS has scanned and stored the following records in Laserfiche:

• Case files.
• Food & Nutrition Services.
• Child Welfare.

In addition, it’s currently about halfway through the conversion of its Medicaid records. “DSS will be moving into the county’s new Human Services Building at the end of 2012, and our goal is to be completely paperless by then,” explains Sharon Hirsch, Assistant Director of Customer Accountability for Durham County’s DSS Department. “It’ll make the move a lot easier,” she adds, “and there’s also no room in the new building for document storage, so that’s extra incentive to make sure all our records are accessible on the desktop.”

In fact, accessibility is Hirsch’s favorite thing about Laserfiche. “In the past, staff members had to request paper records from the Records Management team, and it sometimes took them a few days to deliver the requested documentation. Today, our staff has immediate, point-and-click access to the records they need. It’s a huge time saver.”

Hirsch also notes that it’s easier for supervisors to review active case files thanks to Laserfiche. “Active files used to be locked up in file cabinets by individual case workers. Laserfiche gives the supervisors greater visibility into work as it’s being done, so they’re able to correct any errors or oversights earlier in the process.”

Seeing the success DSS was having with Laserfiche, the HR, Public Health and Legal Departments soon implemented the system for themselves.

Branching Out

…into Legal

According to Nina Bullock, Administrative Assistant to the County Attorney, the Legal Department was tired of making multiple copies of documents like medical records and transcripts, which could number thousands of pages. “It was a constant strain on both material and staff resources,” she says.

The Laserfiche implementation has been particularly useful for the Legal Department in regard to document duplication and distribution. “Instead of copying and couriering documents to interested parties, we’re now able to e-mail them or send the documents on a CD.”

Additionally, the county’s lawyers no longer have to drag boxes of paper into court. Instead, they simply bring their laptops and access documents through Laserfiche. “Because staff no longer has to transport heavy files to court or move heavy boxes to retrieve closed files, the risk for injuries, particularly back injuries, has been greatly reduced,” says Bullock. “Back injuries are the most expensive costs for the Risk Management Division’s Workers’ Compensation claims. Changing the way the county works in this manner is setting a precedent that will potentially mitigate Workers’ Compensation claims by millions in the next few years.”

Other cost savings, she explains, have been substantial as well. “From fiscal 2007-2008, our expenditures on paper, toner cartridges, printer replacements and other related costs have decreased by 59% as a result of implementing Laserfiche. As our process becomes more streamlined and court systems become more technologically equipped to receive case filings electronically, we anticipate that these costs will decrease even more.

“So far,” she adds, “these savings have allowed us to avoid cutting staff for two years in a row!”

In addition, Bullock notes that use of Laserfiche has saved the Legal Department’s support staff approximately 10-15 hours per week, totaling roughly 3,500 hours a year. In particular, she appreciates that staff no longer has to spend days painstakingly stamping Bates Numbering onto each page of an evidentiary document; instead, Quick Fields does it automatically.

She explains, “With Laserfiche, our work product is better and our volume is higher, because the time we save on repetitive, manual tasks has been redirected to more substantive aspects of our jobs.”

Bullock believes that the benefits of Laserfiche—including lower costs, higher staff efficiency and increased confidentiality of client information—will continue to improve the department’s performance for years to come.

…into Public Health

For the Public Health Department, eliminating the need for document storage has driven the adoption of Laserfiche. “In February 2011, the department is moving into the county’s new Human Services Building, where there’s no space to store medical records,” explains Marcia Robinson, Local Public Health Administrator for Durham County.

“Prior to Laserfiche,” she adds, “we were storing current records in a 10’4” x 16’9” room, and we were archiving old records offsite with Iron Mountain. The process of finding, copying and filing records was both expensive and time intensive.”

Although the department has saved a significant amount of money on charts, labels, paper, document storage and toner, the real benefit has been the boost in customer service. According to Robinson, “Our medical records clerk no longer has to spend hours making copies to respond to requests from clinicians, practitioners, lawyers and other providers. She now has the option to e-mail the information directly from Laserfiche, eliminating backlogs and providing much more up-to-date files than she could when we were using paper records.”

She continues, “With Laserfiche, staff saves roughly 15 minutes per client during the registration process, reducing wait time and increasing our clinicians’ ability to serve more clients. Laserfiche also prevents many lost staff hours spent on chart preparation, along with the frustrations of searching for misfiled, misplaced and misnumbered charts.”

Overall, Robinson believes that Laserfiche is crucial to the department’s ability to respond efficiently and effectively to the needs of its clients. “In this time of budget constraints,” she says, “our investment in Laserfiche has paid great dividends.”

Overcoming the Limits of a Departmental Approach

Although these departments were all realizing great benefits from their use of Laserfiche, the lack of an enterprise approach to ECM was a problem.

Barden explains that there were two different resellers managing four separate Laserfiche deployments within Durham County. “Each department had a lot of flexibility to use the system as they saw fit,” he says, “but the IT Department didn’t have a lot of control over what was going on.”

For example, there was one repository on a drive that was never backed up, and a number of indexes that weren’t being backed up, either. In addition, Barden discovered that DSS had been scanning documents without using OCR, which made it difficult to find information contained in the repository. “When the IT Department doesn’t have central control over an organization’s ECM system, you run the risk of losing important information and other similar problems.”

Barden notes that the implementation hasn’t been without its flaws, but credits One Source Document Solutions, Durham County’s Laserfiche reseller, with being available to assist with any issues that arise.

“Although people aren’t always thrilled to let go of their paper,” he says, “in the long term we know that standardizing on Laserfiche is going to help the entire organization be more sustainable, more efficient and more available to our citizens. I had no idea what I was getting into when this project started, but it’s been gratifying to play a role in transforming the way the county does business.”

When Jonathan Stafford took over as Administrator of LBPD’s Records Division in 2004, he inherited a legacy imaging system built with Kofax and ApplicationXtender. “Even back in 2004, I knew the system was outdated,” says Stafford, whose area of responsibility grew to include LBPD’s Technology Division in 2008. “We were in desperate need of a flexible, easy-to-use content management solution that would grant our officers and employees access to mission-critical information from wherever they happened to be.”

Ed Ivora, Assistant Administrator of LBPD’s Records and Technology Division, notes that the old system “took too much time to manage, administer and troubleshoot. We wanted an easily customizable ECM solution that we could use without advanced engineering degrees.”

In the past, the LBPD had made use of an optical jukebox for digital document storage. “We’d take files off the server and burn them to optical disks,” explains Ivora. “The jukebox was a big piece of hardware that stored 256 disks, but like anything mechanical, it was prone to breaking down.”

Stafford notes that it wasn’t just the unreliability of the jukebox that concerned him, it was also the expense and limited archiving capabilities. “We had a half-a-million dollar archiving solution that didn’t give us a way to dispose of records that had outlived their retention schedules. From an efficiency standpoint, it just didn’t make sense.”

In August 2009, the City of Long Beach chose Laserfiche as its enterprise content management (ECM) standard, which was something Stafford had been pushing for quite some time. “We were delighted when the City decided to standardize on Laserfiche, because it was our first choice for the PD. We knew that the simplicity and flexibility of the system would enable us to be more efficient.”

Curtis Tani, Director of Technology Services for the City of Long Beach, adds, “We selected Laserfiche to create more consistency, efficiency, and transparency, while saving the city thousands of dollars in equipment and maintenance fees.”

In the PD, the transition to Laserfiche—including the migration of three million documents and nearly ten million images from the department’s legacy system—went smoothly. “We were done with the conversion process way before I expected to be,” says Stafford.

All in all, Ivora estimates that installation, including file conversion, was 100% complete within two months.

Adaptability Is Key

Through the migration process, the LBPD was able to add 20 years’ worth of arrest records to the Laserfiche repository, along with 10 years’ worth of crime reports. “What had never been digitized in the past,” says Stafford, “were the field interview cards and case files. So the first new thing we did with Laserfiche was to bring in field interview cards.” According to Stafford, detectives had been pushing him to digitize the FI cards for quite some time, since instant access to them enables them to more easily solve crimes.

When capturing files, the LBPD uses Laserfiche Import Agent, a tool that automatically brings files into Laserfiche from network directories, fax servers and local folders. “Import Agent lets us use the fax servers, MFPs and other Xerox machines we already had in place,” Ivora explains.

Just as the Records & Technology Division didn’t have to invest in new hardware, it also didn’t have to invest in creating all-new folder structures. “Everyone was happy with the way general information—like maps, procedural documents, assault weapon information and so on—was structured and organized in our legacy system,” says Ivora. “Laserfiche is flexible and adaptable enough that we could mirror the old structure in a Laserfiche folder called PD Docs, allowing people to access and view this information in a familiar format.”

He adds, “Laserfiche is great because it’s easy to customize it to our needs.”

Expanding Access to the Field

To date, the LBPD’s repository contains a wide range of electronic and scanned content, including:

• Tickets.
• Restraining orders.
• Arrest reports.
• Timecards.
• Policies and procedures.
• Forms.
• And more.

With Laserfiche, LBPD officers have the ability to retrieve many of these document types directly from their patrol vehicles, whereas in the past they could only view them from computers in the police station. Laserfiche WebLink, a browser-based thin client that provides secure, read-only access to the repository, gives them immediate access to these documents when they’re in the field, saving time and ensuring that they follow the proper procedures and have the most current information on hand.

“One thing I’ve learned over thirteen years of working for the PD is that you have to make things easy for the officers,” says Stafford. “They need to worry about protecting us, not about finding the right paperwork.”

Targeting Gang Members

The PD’s gang injunction program has benefitted tremendously from remote access to the Laserfiche repository. Gang injunctions are court-issued restraining orders prohibiting gang members from participating in specific activities such as loitering, smoking marijuana or wearing gang colors. These injunctions allow officers to arrest named gang members for injunction violations rather than waiting for a more serious crime to occur.

In order to make an arrest based on a gang injunction, officers must first confirm that the gang member in question has previously been served a copy of all court documents related to the injunction. In the past, LBPD officers were forced to call around the PD to confirm proof of service. Tracking down the paperwork was frequently a time-consuming task that resulted in missed opportunities to make arrests.

Today, a tight, three-way integration between Laserfiche, Tiburon (the PD’s records management application) and Business Objects (LBPD’s business intelligence software) gives officers the ability to pull up specific Crystal Reports containing hyperlinks to images stored in the Laserfiche repository. Through Laserfiche WebLink, officers can instantly access the injunction-related information and images needed to make arrests.

“This integration allows us to deliver injunction information to officers in the field in as few clicks as possible,” says Stafford. “The impact has been huge.”

In fact, on November 8, 2010, the LBPD, along with Long Beach’s mayor and prosecutors, announced a massive gang injunction against more than 100 known gang members with ties to the Mexican Mafia. The injunction targets gang members from all over Los Angeles County who commit crimes in Long Beach—not just those based in Long Beach. Without Laserfiche, enforcing this injunction would be difficult, to say the least.

Working Up to Workflow

Although Stafford is happy with the progress LBPD has made with Laserfiche so far, he explains, “We’re going to push this system to automate business processes as well as eliminate our paper files.”

Laserfiche Workflow will be the engine driving the automation of business processes, and the uniform ordering process will be the first one to be transformed.

Currently, officers fill out a paper form when they need new boots or a new shirt. The form must be approved by the officer’s sergeant and then his commander before it moves on to Personnel. After Personnel checks the officer’s order history, the form moves to the Fiscal Department, which forwards it to the uniform service. After that, Fiscal must call the officer and inform him that he may place his order directly with the uniform service.

According to Stafford, “It’s a frustrating, repetitive process that would be much simpler with e-forms and automatic e-mail routing.”

Once the uniform ordering process has been automated, Stafford’s team will tackle police report request process, which will enable employees to more efficiently manage citizens’ and insurance companies’ requests for police reports.

Business-Led Technology

With 1,450 employees in the LBPD, all of whom have access to Laserfiche, Stafford notes that the system’s ability to balance central control with local flexibility is vital.

“We create different repositories for different divisions because they all have their own unique document types and preferred filing methods,” explains Stafford. “Laserfiche gives us central control over system administration and security, while giving each of the divisions control over its own information.”

He continues, “When we were evaluating ECM technology, we knew we wanted a system that would adapt to the needs of our business, not the other way around. Laserfiche is helping us solve crimes and save lives, and it’s doing it in the way we want, not the way a vendor prescribes.”

As he outlines the overall benefits of Laserfiche, including simplicity, user-friendliness and adaptability, Stafford points out that the PD is only one year into a five-year implementation. “We’re getting there,” he says, “but this is just the beginning.”

“Since 1954, our physicians have been refining the way they keep track of patient information,” says Bill Duke, executive director of the practice. “Although we knew we wanted to transition away from paper charts, we wanted our electronic records to mirror the form and format of our paper charts exactly. There aren’t many solutions out there that are flexible enough to do that.”

Duke would know. As the man in charge of the business side of the practice, he led the effort to find and implement a content management system. “Prior to 2007,” he says, “we used paper charts at all three of our locations. Storing so much paper took up a lot of space, and finding the right information took up a lot of staff time. And there was always the possibility that a document could go missing.”

For a practice dedicated to excellence, continued reliance on paper files was not the answer. “Providing state of the art care isn’t just about attracting the best doctors and staying abreast of the latest medical developments,” explains Duke. “It’s also about implementing innovative technology that helps your practice run as smoothly as possible.”

In 2007, Dallas Associated Dermatologists added a document management module to its billing software. The result, Duke says, was less than ideal. “What we got was basically a managed repository—the search functionality was limited, and you pretty much had to know exactly where you’d saved a document in order to locate it again.” It quickly became clear that the practice needed a more robust solution.

“The first time around, I confined my search to software that had been designed specifically for the healthcare community,” Duke explains. “The second time around, I looked further afield.”

Technology that Adapts to the Flow of the Practice

After describing the needs of his practice to a scanning company, Duke was directed to take a look at Laserfiche, a company that creates simple and elegant enterprise content management (ECM) solutions for organizations across a wide range of industries—including healthcare.

“I remember seeing a postcard from Laserfiche that said something to the effect of, ‘Our approach to electronic medical records doesn’t make doctors change the way they work.’ I thought, ‘If that’s true, then that’s exactly what we need,’” he says.

Duke began talking to ImageNet Office Systems, a Laserfiche reseller that’s also based in Dallas, and purchased Laserfiche in 2009. According to Brian Simpson, solutions manager at ImageNet, more and more medical practices are becoming interested in Laserfiche solutions because “they handle the business processes involved in automating the capture and processing of medical records in a way that’s not overwhelming, complicated or cumbersome for doctors and staff, and they do so in a way that addresses business needs outside the scope of an EMR as well.”

“A lot of vendors want to fit a round peg into a square hole by forcing you to use their templates,” Duke adds. “With Laserfiche, we can create our own templates, our own fields and our own classifications for documents. That flexibility gives us control over our output, and it lets our physicians continue to chart in the way that works best for them.”

According to Duke, the doctors at Dallas Associated Dermatologists want to interact with their patients during appointments and have balked at reviewing EMR systems that require them to type their notes into the system while they’re in the room with a patient. “That’s not conducive to building the patient relationship and providing high-quality care” says Duke. “Laserfiche provides us the opportunity to bring our documents to life without having a negative impact on our patient relationships.”

Technology that Accelerates the Flow of the Practice

Since implementing Laserfiche, the practice has been scanning patient records into the system on a day-forward basis. Laserfiche Quick Fields automates chart processing by capturing data from the practice’s various forms and sorting the documents according to custom criteria. Once the information has been indexed and stored in the Laserfiche repository, it is immediately available to Dallas Associated Dermatologists’:

• Doctors and Nurses
• Front Desk
• Appointment/Service Center
• Telephone Triage (Rx refills, Special Request)
• Billing and Collections

“With Laserfiche,” Duke says, “there’s no such thing as a failed scan. Our users can quickly and easily verify the scan or find anything that’s been scanned into the system, using whatever search method they prefer. Nothing is lost, and that helps me sleep better at night.”

In addition to the ease of search and retrieval, the practice also benefits from the business process management (BPM) tools included in the Laserfiche suite. “Workflow automates much of our sign-out process for physician notes,” Duke explains. “Once transcriptions have been imported into Laserfiche, they’re automatically routed to the Transcriptionist folder where they’re linked to their .wav files. We’re also testing how to automate other paper-intensive processes, such as prescription refill approval, using Workflow.”

The practice is also working to implement Laserfiche in areas of the business that are not directly related to patient charts, such as Accounts Payable, Inventory and HR. “EMR systems are focused exclusively on patient records, but Laserfiche is going to allow us to streamline operations across the practice,” says Duke. He anticipates that once the system has been configured to do everything he wants it to do across the practice, the time savings for staff will be huge.

In addition to the forthcoming efficiency gains, the practice is already benefitting from its ability to eliminate document storage. “Space that would have been used to store hardcopy files is now used for revenue-generating activities,” Duke explains.

“Laserfiche lets us do exactly what we want to do, in exactly the way we want to do it. Our staff takes pride in making sure our digital files are in tip-top shape, and we’re always looking for new ways to use Laserfiche to help make us more efficient,” he concludes.

• Cardiology
• Dermatology
• Gastroenterology
• General Medicine
• Neonatology
• Obstetrics and Gynecology
• Orthopedics
• Psychiatry

Prior to implementing Laserfiche in 2007, PPS’s manual cash posting process was paper-driven. But from an operational and cost perspective, paper wasn’t a particularly efficient medium for PPS; even assigning the daily distribution of work was time consuming because someone had to manually review that day’s lock box payments and portion them out to the processors.

“At first, we tried implementing a different system to improve the efficiency of our operation,” said Stacy Devine, IT director at PPS. “But we had some security concerns with that system, and it also had a higher cost.”

Soon after, Russ Surette, director of billing operations, mentioned the situation to Mike McDonough at Duplitron, a hardware vendor and Laserfiche VAR that had long provided PPS with printers, scanners, copiers and other electronic devices. “Mike suggested that we take a look at Laserfiche, because it’s so easy to use.”

After doing its due diligence by talking to a number of Laserfiche users, PPS purchased a Laserfiche enterprise content management (ECM) system to streamline operational processes and eliminate the need to store paper office documents and training materials.

Leveraging Laserfiche

According to Surette, the use of Laserfiche—in conjunction with a few other initiatives—has helped PPS increase productivity by 20% over the past year, while at the same time increasing gross billings approximately 20%. When one employee left the company, the increased efficiency meant that PPS did not need to fill that position.

Here are a few of the benefits Laserfiche provides:

• Better security of information. “When you’re using paper or a file server, it’s nearly impossible to keep track of changes or restrict people from removing content,” says Devine. “Laserfiche’s security controls allow us to restrict access to folders in the repository by department and user, so that, for example, a claims processor will only see his or her assigned claims. This helps us better protect patient information and more easily comply with HIPAA.”
• Automatic data capture. Laserfiche Quick Fields automates information processing by capturing data from various formats and sorting documents according to custom criteria. For PPS, Quick Fields has simplified payment processing by automatically extracting data such as check number, transaction number and insurance carrier from bank image files and tagging it as metadata in the Laserfiche repository, where the images are stored by date. Surette says, “Before implementing Quick Fields, we had a full-time employee who did nothing but scanning and data entry all day long. Today, we have one part-time employee who scans for about 10 hours a week.”
• Smoother payment processing. After payment information is stored in the repository, Laserfiche Workflow routes it to specific claims processors based on the bank account number/insurance company associated with the payment. After the payment has been processed, Workflow automatically sends the information back to its original folder. When a claims processor is out of the office, Workflow automatically delegates his or her work to an alternate processor. “The distribution of daily work is much easier with Laserfiche,” says Surette. “Nobody has to sort through files to figure out what should go where.”
• Faster follow up. “The optical character recognition (OCR) process available through Laserfiche has made searching so much easier,” says Surette. “In the past, processors would have to look through 200-page documents to find the one paragraph that was relevant to an insurance follow up. OCR makes searching for specific words and phrases within a document easy, and it’s dramatically cut down on the amount of time our processors spend following up on claims.”
• Increased visibility and oversight. Laserfiche Audit Trail monitors, records and reports on system activity, providing the management team at PPS with a comprehensive overview of how quickly payments are processed and the value of the payments processed on any given day. “Laserfiche reporting eliminates the need to check spreadsheets,” says Surette.
• Easy integration with GE Centricity. By serving as integrative middleware that links into GE Centricity, PPS’ practice management system, Laserfiche allows staff members to access information stored in Laserfiche through the click of a button. With the integration, processors can access information in the manner and environment with which they are most comfortable, without toggling back and forth between applications.

Results

“Over the past year, even though one of our employees left and hasn’t been replaced, we’ve increased business by about 20%,” says Surette. “Implementing Workflow has been a huge part of that.”

PPS is, in fact, so satisfied with Workflow that Devine, Surette and Duplitron’s McDonough are planning to do a demo of Workflow at a regional training session for GE Centricity users this fall. “We recommend Laserfiche to other billing companies all the time,” says Surette. “When you’ve got something this good, you can’t just keep it to yourself.”

Of his probationers, Eyrick says, “They’re just people who make some bad decisions. I try to focus on their issues and their individual dynamics, while at the same time testing them and making sure they’re doing what they’re supposed to be doing.”

In recognition of his commitment and personal dedication to the job, Eyrick received the 2009 “Order of Augustus,” an annual statewide probation officer award named for John Augustus, the father of probation in America.

But Eyrick’s responsibility extends beyond offering assistance to individual offenders: He’s also tasked with developing and coordinating the direction of the probation department as a whole.

For Eyrick, technology plays an important role in shaping departmental strategy. Under his direction, the department recently rolled out a video conferencing system, which has improved security by keeping inmates in jail during their arraignments. The department has also benefitted from the chief probation officer’s decision to implement Laserfiche content management more than seven years ago.

“Prior to implementing Laserfiche,” Eyrick says, “we were storing piles of files that had accumulated over the course of more than twenty years. Organizing everything was a problem, as was finding enough storage room. Laserfiche changed all of that.”

Specific benefits the probation department has realized since implementing Laserfiche include:

• Increased efficiency. Without leaving their desks, employees are now able to instantly locate probationary records within the superbly-organized Laserfiche content repository. Staff members are more productive because they no longer have to waste time searching for client files in cluttered filing rooms.
• Easy integration. Laserfiche provider BOLT Document Management created a useful integration with the probation department’s case management system that allows probation officers instant access to clients’ files while viewing case information in the database.
• Storage savings. Scanning old records into Laserfiche allowed the department to destroy thousands of hardcopy documents and reclaim a large storage room that had been in utter disarray. The Court Clerk, who shares the space, benefits from how neat and organized the room is today.

Eyrick’s success with Laserfiche soon attracted attention outside of his department, and it wasn’t long before Darlene Hale, IT director for the entire county, came calling.

The Tipping Point: From One Department to Many

Charged with delivering the most effective and affordable technology to all LaPorte County offices including the auditor, treasurer, probationer, surveyor, juvenile detention and more, Hale had noticed a few problems with the way content management had been rolled out county-wide. Chief among them was that, in the years before she’d taken the helm, individual departments such as Eyrick’s had been allowed to choose and deploy their own preferred IT systems. As a result, interoperability was lacking, sharing information was difficult and costs were high.

It was time to standardize.

In the course of Hale’s research, she determined that if one of the content management systems already in use could be expanded, the cost of conversion wouldn’t be quite so high. Two systems rose to the top: Laserfiche and Docuware. Ultimately, after talking to Eyrick and his department, comparing features and functionality and considering ROI, Laserfiche won out.

According to Hale, “The biggest thing that sets Laserfiche apart from other content management solutions is the sheer ease of use. The layout is simple and intuitive, so it’s easy for users to pick up, but just as important for IT professionals like me is that it’s also easy to administer. Setting up templates and user licenses, integrating it with other products and external applications: everything is just so easy.”

BOLT helped LaPorte County migrate the content stored in Docuware into Laserfiche by completing the following five steps:

• Examining the document and information structure of the old Docuware repositories.
• Obtaining samples of documents and data from every unique document set.
• Using the samples to determine the logic and structure incorporated in the repositories.
• Creating a unique conversion program for each document set.
• Importing and testing samples from each set in Laserfiche.

Once the testing was successfully completed, the conversion process began—one department at a time.

Each phase of the migration project was carefully defined and scheduled, since departments needed continuous access to stored content even while the process was underway. Employees could look up existing information in Docuware, but to prevent “orphaned” records, staff was not allowed to make any additions or changes. After the process was complete, the converted information was mounted as new volumes to the county’s Laserfiche server. BOLT then installed and configured the Laserfiche client software on department computers and trained each department’s personnel.

Users Love Laserfiche

Although LaPorte County now has centralized control over all of its content (ensuring that information from all departments can easily be shared), Laserfiche grants each department the flexibility to adapt the system to the way they work and manage their files. “Our users love Laserfiche,” Hale explains. “It just has so many more uses and capabilities than what they were using before.”

The county, too, has reaped the benefits of standardizing on Laserfiche. Overhead costs for content management have diminished, and information management throughout county offices has dramatically improved. In addition, all of the advantages that Steve Eyrick’s probation department realized as a result of implementing Laserfiche—increased staff productivity, storage savings and easy integration with mission-critical applications—have now materialized for all of the departments under Hale’s purview.

“Better system, more functionality, lower overhead costs, excellent ROI,” Hale concludes thoughtfully. “What’s not to love?”

The hospital relies heavily on paper—particularly for patient records. Some nursing documentation is housed in Meditech, but none of the physician orders, progress notes or surgical packets are handled electronically. With over 500 physicians and an additional 100 residents serving THE MED’s patients, the HIM department is forced to manage an overwhelming amount of paper records.

Building the Case for Enterprise Content Management

Prior to implementing Laserfiche, the HIM department had to store many of the hospital’s paper records onsite because researchers routinely required access to files. This, of course, uses valuable real estate that can be put to better use caring for patients.

But it wasn’t just the clinical staff that needed access to patient records: HIM frequently found itself copying and/or carting charts to various departments, leading to processing inefficiencies and delays.

The HIM department tried to solve its paper problem by using a vendor to scan records to the vendor’s database. However, outsourcing this important task didn’t yield positive results, as the vendor did not always properly index the records, making it difficult for hospital employees to find the desired electronic files.

Rosson knew the HIM department needed to find a better way to manage its records, but cost concerns were a limiting factor, particularly when it came to traditional electronic medical record (EMR) systems.

“THE MED is the ‘safety net’ hospital for the area,” she explains, “so we serve a large number of people who are unable to get care elsewhere.”

It was obvious that an EMR solution from the likes of Cerner or McKesson—which can cost millions of dollars—was out. Rather than scrapping the idea of EMR altogether, though, Rosson decided to take an incremental approach.

Laserfiche Becomes the Cornerstone for Hybrid EMR

Rosson’s vision centered around the creation of comprehensive EMRs that include current and historical nursing documentation from Meditech, physician documentation, pathology reports, EKGs and more. “I didn’t want employees to have to piece together a complete patient record from a variety of sources,” she says. “I wanted everything to be central and secure.”

The hospital’s CFO encouraged her to investigate an EMR solution from another vendor. “The vendor stated that its current solution didn’t have the functionality I needed just yet, but if I could wait a year, the next release would blow me away,” Rosson says. “I’m not going to waste a year waiting for something that may or may not happen.”

Instead, Doc Imaging, the company that manages THE MED’s copiers, proposed Laserfiche Rio. “From the very first demo, I thought Laserfiche was the answer,” Rosson says.

In terms of features and functionality, the HIM department was particularly impressed by Laserfiche’s:

• Ease of use.
• Robust and flexible storage.
• Advanced search.
• Granular security.
• Affordable price.

As a result, the hospital decided to purchase Laserfiche in December 2009, implementing the system in February 2010.

Breaking Ground with Hybrid EMR

Although Laserfiche has only been in place a little over six months, THE MED already uses Laserfiche to retrieve ER, inpatient, day surgery and ancillary records. “Any medical record documentation that’s not in Meditech gets scanned into Laserfiche,” Rosson says.

She adds that the hospital uses Laserfiche Quick Fields, a high-volume capture tool that automatically sorts, organizes and stores documents, to batch scan records into the system.

Pathology reports (and soon EKGs) are “cold fed” directly into Laserfiche, eliminating the need to print and store hard copies.

Each patient’s record is organized in the repository by visit number and medical record. “Our goal is to ‘ghost print’ everything from Meditech—including nursing documentation—into Laserfiche so the complete record is available to our physicians through the Laserfiche system,” the HIM director explains.

According to Rosson, physicians access records through the Web, using Laserfiche’s advanced search capabilities to quickly locate the records they need. “Laserfiche is so intuitive that users can pick it up with virtually no training,” she says.

In addition to the fast and easy access that Laserfiche affords, Rosson is excited because multiple users can view the same patient information simultaneously. “In my world, the fact that three people can be in separate rooms and all look at the same thing at the same time is huge! Laserfiche is a huge time saver in this regard.”

She also notes that THE MED’s file room is in the basement, which means HIM employees are constantly running up and down the stairs to retrieve paper files. “With Laserfiche,” she says, “our physicians don’t have to wait for someone to finish reviewing a chart, or for my department to make them a copy. They just log into Laserfiche and everything is right at their fingertips!”

Moving forward, Rosson is also excited that Laserfiche will enable coders to work from home. “The flexibility to telecommute is a big recruiting benefit,” she says, “and it frees up more space in the hospital for additional patient care areas.”

A Solid Foundation

Rosson is clear that what her department is doing with Laserfiche is more than mere archival: “We’re using Laserfiche to manage active medical records,” she says. “This is my EMR.”

Although the IT department would like to one day implement an EMR system with a CPOE component, Rosson stresses that for the time being, Laserfiche provides a sound and effective hybrid solution. “From a cost standpoint, from an access standpoint and from a productivity standpoint, Laserfiche is giving us everything we need right now.”

Besides, she points out, even if THE MED migrates to a complete EMR solution, “there’ll still be paper to manage. It’s not like the need for a content management solution is going to go away.”

• Providing in-home services to help homebound older people live in their own homes as long as possible.
• Helping active older people stay fit, healthy and involved through senior center programs and volunteer opportunities.
• Providing family caregivers the resources and support they need to maintain their own lives while caring for older loved ones.

But with 19,000 clients, CareLink was contending with a challenge of its own: filing, storing and accessing customer charts and other documentation in a timely and efficient manner.

Paper’s Pain Points

According to Luke Mattingly, CareLink’s chief operation officer, the agency employs 740 employees, with many of them providing home-based customer care. Some of these field employees live and work nearly 100 miles away from CareLink’s main office, which made filing and accessing customer charts a time-consuming and difficult task—one that took away from the face-to-face time they could spend with customers.

“Our employees are kind and compassionate people who entered this field in order to help senior citizens,” says Mattingly, “not spend hours filing and retrieving reports.”

In addition to staff productivity concerns, CareLink’s paper-based processes also caused delays when it came to funding. As a nonprofit, the agency receives funding from a variety of sources, including:

• Medicaid.
• Federal awards.
• State assistance.
• Private insurance companies.
• Personal donations.
• Private individuals (fee for service).

“We have thousands of customer charts and documents related to a variety of funding sources, and we get audited by third parties in conjunction with their funding requirements,” explains Mattingly. “Paper is just not conducive to quick and easy audits, particularly in the document collection phase.”

Electing to Go Electronic

In 2006, CareLink decided that enough was enough: the agency needed to find a solution that would allow it to do away with paper records and manage electronic content instead.

After evaluating several systems, CareLink found that “Laserfiche had the features and operational capabilities we were looking for, including excellent security, comprehensive records management and ease of use.” Plus, adds Mattingly, “Laserfiche was offered by Datamax Micro, one of our long-time, trusted vendors, and we knew that we could count on them to implement the system according to our needs.”

How ECM Helps

Implementing an enterprise content management (ECM) solution has transformed the way CareLink handles customer information in a number of ways:

• Electronic customer charts increase employee efficiency. With Laserfiche, field employees no longer have to travel to the main office to retrieve and file customer charts, which greatly enhances their efficiency. They simply access Laserfiche via a Citrix connection and find and file electronic records in the Laserfiche repository. According to Mattingly, this ability to capture documents in the field saves significant staff time. With distributed capture, CareLink has created a five-day filing rule that ensures data is uploaded to Laserfiche on a regular basis. This keeps charts current and protects against the possibility of losing files due to local hard drive failures.
• Automated filing process increases organizational efficiency. Using Laserfiche Quick Fields and Workflow, CareLink has created a quick and easy way to capture, index and auto-file documents in its Laserfiche repository. “Quick Fields captures our customer charts, saves them to the correct location and extracts index field data from specific areas of our forms in order to pre-fill our templates. Workflow further enhances the process by automatically populating template data based on folder name/designation. The automated filing process has been marvelous at eliminating manual data entry and saving staff time,” Mattingly reveals.
• Enhanced security eases HIPAA concerns. Prior to implementing Laserfiche, customer charts were kept in a large file room where it was impossible to be 100% sure that personnel only had access to the records of their assigned customers. In addition, staff sometimes forgot to record when a file was removed for review. “The granular security controls in Laserfiche eliminate the possibility that employees can view customer files they’re not supposed to see,” says the COO. “The system also provides an audit trail so that administrators can easily see all the activity that’s taken place on any given file.”
• Easier access to information eases audits. “In conjunction with our funding requirements, CareLink is audited by third parties on a regular basis,” Mattingly explains. “Laserfiche sped up the process of retrieving documents when those entities show up unannounced.” The system has also simplified internal audits that are designed to ensure that various departments and individual employees are completing an appropriate amount of work. “With Laserfiche’s advanced search capabilities, we can quickly determine the number of documents filed by any employee or department during a given date range. This has been very helpful and saves us a lot of time,” Mattingly says.

But customer charting isn’t the only area of agency operations that has been enhanced by ECM. Finance uses Laserfiche to manage financial documents, check registers and payables invoices. The fundraising department uses it to keep track of content such as proposals and thank you letters. HR uses it to control personnel files, time sheets and employee training files. In addition, the repository also houses organizational policies and procedures, letters, correspondence and individual employee files.

“Laserfiche started out as a solution for electronic charting but it’s grown to encompass so much more,” Mattingly says.

Return on Investment

According to Mattingly, Laserfiche has enabled CareLink to cut its paper consumption in half. Over the past three years, paper savings and the reduction of off-site storage costs have completely covered the cost of purchasing the system. “Over the next seven years,” Mattingly states, “eliminating off-site storage entirely will offset the annual maintenance fees for Laserfiche.”

Mattingly reminds us, however, not to forget about the cost savings associated with the efficiency gains CareLink has gained through its use of Laserfiche: “We estimate a 40% efficiency gain for audits, for example, and our field staff has absolutely seen a productivity boost. Although we haven’t assigned these gains a dollar value, this is where the real savings lie.”

As a large community bank and federally-insured financial institution, Nara gets audited “all the time,” says IT Manager Mona Chui. “Keeping information secure and confidential is a top priority for us.”

According to Chui, audits are conducted by the following regulatory boards: the FDIC, the Federal Reserve Bank, the California Department of Financial Institutions and the Office of Thrift Supervision. The most frequent types of audits the bank faces include:

• Safety and soundness (FDIC), to assess the bank’s overall financial condition.
• Information Technology (FDIC), to evaluate the security of the bank’s electronic systems.
• Compliance, to gauge the bank’s compliance with consumer protection regulations such as the GLBA (the Gramm-Leach-Bliley Act).
• Community Reinvestment Act (CRA), to assess the bank’s performance in meeting the community’s credit needs. Enforced by OTS, OCC, FRB and FDIC.

Nara Bank knew that an enterprise content management (ECM) solution could help accelerate audits, facilitate compliance and ease the e-discovery process—all while decreasing costs.

“With paper, it’s hard to keep track of the most current version of any given document,” says Chui, “and it’s impossible to ensure that people are following compliant processes each and every time they handle a record. With 20 branches, we were shipping paper all over the place, and those costs added up fast.”

Selecting Laserfiche

Because Nara Bank’s core accounting system is from Fiserv, the first place it looked for ECM recommendations was from Fiserv itself. Cost was the limiting factor with the ECM integration offered by a Fiserv partner, however, since Nara Bank would have been charged based on the number of its client accounts. “That kind of cost structure is okay for smaller banks,” says Chui. “But it’s not cost-effective for a larger bank that’s constantly growing.”

Chui had heard of Laserfiche in the past, and was attracted to the affordability and flexibility of the Laserfiche system. As she did more research, it quickly became clear that Laserfiche could both integrate with Fiserv and offer the kind of superior security that would carry Nara Bank through the audit and e-discovery processes unscathed.

“Laserfiche works with all kinds of government agencies,” explains Chui, “so it was pretty obvious that the granular security we needed to protect our data and ensure compliance was in place.”

In addition, Chui saw that Laserfiche had a team of expert engineers who could work with Nara Bank’s IT department to get the system up and running. “We have an IT team of ten people managing the bank’s network and telephony systems, as well as 100 different applications,” she says. “We just don’t have the resources to develop deep Laserfiche expertise, so it was important to us to have Laserfiche engineers on our side.”

Using Laserfiche

So far, Nara Bank has built central repositories to manage content related to three different functions, including:

• Deposits. New account checklists, signature cards, cash management service agreements, credit reports, account statements, wire transfer applications and more.
• Loans. Loan applications, credit reports, appraisal reports, title-related documents, personal financial statements, verifications of down payments and more.
• Human resources. Job applications, offer letters, background search results, W-4 forms, benefit enrollment forms, confidentiality agreements, annual review forms and more.

Content stored in these three repositories are accessible by authorized personnel across Nara Bank’s 20 branches.

The bank has also established a standardized capture process for all deposit and loan documents that relies heavily on Laserfiche Quick Fields, which automates processing for a high volume of information by capturing data from various formats and sorting documents according to custom criteria. Quick Fields automatically draws data from Nara’s Fiserv database in order to populate template field information in Laserfiche, reducing the amount of staff time spends transferring information between the two systems. By automating the capture process, Quick Fields reduces manual data entry and ensures the consistency, reliability and availability of information throughout the branch network.

The steps in the capture process are:

• Generate barcode cover sheet. Scanner operators at branch offices generate an account-specific barcode cover sheet using the Quick Fields barcode plug-in. The plug-in reads barcodes for automatic separation of batch scanned documents.
• Scan documents. Scanner operators at branch offices batch scan documents into a shared folder that can be accessed across the bank’s network.
• Process documents. An employee at the central office uses Quick Fields to process the scanned images from the branch offices.
• Verify documents. Quality assurance operators verify each document in the repository. Laserfiche Workflow routes verified documents to their final destination, while documents with issues are routed to an “Issues Remaining” folder. (Once the issues are resolved, QA operators change a template field to indicate that the status of the documents has been verified, and they are routed appropriately.)
• File documents. Documents are filed to their final locations in the central Laserfiche content repositories and remain there for archival and retrieval purposes.

“Laserfiche has brought greater efficiency and consistency to the way we handle content across our branch network,” says Chui. “Quick Fields reduces the amount of manual data processing necessary, and Workflow ensures that our employees don’t have an opportunity to do anything with the scanned documents that is outside of our approved and compliant policies and procedures.”

She continues, “Audit Trail keeps track of what our administrators are doing, along with the Laserfiche rights and privileges they’re granting to various employees. And the Records Management module allows us to easily adhere to our clearly-defined policy for records retention, which in turn helps with e-discovery.”

Future Plans

Although Nara Bank currently uses Laserfiche for deposits, loans, HR and some general archival for the legal, IT and procurement departments, it plans to continue rolling the system out across all departments enterprise-wide.

“Before we implemented Laserfiche, the bank was completely paper-based,” says Chui. “Ultimately, all of our paper-based processes will take place within Laserfiche, which provides centralized control over content and specialized workflows for each department’s business needs.”

Overall, Chui believes that Laserfiche has given Nara Bank a cost-effective and compliant way to keep important client information safe and secure. “Laserfiche is an affordable, flexible and user-friendly system that goes a long way in facilitating compliance.”

“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.”

“A brownfield site is an abandoned industrial property with an environmental or safety stigma attached to it,” says John Hulewicz, environmental health supervisor in the Elkhart County health department. “Maybe people think there’s hazardous material onsite that’s leaching into the water supply, or maybe they believe that the property is a gathering place for vandals and gangs. Whether these beliefs are based in fact or fiction, brownfields decrease the county’s tax base. Our goal is to encourage revitalization and redevelopment wherever and whenever we can.”

Brownfield sites are a particular concern in Elkhart County for two reasons:

• Sandy soil, high water levels and a reliance on wells make residents especially susceptible to getting ill from consuming polluted groundwater.
• The close proximity of residential and industrial zones means that residential property values are often adversely affected by the presence of brownfield sites.

To help combat the problems associated with brownfields, Elkhart County was awarded a federal grant as part of the EPA Brownfield Assessment Grant program. One of the main objectives of the grant was to create an inventory of all 5,000 of the county’s brownfield sites, along with an easy-to-use tool for finding and managing information about them.

Such a tool—which would come to be called e-Atlas—would ultimately enable the county to better prioritize these sites for Phase I and II Site Investigations, which include visual inspections, records review and/or the analysis of soil, groundwater and/or building materials. These investigations provide potential buyers with information that can help them determine clean-up and redevelopment costs, increasing the likelihood of selling and rehabilitating the land.

Information Overload

According to Hulewicz, the county had plenty of information about the brownfield sites, but much of it was crammed into 44 file cabinet drawers. “The paperwork was available, but it was difficult to wade through,” he says.

“Managing the information and responding to requests from the public had become an increasingly time-consuming task,” he adds. “Our resources were stretched thin and work performance was suffering. Field staff was spending more time in the office than conducting inspections. To remedy the situation, we needed to create a tool that would combine GIS capabilities with enterprise content management.”

Hulewicz says he “dreamed of the day” when Elkhart County employees would be able to click on a parcel of land within the county’s ESRI ArcGIS application and gain instant access to information relevant to that site, including:

• Historical site records.
• County-wide environmental scoring.
• Groundwater protection records.
• Pollution reports.
• Elkhart County’s parcel information portal.

With such a tool, the environmental health department would be able to have a complete inventory of brownfield sites and associated records at their fingertips, enabling faster site assessments and knowledge sharing. Ultimately, the tool would help the department achieve its mission of “preventing disease, preserving the environment and improving the quality of life in Elkhart County through education, assessment, and assurance.”

e-Atlas Is Born

In order to create the e-Atlas tool, however, it was necessary to standardize the information relevant to the brownfields in the county. Elkhart turned to Symbiont, an environmental engineering firm based in Wisconsin, to collect and analyze the data, and then to map the sites to Elkhart’s ArcGIS system. The resulting database provided a table of primary reference coordinates for linking information.

Next, the e-Atlas project team needed to select a content management system that could store, index and link digital copies of relevant reports and records to specific GIS coordinates. A couple of content management solutions—including Laserfiche—were actually already in use in different county departments. In the end, the team chose Laserfiche as the information management anchor of its new assessment tool for two main reasons:

• Ease of integration. “The integration between ArcGIS and Laserfiche was quick and simple,” explains Ryan Eckdale-Dudley, GIS coordinator at Symbiont and the e-Atlas project lead. “People query sites in the GIS application, and Laserfiche WebLink provides a hyperlink to associated records and reports. It works exactly as intended.”
• Ease of use. “Laserfiche is useful and easy to use,” says Hulewicz. “You don’t need a PhD to understand it. We can train someone to retrieve documents with Laserfiche in ten minutes flat.”

The team purchased its new system from BOLT Document Management, a local Laserfiche reseller. BOLT scanned and indexed thousands of pages of county brownfield records, loaded them into Laserfiche and then assisted Symbiont with the integration of Laserfiche and ArcGIS. According to Eckdale-Dudley, BOLT delivered all of this on time and under budget.

e-Atlas Shrugs

Just as the team was putting the finishing touches on e-Atlas, Elkhart County acted on the advice of a consultant to standardize the county on a different document management system. This meant that all of the content stored and indexed in Laserfiche had to be converted to the new system before e-Atlas could go live.

The e-Atlas project was on hold for over a year before Elkhart County realized that the conversion promised by the new vendor wasn’t going to be easy, fast or cost-effective. When the county’s new IT director came on board, Hulewicz and his team asked to switch back to Laserfiche. After giving the new vendor a last chance to perform the conversion, the IT director agreed.

Within three days of the decision, BOLT had restored Laserfiche and e-Atlas was back online.

Moving Forward

The Elkhart environmental health department is extremely pleased to have e-Atlas up and running again. The tool has been essential in identifying, analyzing and managing potential and existing brownfield sites throughout the county, and it has saved the department “time, storage space and paper cuts,” Hulewicz says.

In fact, the e-Atlas project has been so successful that it received recognition outside of Elkhart County: At the U.S. EPA Brownfields 2008 Conference, the county was awarded Best New Technology Paper for its use of U.S. EPA assessment and cleanup grants.

The success of e-Atlas has also inspired a public-facing tool called What’s in My Back Yard (WIMBY). Accessible through Elkhart County’s Website, WIMBY leverages Laserfiche and ArcGIS to show brownfields and other community threats such as sexual offenders’ residences and former meth lab sites. The long-term goal of WIMBY is to provide the citizens of Elkhart County with easy access to publicly-available information on the health and quality of life factors that affect the communities in which they live.

“As a government organization, we strive for transparency,” explains Hulewicz. “Through WIMBY, Laserfiche provides our citizens with access to the information they need to make a difference in the community.”

But medical records are only one area in which providers can reap the benefits of working with secure, digital files. For organizations such as Molina Healthcare, a managed care organization (MCO) serving low-income individuals who frequently depend on government assistance, implementing a Laserfiche enterprise content management (ECM) system to digitize and streamline the healthcare provider credentialing process has proven to be extremely valuable.

The Importance of Credentialing

Credentialing is integral to the success of any healthcare organization, but it is a particularly important process for an MCO like Molina Healthcare. Effective credentialing helps MCOs manage liability risk, attract customers and obtain accreditation from organizations such as The Joint Commission and NCQA. It is also a procedural requirement by federal agencies such as CMS and various state agencies.

Molina Healthcare, a Fortune 1000 company that operates in nine states—California, Florida, Ohio, Michigan, Missouri, New Mexico, Texas, Utah and Washington—handles more than fifteen thousand provider applications a year. Legally, a healthcare practitioner cannot participate in Molina’s network until the credentialing process is completed and a determination has been made to approve that provider for participation.

“Every day a provider remains in the credentialing process,” says Ryan Boe, corporate credentialing manager at Molina Healthcare, “is another day that he or she can’t provide care for our members.”

According to Boe, applications frequently consist of 30-100 pages of material, including a physician’s state license, board certification, criminal history report, stated work history, educational background, malpractice history and more. “Dealing with paper,” he says, “is much slower than working with electronic records.”

Paper Process

In the past, Molina’s credentialing department produced a single paper copy of each application and routed it to different people during the credentialing process. According to Michael Eisenman, healthcare analyst for the credentialing department, coordinating the logistics and timing for moving applications through various steps of the process was difficult.

“When you’re reviewing hundreds of applications a month, it’s not practical to physically transfer them one-by-one,” he says. “But transporting hardcopy files in batches leads to processing bottlenecks, which slows everything down.”

From a cost standpoint, printing paper applications consumed reams and reams of paper, and the special couriers who shipped credentialing files between offices were an additional expense. Additionally, the physical space needed to store and retain the documentation (including a great number of wall racks) led to extra cost.

Working with paper also brings up liability issues for MCOs like Molina: “HIPAA mandates that we keep medical information secure, but it’s hard to do that with paper files,” Eisenman explains. “Paper isn’t password-protected, and it doesn’t produce an audit trail.”

Implementing ECM

Tasked with finding the best way to digitize credentialing applications and automate key pieces of the credentialing process, an IT committee chose a Laserfiche Rio ECM system due to its rich scanning, workflow, security and auditing features.

Despite a few initial difficulties around business process engineering, solution design, training and adoption, the department soon ironed out the kinks, staggering the implementation state-by-state over a period of six months.

According to Sampath Nalam, technical lead in Molina’s IT department, the system’s ease of use accelerated its adoption. Initial product training and consistent technical support from the Laserfiche technical team also helped Molina to understand the Laserfiche product architecture, resolve implementation issues and accelerate the project deliveries.

The IT department trained the credentialing managers, who then trained their staff. “Most users picked it up pretty easily within a couple of days,” says Nalam. “It’s not too complex for users to understand and navigate through the Laserfiche application.”

Eisenman echoes this sentiment: “Laserfiche is very intuitive for users. It’s pretty close to point and click.”

ECM in Action

In order to put Laserfiche into action, one of the first steps for Molina was to restructure its credentialing process to take advantage of the system’s capabilities. “Today,” says Eisenman, “all roads for credentialing lead to Laserfiche.”

When a practitioner is being credentialed with Molina for the first time, departments outside of Credentialing obtain the application data—either from a physical application or from CAQH, one of the largest credentialing data sources in the country. The application data soon ends up in the credentialing department, which is where 85% of the work associated with the credentialing process takes place.

“We get a hodgepodge of data sets,” explains Eisenman. “XML data, text files, PDFs, spreadsheets, paper… the list goes on and on. We pre-process the data to make sure it meets our standards and organize it into an intelligent list, at which point it all goes into Laserfiche.”

In Laserfiche, the data is automatically filed—usually in large batches—in the Laserfiche folder structure. Once the information is in the system, the ‘Laserfiche workflow’ kicks in, alerting people to the various tasks they must perform on each application. For example, credentialing specialists populate template fields with metadata to indicate file completion or file discontinuance, which moves the file forward to a credentialing lead, who quality checks each file.

“We now have about 100 people using Laserfiche to some degree, and about 50 of those people use Laserfiche on a continuous and daily basis,” says Boe. “After a bit of trial and error, we’ve figure out our ideal process for implementing a centralized and paperless credentialing system.”

Measurable Results

Molina’s corporate credentialing department has realized a number of benefits resulting from its Laserfiche implementation, including:

• Decreased turnaround time (TAT) for processing applications by 44%.
• Twice as many applications processed per month.
• Greater visibility of information enterprise-wide.
• Faster provider network development.
• Decreased credentialing costs.
• Standardization of procedures and workflows.
• Improved security of protected information.

“The Laserfiche SDK has enabled us to automate an incredible amount of our data processing,” Eisenman says. “It has made the credentialing process much faster and much more consistent.”

“When we first started working with Laserfiche, there was a brief period when the TAT went up and our volume went down as we adjusted to the new process and the new technology,” Boe explains. “Once we’d conquered that initial learning curve and overcome the initial technical hurdles, however, the speed at which we can process applications skyrocketed. We’re currently completing approximately 1,500 applications a month, which is up from just under 800 a month a year back.”

Eisenman reports that Laserfiche has greatly increased the visibility of credentialing information across the company, while also decreasing the liabilities that are related to working with paper files. “Visibility has gone up, while unauthorized access to information has been eliminated,” he says, adding that the department’s paper costs “have fallen off sharply.”

“We’re very happy with Laserfiche,” Boe concludes. “It has accelerated the credentialing process and added a lot of value to our organization.”

“Most people don’t have pleasant memories associated with hospital stays: You’re sick, you’re scared, you’re away from your family,” says Shawana Rucker, IT manager at SSCBR. “SSCBR’s goal is to change all of that.”

Founded in 2003 as a physician-owned specialty hospital, SSCBR set forth to serve the needs of the local community. In 2008, the physicians partnered with Our Lady of the Lake Hospital and continue to provide a patient-focused facility serving the needs of the community. In this capacity, SSCBR is fully committed to providing the highest level of patient care. This commitment extends from architectural design to inpatient amenities, staffing and even medical records requests.

“As a specialty hospital, SSCBR uses the most advanced technology available to enhance the level of patient care—and not just in the operating room,” explains Rucker. “For example, Laserfiche gives us a user-friendly way to provide staff with instant access to the information they need to admit and treat patients. It also allows us to respond more quickly to patient requests regarding billing or medical records inquiries.”

Easy Road to EMR

With approximately 200 employees and a patient load of nearly 20,000 hospital services per year, SSCBR wanted to scan and store patient records in an electronic format, but its health information system (HIS) could not handle the high volume of content required.

“We’d only been open for a year,” says Rucker, “and we were already running out of space for record storage. We thought HIS would solve our problem, but when it didn’t, we turned to Laserfiche for help.”

In 2005, SSCBR purchased Laserfiche from JPI Data Resource, a Laserfiche reseller that specializes in healthcare deployments. “We chose Laserfiche because it’s so easy to use,” explains Rucker. “Although it doesn’t fulfill all of the government’s criteria to be considered a comprehensive EMR, Laserfiche has absolutely given us a centralized and secure way to manage our electronic records.”

To get records into the system, SSCBR uses Laserfiche Quick Fields, a high-volume document capture and processing tool. By automating the capture process as follows, Quick Fields eliminates the potential for keystroke errors when digitizing records:

• SSCBR puts barcodes on hardcopy medical records so that they can be easily scanned into Laserfiche.
• Quick Fields reads a barcode, automatically capturing important patient identifiers.
• Quick Fields automatically creates the folder structure and autofiles the patient’s scanned records.

“Laserfiche definitely makes life easier for our staff,” says Rucker. “It saves a lot of time on data entry with only minimal training. The only thing end users need to do in Quick Fields is tell the system where to store the records.”

In addition to simplifying patient records management, Laserfiche also streamlines admissions procedures by allowing SSCBR’s front-desk personnel to quickly scan and process insurance cards, driver’s licenses, patient history forms and more. Likewise, Laserfiche speeds the billing process by providing on-demand access to patient EOBs, claims and statements.

From a patient care perspective, Laserfiche enables staff members to locate medical records, admissions items and billing information within seconds so that they can answer patient inquiries faster. “Whether a patient is onsite or phoning in with a follow up question, our employees don’t have to search through boxes of paper files anymore,” says Rucker. “Laserfiche makes it fast and easy to keep our patients informed.”

Securing Compliance

As with any hospital or medical practice, protecting the integrity of patient information—and complying with HIPAA—is critical to SSCBR’s success. Laserfiche provides comprehensive security that protects sensitive information while still allowing authorized personnel to instantly access necessary files.

According to Rucker, SSCBR integrated Laserfiche with Windows Active Directory® to simplify the authentication process. “The IT department assigns Laserfiche rights and privileges to staff through Active Directory, which makes it easy for people to log into the system and easy for us to administer,” she says.

“We have role-based security in place. People in the admissions department see the admissions items. People in the business office see the EOBs. Clinical staff has access to the medical records. Most people have read-only access to the documents they’re authorized to view. With Laserfiche Audit Trail, we have the ability to run security audits, but I run them very rarely because the security controls are so good that people really can’t do anything wrong.”

What’s Next

SSCBR is very pleased with the benefits it has received from Laserfiche over the past five years. “The system is easy to use, it doesn’t require much training and it saves us a lot of time,” explains Rucker.

Moving forward, SSCBR is considering implementing Laserfiche Workflow in its purchasing department. Workflow enables organizations to automate collaborative business processes by designing custom workflows to fit their needs. A workflow automatically performs specified actions at appropriate times, such as sending a document to a specific user, populating a field, adding a tag or sending an e-mail.

According to Rucker, Workflow would deliver additional time-saving benefits during the procurement process, “especially for activities such as creating POs.”

At the end of the day, though, SSCBR’s investment in Laserfiche comes back to the standard of care. “Patient service is important,” Rucker concludes. “In that, we strive to be like a five-star hotel. Laserfiche helps us to operate more efficiently and effectively, and by accelerating our response to patients, it enables us to increase their comfort level as well.”

Back then, CHMB was struggling to manage a surplus of paper documents so colossal that “we were using filing cabinets as walls and dividers between cubicles,” Anderson remembers. When this elicits chuckles from his listeners, he suddenly gets serious: “It’s funny until it costs you money. And, boy, that paper was costing us a lot.”

The Paper Pit

With over 700 physicians as clients, CHMB currently processes more than two million patient encounters annually—which translates into approximately 10 million documents a year. CHMB breaks the various types of documents down into four different “batches” for processing:

• Charges. Includes superbills, operative reports and patient information.
• Payments. Includes explanations of benefits (EOBs), checks and deposit slips.
• Correspondence. Includes requests for additional information from insurance companies/payors.
• Discrepancies. Includes items that require corrections or more complete information.

“Prior to implementing Laserfiche, we were using couriers to transport materials back and forth between our office and our clients’ practices, and paper storage was consuming valuable work space,” recounts Anderson.

But the cost of managing so much paper wasn’t limited to courier, mail and storage costs; it also extended into employee time and productivity. “Staff had limited access to the paperwork they needed to process, so there were a lot of inefficiencies there,” says Anderson. “And with so much paper coming in and out the door, we were constantly struggling to intelligently manage our workflow; there were just too many moving parts.”

To stop the bleeding, CHMB started looking into content management solutions. According to Anderson, “There are less expensive options out there, but if your system becomes an obstacle to productivity, that’s a problem. We chose Laserfiche because we knew that it would make us more efficient. There was no question about that.”

Serious Savings

With the help of Laserfiche reseller JPI Data Resource, CHMB implemented its content management solution in 2004. Since then, the billing company has been released from its dependence on paper. The volume of paper coming into the office has decreased, since approximately 50% of CHMB’s clients scan and upload their documentation directly to the medical billing company via a secure FTP site. Although the other half of its clients still send paper, CHMB immediately scans the paperwork into Laserfiche and securely disposes of the paper originals after 30 days. “Our shredder stops by twice a week,” says Anderson. “Paper is ugly, and we’re no longer using file cabinets as cubicle walls.”

Laserfiche has also decreased CHMB’s couriering costs by 50%, but the efficiency gains have been even more impressive. “Laserfiche has enabled us to streamline, manage and audit our workflows,” Anderson explains. “Productivity has increased by 20%.”

With Laserfiche, employees have desktop access to all of the documents they need, and data from the system also provides management with a comprehensive overview of the company’s workflow, including:

• Where documents are in CHMB’s workflow.
• Who is working on each document.
• The length of time it takes to process each document.

This type of tracking enables CHMB to measure the efficiency of its workflow and staff. It also enables the company to send reports to clients so that they can quickly identify whether they’ve neglected to send any necessary documentation. As a result, claims are paid faster, clients are happier and CHMB is more profitable.

Unexpected Benefit: Laserfiche Enables a Remote Workforce

According to Anderson, the biggest benefit of implementing Laserfiche is something that CHMB had never even imagined. “When we first bought the system, we had no idea that it would allow us to add 150 employees without relocating or acquiring additional office space,” he says.

Today, CHMB employs a corps of remote workers located around the country who connect to the company’s systems via a secure VPN. To ensure productivity, CHMB created standards and benchmarks for its remote workforce, and the results have been a tremendous success.

“The quality of our staff has increased since we began employing telecommuters,” says Anderson. “We’re able to attract the best people, without geographic limitations, and we find that people who value the flexibility to work from home work harder because they don’t want to lose that perk.”

Laserfiche has also enabled CHMB to offshore certain processes. “We now have a 24-hour workforce,” explains Anderson. “We’re getting work done around the clock.”

Thanks to its increased productivity and profitability, CHMB has been in acquisition mode of late. In September 2008, it acquired a San Diego-area billing company, and in October 2009 it bought a billing company in Orange County. “The first company we acquired was already using Laserfiche,” says Anderson, “so that merger was incredibly smooth. The second company used a different content management platform, so that transition has taken a little more work.”

Overall, “Laserfiche has been a huge differentiator for us,” Anderson concludes. “We’re saving money, we’re more efficient and we’ve added 150 new employees without having to pay for additional office space. Laserfiche is a great product that’s had a huge impact on CHMB and the high quality results we provide for our clients.”

For example, it was nearly impossible for employees to append pages to scanned documents that were stored in Alchemy; typically, in order to add pages, the whole document needed to be rescanned and resaved.

Jacquez-Nares urged the city to find a more sophisticated, user-friendly solution. It was at this point that a collaborative, inter-departmental team was formed with Jacquez-Nares as the project manager.

All of the City’s departments—City Clerk, City Manager, Community Development, Community Services, Finance, Human Resources, IT, Police and Public Works—came together to define their requirements for the RFP. The selection came down to two choices: Laserfiche and LibertyNET. In the end, the balance tipped in favor of Laserfiche for two reasons:

• Its comprehensive search functionality and easy-to-use Web interface made Laserfiche the most user-friendly choice.
• A formal needs assessment showed that implementing Laserfiche would ultimately save the city $273,200 by freeing up enough office space to create a total of 13 workstations for essential city services such as traffic management.

Westminster purchased the software from Laserfiche reseller ECS Imaging in June 2008. Because Laserfiche is easy to use and Jacquez-Nares already had a lot of experience with it, virtually no formal training was required. By August, the solution had been installed, the City had begun back scanning the Planning Department’s records and by November, all Alchemy files had been migrated into the new system.

Making City Content Accessible in Seconds

As a part of its Laserfiche enterprise content management (ECM) solution, Westminster deployed Laserfiche WebLink, a secure Web content portal, to make content immediately accessible to all 402 city employees.

“In the old days, people in our Community Development department had to visit our offsite storage facility three or four times a week in order to locate planning documents,” says Jacquez-Nares. “When you add up the 15-30 minutes it took to drive there, the time spent looking for relevant documents and then the time it took to drive back to City Hall, you’re talking about 4-5 hours a week. With Laserfiche, it only takes a few seconds to call up all necessary documentation.”

The impact of Laserfiche on the City Clerk’s Office has also been great. “As the lead office for Public Records Act Requests, we receive all records requests and hear directly from the public about their concerns,” says Jacquez-Nares. “With Laserfiche, citizens no longer have concerns about transparency or document integrity because digital records don’t get lost or damaged, and they’re available much faster than their paper-based counterparts.”

All the City’s departmental records are currently scanned into Laserfiche on a day-forward basis by Kelly Lore, the centralized scanning records clerk. Just a few of the different types of content stored in Westminster’s Laserfiche repository include:

• Agendas
• Agreements
• Bids
• Building permits and plans, including large format plans
• Deeds
• Planning Department records
• Staff reports

“All of our departments have access to Laserfiche, and people are always coming up with new ideas for how to use it,” says Jacquez-Nares. “It’s much more useful than Alchemy—and much easier to use!”

IT Support Is a Snap

For a city like Westminster, with an IT department of only five employees, software applications must not only be easy to use, but also easy to maintain and administer. In fact, Laserfiche is so easy to support that Jacquez-Nares serves as system administrator, working with users across the City’s departments to structure the City’s content repository, create index fields for various City forms, and set up Quick Fields sessions to automate information capture.

“IT staff members create a backup when they’re updating the server,” says Jacquez-Nares. “Other than that, they pretty much leave everything to do with Laserfiche up to me.”

Future-Forward

Westminster has exciting plans for Laserfiche moving forward. Incoming City Clerk Robin Roberts recognizes the efficiency that Laserfiche ECM brings to Westminster and seeks to build on the project’s success by promoting city-wide use of Laserfiche through added integrations and training sessions.

With the help of ECS, the team is currently in the process of integrating Laserfiche with the City’s GIS system so that all building plans associated with any given address are accessible from within Westminster’s GIS application, CityGIS. Similarly, the City is also working on integrating its electronic permitting application with both Laserfiche and CityGIS. These integrations will save staff from performing time-consuming research to locate information about various addresses or land parcels.

The City also has plans to upgrade to Laserfiche Avante, which will bring Workflow functionality into Westminster’s arsenal, enabling it to automate standard business processes such as approvals and document routing. According to Jacquez-Nares, Westminster is also contemplating integrating Laserfiche with SharePoint, which the City owns but has not yet rolled out. Using SharePoint as a collaborative portal would, for one, help the City Clerk’s Office generate agenda Council packets in a paperless manner. Combining Laserfiche with SharePoint would bring imaging capabilities to SharePoint and enhance the SharePoint repository.

Even without these system expansions, the City is extremely pleased with the Laserfiche implementation. “Many people had to work together to make this project a success, and it’s wonderful to see just how effective a collaborative management team can be,” concludes Jacquez-Nares. “People are using Laserfiche, and the positive results have been staggering so far.”

• Faster audits.
• Streamlined lending.
• Improved business continuity planning.
• More efficient processes for opening new accounts.
• A 33% reduction in hard copy document production and an 85% reduction in paper storage.

Original Pain Points: Data Storage and Accessibility

When Tato Munoz joined D.L. Evans as IT director in 1998, one of the first challenges he set out to tackle was the bank’s approach to data storage. “With the incredible amount of information we had, keeping everything accessible and knowing where it was all located at any given time was difficult,” he says.

At first, the bank considered simply finding a more efficient way to manage its paper-based documents. However, as Munoz explains, “That wasn’t really an option because we were filling up our secure storage facilities pretty fast.” At the time, the bank’s storage space included a 20×13 room, a 12×12 vault and an off-site warehouse. According to Munoz, “Keeping track of what was due for disposition, finding it in that crowded warehouse and then shredding it all was a nightmare.”

In addition to the headache associated with storing paper records, Munoz knew that paper was a frighteningly fragile medium, and he wanted to ensure that records would be accessible even in the face of tragedy or natural disaster. “If we gave documents to an auditor and he got into a car crash and the documents were destroyed, we had no back-ups,” he says. “It would have been extremely detrimental to our business.”

To break the bank’s reliance on paper records without breaking the IT budget, Munoz began investigating enterprise content management solutions.

Pioneering Laserfiche within a Banking Environment

It was September 15, 1904, when a group of enthusiastic and dedicated pioneer businessmen led by D. L. Evans met to organize and open the first bank in Cassia County, Idaho. But it was nearly a hundred years later that Tato Munoz brought that same pioneering spirit to the bank’s approach to content management.

“Back when we were evaluating content management systems, there were no other banks using Laserfiche,” says Munoz. “I saw what government, education and healthcare customers were doing with it, though, and I knew that we could realize the same benefits.”

According to Munoz, the deciding factors in selecting Laserfiche were reliability, security and ease of use. Chief among these, however, was ease of use. “It was clear that Laserfiche was very easy to implement and use,” says Munoz. “And now we have 10 years of experience to back that up!”

Streamlining Lending

When it came time to deploy the new Laserfiche content management system, D.L. Evans started with its consumer loan department, where loan packets routinely numbered 500 pages and frequently had to be photocopied as many as 20 times.

Originally, the bank planned to focus on converting loan applications and supporting documents into an electronic format on a day-forward basis, only back scanning about a year’s worth of files. It wasn’t long, however, before D.L. Evans decided to scan and store all existing loan records in Laserfiche. “Once we started processing our paperwork, everything was so quick and easy that we decided to go all the way back,” says Munoz. “We also extended our deployment into the commercial loan department pretty fast.”

Today, lending documents are generated electronically at the branch locations and captured into Laserfiche using Snapshot, which creates TIFF images of electronic documents for long-term archival—and eliminates the need to print paper documents in order to scan them into the system. Missing information, along with supporting paper documents, is later scanned into the system at the head office.

The bank has one centralized Laserfiche repository, which is critical for ensuring that staff from different branches can access and review lending materials at any time.

According to Munoz, “What used to be an extremely time-consuming, cumbersome process is now fast and easy, especially on the document retention side.” He adds, “We used to store one year’s worth of lending documents in a 12×12 vault. With Laserfiche, electronic document retention is unlimited, and our vault has been freed up to hold seven years’ worth of titles, which must be stored in a physical format per the FDIC.”

Expanding Laserfiche throughout the Organization

Building on the success of Laserfiche within the consumer and commercial lending departments, D.L. Evans soon rolled the system out to departments enterprise-wide, including:

• New Accounts, where staff streamlines document capture for 258 different types of documents, including signature cards, CD applications and ATM requests, using Quick Fields.
• Tellers, who automatically access client documentation from the Laserfiche repository through an integration with EZTeller, the bank’s branch automation software.
• Human Resources, where staff uses Laserfiche to securely manage confidential employee information.
• A/R and A/P, whose staff tracks and stores incoming and outgoing invoices.

When asked whether there have been any issues with user adoption, Munoz laughs and replies, “Yeah, we’ve got a little problem with adoption: Once people see Laserfiche and how easy it is to access information that’s in the system, they want to use it for more and more things. Our problem is that people like it too much!”

In fact, over the past year, the bank implemented Quick Fields in response to the new account desk’s requests to streamline its processes by automating data capture and eliminating the need to populate template fields manually. With 258 different types of forms brought into the system via both Snapshot and manual scanning, “the new account desk uses Quick Fields extensively,” says Munoz. “They run approximately 450 Quick Fields sessions every night on all kinds of documents, including signature cards, CD applications, ATM requests and so on.”

For tellers, Laserfiche has become a significant part of their daily business processes due to an integration with EZTeller, the bank’s branch automation software. EZTeller links ups with Laserfiche, automatically pulling up relevant documents stored in the repository so that customer service is faster and more efficient. HR staff, meanwhile, particularly appreciates the ability to easily and automatically redact confidential employee information using Laserfiche’s secure black-out and white-out redactions. Accounts Payable and Accounts Receivable digitize all of their invoices, making them simultaneously accessible to multiple people and easier to keep track of.

Laserfiche has also shored up D.L. Evans’ data retention and compliance policies. And it’s cut down the time it takes to perform external FDIC audits and internal audits by approximately 50%. “We give our auditors encrypted USB drives with all of the electronic documentation they need to review, so they can complete most of their work off-site,” explains Munoz.

“Audits used to take three to four weeks,” he continues. “Now they take two weeks at the most.”

In terms of security and disaster recovery, Munoz says that all of the bank’s information “is encrypted and backed up to disk. Laserfiche is mirrored on an external drive that we pull out once a week and store offsite as an encrypted drive. The system’s images and SQL database are also mirrored and continually sent out to another location via the network. I never worry about security, and I never worry about business continuity anymore, either.”

With ten years of savings and streamlined processes in multiple departments under its belt, the bank is now considering adding Laserfiche Workflow to its arsenal for improving institutional efficiency.

From a Supporting Application to a Critical One

Overall, using Laserfiche has “changed the way we do business,” Munoz explains. “It’s changed our mindset and streamlined all of our processes. In the past, people used to think, ‘If I don’t have it on paper, it’s no good.’ That way of thinking has totally shifted, and now it’s more like: ‘If it’s not electronic, it’s not as accessible, it’s not as affordable, it’s not as secure.”

A happy early adopter of Laserfiche content management in the banking space, Munoz concludes, “Laserfiche went from being a supporting application in a couple of departments to being a critical one enterprise-wide. It’s a great product and we’ve been extremely satisfied.”

With ten clinics and two in-vitro fertilization (IVF) centers located throughout the greater Chicago area, the Fertility Centers of Illinois (FCI) already had an Electronic Medical Records (EMR) system in place. However, the ArtWorks EMR system only stored patients’ current, FCI-based medical data—historical medical records were kept as paper files, as were lab results, surgery reports and other outside correspondence.

After turning to Laserfiche in order to convert the processing of insurance company explanation of benefit (EOB) reports from paper to a digital system in May 2006, FCI quickly realized that its use of Laserfiche could be expanded to encompass additional medical data—such as lab results and X-rays—that was not stored in ArtWorks. According to Bonnie Kelly, IT supervisor at FCI, “When we switched from paper to Laserfiche for EOBs, the patient account representatives were working with it like veterans by the end of the first day. Over the next several weeks, we saw so much improvement and so few problems that we felt confident that we could move on to patient charts.”

Laserfiche reseller TKB Associates integrated ArtWorks and Laserfiche, working in conjunction with the ArtWorks support team at IntegraMed® America, Inc. (NASDAQ: INMD), FCI’s New York-based national network. “With the integration,” says Kelly, “our doctors have complete access to every bit of their patients’ records, both current and historical.”

In July 2006, the FCI clinic in Glenview began converting its paper charts into digital Laserfiche files. Eleven weeks later, nearly 7,000 charts had been scanned into the system, freeing up enough storage space to create a new nurses’ station.

Quick Capture with Quick Fields

According to Kelly, the conversion process was swift because Laserfiche Quick Fields, a high-volume document capture and processing tool, makes scanning “foolproof and easy.”

FCI knew that it wanted its digital repository of charts to be alphabetical by patient name, with each chart divided into 16 sections, including Demographics, Insurance, Previous Medical Records, Ultrasounds and X-Rays, Lab Results and so on. With the help of Jerry Breitbarth at TKB, FCI used Quick Fields to design a process that accelerates scanning and makes the electronic information readily accessible:

• FCI created a template in the ArtWorks EMR that prints a collection of header sheets for each chart.
• Header sheets contain a keyword (NEWF) that tells Laserfiche it is dealing with a new record.
• Patient’s last name, first name, middle initial, social security number and birthday are printed onto the header. There is a new header sheet for each chart section.
• Quick Fields reads the information off the header sheets and creates a file (including subfolders for each chart division) for each new patient.
• Laserfiche files new charts alphabetically within the folder structure, and files each patient’s documents within the appropriate subfolders in their chart.

This way, people do not have to stop and tell Laserfiche where each page of the chart is supposed to go; they simply print the header sheets, replace the chart dividers with the appropriate header sheets and scan the charts—Laserfiche does the rest.

To date, nine of FCI’s clinics have fully transitioned their patient charts to Laserfiche, with another clinic and the two IVF centers next in line.

Running Smarter

For Tracy Guzman-Barron, administrative services supervisor at FCI, there are three major benefits associated with the company’s Laserfiche implementation:

• Increased information access.
• Enhanced security and easier compliance with HIPAA and other privacy regulations.
• Savings from reduced couriering, storage and paper usage.

First, says Guzman-Barron, “In an emergency, our doctors don’t have to wait around for someone to retrieve a patient’s chart. With Laserfiche, you get instant access.” It’s also next to impossible, Guzman-Barron reveals, to lose a chart in Laserfiche. “Even if something gets misread and misfiled, if it’s in Laserfiche, you can use the system’s search functionality to track it down. That’s not the case when you’re dealing with fifty, sixty or seventy boxes of paper files.”

Second, in terms of data security, “It’s much safer having patient information in a secure, electronic repository than to have paper copies of records lying around on people’s desks,” Guzman-Barron says. “No one can access Laserfiche without a log-in and a password. Even then, everyone’s level of access is tailored specifically to their role and responsibilities. For example,” she adds, “there are only two of us who have the ability to delete.” In addition, Laserfiche Audit Trail tracks and records user activity within the repository. “If anyone is doing anything incorrectly,” Guzman-Barron says, “I can address it with that person right away.”

Third, FCI has experienced a wealth of savings in a number of different areas. “With Laserfiche, we reduced our off-site storage bill by $500 a month,” says Guzman-Barron. “As we scan and destroy old paper medical records, the cost for record retention will continue to decrease.” Documents are shredded after they’ve been scanned into Laserfiche, and several of the clinics been able to convert old storage space into office space as a result. And because electronic records can quickly and easily be printed and mailed or faxed to authorized healthcare providers, FCI saves $50-$75 in couriering and processing costs per chart with Laserfiche.

Furthermore, in these tight economic times, Laserfiche is helping FCI to do more with less. In fact, when the company had an internal reorganization and had to let go of five administrative staff members, it was able to continue doing the same amount of work within Laserfiche thanks to the system’s ease of use. “We used to have seven dedicated staff members who scanned everything into Laserfiche,” says Guzman-Barron. “Now two of us go to the different clinics and train the office staff on how to scan and organize things for themselves. We create centralized templates and standards and then give the offices the flexibility to import files as they see fit.”

She adds, “This isn’t a hard system to learn. I was a novice when I started here in 2007, but it was extremely easy to get into the swing of things. All of our doctors use Laserfiche. It saves us a ton of time, money and frustration.”

Looking Ahead

As FCI gets close to having all patient charts at all of its locations securely stored in Laserfiche, it is planning to expand its system use to various other departments. According to Guzman-Barron, Human Resources will get the next big efficiency boost. After that will come Payroll.

“Laserfiche makes everything easier,” concludes Guzman-Barron. “It’s been a godsend for us.”

Created in 1965, Head Start is the most successful national school readiness program in the United States. It provides comprehensive education, health, nutrition and parent involvement services to low-income children and their families. All told, nearly 25 million preschool-aged children have benefited from the program nationwide.

The Los Angeles County Office of Education (LACOE) operates the largest Head Start-State Preschool program in the country, contracting with 26 agencies that employ a staff of more than 3,000 people and serve more than 25,000 children—and their families—in the greater L.A. area each year alone. Of course, with that many clients comes all kinds of records: attendance tracking, child abuse and accident reporting, growth charts, fiscal reports and more. Organizing and ensuring fast access to them all was becoming a major problem.

Dealing with Data Silos

“Head Start has three units that monitor the services we provide and the agencies we contract with,” says Shirley Lee, an administrative analyst with LACOE. “In order to get a full picture of the agency, you need to be able to review content from all three units at once. Prior to implementing Laserfiche, each unit was its own data silo. It took a lot of time and effort to track down all of the information necessary to gain a 360 degree view of our operations.”

Head Start’s three monitoring units are:

• Program Review and Support (PRS). Manages program-related information from children and their families, health and social services, and personnel.
• Internal and External Affairs (IEA). Manages information related to enrollment and attendance, funding and program goals and objectives.
• Fiscal Operations and Support (FOS). Manages financial information and ensures that costs are necessary, allowable, reasonable and allocable.

According to Lee, centralizing the agency’s approach to data governance was a key driver for implementing an enterprise content management (ECM) solution. Other drivers included:

• Inadequate storage space. LACOE used massive quantities of paper to print out hardcopy records relating to the Head Start program. The file room was constantly overflowing, and employees were always on the lookout for additional storage space.
• Missing files. Inconsistent labeling, the lack of a file index, ineffective check-in/check-out procedures and uncontrolled access to the filing room led to a large number of lost and misplaced files, as well as concerns over information security.
• Decreased productivity. Staff members spent many hours storing, retrieving and searching for documents. Because records could not leave the file room, employees needed to photocopy any document they wished to review at their desks, consuming even more time and paper.

“We were all tired of running around to the various monitoring units looking for documents that were stored all over the place,” explains Lee. “Our old way of doing things made it difficult to get a comprehensive view of the program, ensure compliance with county requirements and guarantee document security.”

Giving Head Start a Leg Up

Laserfiche has helped LACOE’s Head Start-State Preschool program improve efficiency by digitizing student documentation. Using Laserfiche, the Head Start program now scans all paper documents and stores them, along with electronic content, in a central, secure Laserfiche repository.

According to Lee, the specific benefits Head Start has realized as a result of implementing Laserfiche content management include:

1. Centralized, secure records management. Today, all records and content from the agency’s three monitoring units are stored electronically in the Laserfiche repository. With a single click, authorized employees can easily access all of the information they need from PRS, IEA and FOS to gain a complete, 360 degree view of the agency’s operations.
2. Storage savings. Without the need to save thousands of paper records, LACOE has decreased the size of its filing room so that it has more room for what really matters: better serving its students and their families. The old filing room now serves as a large conference room that can comfortably accommodate a greater number of attendees.
3. Fewer missing files. Laserfiche has eliminated many of the causes that led to lost or missing files, including inconsistent file naming, ineffective check-in/check-out procedures and uncontrolled access to the filing room. Drop-down lists ensure standardized file names, Audit Trail functionality enables LACOE employees to ensure that files have been scanned into the system and tracks who has worked with particular documents, and Laserfiche security limits access to authorized users.
4. More efficient employees. With the help of ECS Imaging, the agency’s Laserfiche reseller, LACOE employees use copiers to scan batch jobs into the system, where Quick Fields automatically indexes and files them into the appropriate Laserfiche folders. This has enabled easy scanning and instant search and retrieval from the comfort of each employee’s desk, saving time and effort.

“We thought we were just getting a repository to hold our electronic files, but Laserfiche is so much more,” says Lee. “Laserfiche content management is helping our whole agency become more organized and efficient. You will be amazed at what it can do for you!”

Of his probationers, Eyrick says, “They’re just people who make some bad decisions. I try to focus on their issues and their individual dynamics, while at the same time testing them and making sure they’re doing what they’re supposed to be doing.”

In recognition of his commitment and personal dedication to the job, Eyrick received the 2009 “Order of Augustus,” an annual statewide probation officer award named for John Augustus, the father of probation in America.

But Eyrick’s responsibility extends beyond offering assistance to individual offenders: He’s also tasked with developing and coordinating the direction of the probation department as a whole.

For Eyrick, technology plays an important role in shaping departmental strategy. Under his direction, the department recently rolled out a video conferencing system, which has improved security by keeping inmates in jail during their arraignments. The department has also benefited from the chief probation officer’s decision to implement Laserfiche content management more than seven years ago.

“Prior to implementing Laserfiche,” Eyrick says, “we were storing piles of files that had accumulated over the course of more than twenty years. Organizing everything was a problem, as was finding enough storage room. Laserfiche changed all of that.”

Specific benefits the probation department has realized since implementing Laserfiche include:

• Increased efficiency. Without leaving their desks, employees are now able to instantly locate probationary records within the superbly-organized Laserfiche content repository. Staff members are more productive because they no longer have to waste time searching for client files in cluttered filing rooms.
• Easy integration. Laserfiche provider BOLT Document Management created a useful integration with the probation department’s case management system that allows probation officers instant access to clients’ files while viewing case information in the database.
• Storage savings. Scanning old records into Laserfiche allowed the department to destroy thousands of hardcopy documents and reclaim a large storage room that had been in utter disarray. The Court Clerk, who shares the space, benefits from how neat and organized the room is today.

Eyrick’s success with Laserfiche soon attracted attention outside of his department, and it wasn’t long before Darlene Hale, IT director for the entire county, came calling.

The Tipping Point: From One Department to Many

Charged with delivering the most effective and affordable technology to all LaPorte County offices including the auditor, treasurer, probationer, surveyor, juvenile detention and more, Hale had noticed a few problems with the way content management had been rolled out county-wide. Chief among them was that, in the years before she’d taken the helm, individual departments such as Eyrick’s had been allowed to choose and deploy their own preferred IT systems. As a result, interoperability was lacking, sharing information was difficult and costs were high.

It was time to standardize.

In the course of Hale’s research, she determined that if one of the content management systems already in use could be expanded, the cost of conversion wouldn’t be quite so high. Two systems rose to the top: Laserfiche and Docuware. Ultimately, after talking to Eyrick and his department, comparing features and functionality and considering ROI, Laserfiche won out.

According to Hale, “The biggest thing that sets Laserfiche apart from other content management solutions is the sheer ease of use. The layout is simple and intuitive, so it’s easy for users to pick up, but just as important for IT professionals like me is that it’s also easy to administer. Setting up templates and user licenses, integrating it with other products and external applications: everything is just so easy.”

BOLT helped LaPorte County migrate the content stored in Docuware into Laserfiche by completing the following five steps:

• Examining the document and information structure of the old Docuware repositories.
• Obtaining samples of documents and data from every unique document set.
• Using the samples to determine the logic and structure incorporated in the repositories.
• Creating a unique conversion program for each document set.
• Importing and testing samples from each set in Laserfiche.

Once the testing was successfully completed, the conversion process began—one department at a time.

Each phase of the migration project was carefully defined and scheduled, since departments needed continuous access to stored content even while the process was underway. Employees were allowed to look up existing information in Docuware, but to prevent “orphaned” records, staff was not allowed to make any additions or changes. After the process was complete, the converted information was mounted as new volumes to the county’s Laserfiche server. BOLT then installed and configured the Laserfiche client software on department computers and trained each department’s personnel.

Users Love Laserfiche

Although LaPorte County now has centralized control over all of its content (ensuring that information from all departments can easily be shared), Laserfiche grants each department the flexibility to adapt the system to the way they work and manage their files. “Our users love Laserfiche,” Hale explains. “It just has so many more uses and capabilities than what they were using before.”

The county, too, has reaped the benefits of standardizing on Laserfiche. Overhead costs for content management have diminished, and information management throughout county offices has dramatically improved. In addition, all of the advantages that Steve Eyrick’s probation department realized as a result of implementing Laserfiche—increased staff productivity, storage savings and easy integration with mission-critical applications—have now materialized for all of the departments under Hale’s purview.

“Better system, more functionality, lower overhead costs, excellent ROI,” Hale concludes thoughtfully. “What’s not to love?”

As the state regulatory agency charged with protecting citizens’ health and safety, the Medical Board regulates the practice of medicine in Texas by licensure, discipline and education. It has a legislative mandate to file and track all complaints filed on any doctor licensed in the state—typically hundreds of them a year.

In the past, investigating all of those complaints led to the creation of thousands and thousands of paper documents that could be used in legal proceedings, and shipping and storing them all was a considerable drain on the agency’s resources. Staff members could injure themselves moving boxes of records around, and it could still take hours to find the exact paper document that was required for a legal hearing.

“The ability to retrieve information on demand is critical to legal proceedings and the agency as a whole,” says Anthony Merritt, a systems analyst with the Texas Medical Board. “At times our staff had boxes stacked up to the ceiling all around the office, just to have the appropriate documents on hand when they were needed. It was crazy. They knew there had to be a better way.”

Fits and Starts

The agency deduced that digitizing the documentation associated with complaints was the way to go, and it started by simply uploading and storing content on a number of different file servers. Managing content this way, however, turned out to be a nightmare: Files resided on different servers, and various departments were saving different versions of documents in their own network spots. There was no consistency. There was excessive redundancy. Worst of all, there was no way for an employee to guarantee that the document he was working with was really in its most current form.

Next, the agency opted to install a document management solution from FileNet. It worked well for a while, but as the agency grew and began to offer more services over the Internet, the existing system just couldn’t keep up. Customizing it to different departments’ needs required hiring a contract programmer, which made the cost of upgrading, customizing and maintaining the FileNet solution too high. According to Merritt, the system’s interface was cumbersome, and due to its limited features, “people were starting to avoid using it entirely.”

Comprehensive, Cost-effective Content Management

Once again faced with an untenable system for handling content, The Medical Board reviewed its alternatives and decided that replacing FileNet with Laserfiche—with its more comprehensive capabilities, lower maintenance costs and easier administration—was worth the upfront investment. “Laserfiche nearly tripled our ability to capture and process complaint documents,” explains Merritt. “It saves us time and energy every day.”

Merritt says Laserfiche’s key difference was its customizability to meet the agency’s specific needs. “There were multiple methods to input information into the system. With Quick Fields, we can manipulate the pages we scan in an automated fashion, while Web Access and WebLink allow us to serve documents to our off-site staff and consultants via the internet,” he says. “We’ve customized our system to cut costs dramatically by using less staff time, and ultimately create a better workflow for our agency.”

Specific benefits the Texas Medical Board has realized as a result of implementing Laserfiche include:

• Multi-file format capture. Because Laserfiche has the flexibility to capture multiple types of enterprise content, Medical Board staff are able to scan and store any file provided by the public, including image files, Microsoft Office documents and DVD media.
• Accelerated scanning. Laserfiche reseller DocuData Solutions set up scanning stations that assimilate thousands of documents into Laserfiche in a matter of minutes, saving massive amounts of employee time and storage space.
• Quick and easy data extraction. Laserfiche Quick Fields extracts information from scanned documents and automatically tags them with metadata (including the Bates Numbers required by the agency’s lawyers), enabling instant search and retrieval without adding extra work.
• Flexible file folders. The top-down file structure makes it easy to navigate the Laserfiche content repository, and unlike FileNet, the folder structure in Laserfiche can easily be altered to reflect changes in the way the agency processes documents or organizes itself.
• Granular security features. Rights and permissions based on department and individual job tasks free the IT department from having to constantly guard and monitor the system—while still ensuring that confidential consumer information is protected.
• Remote access. Laserfiche Web Access gives Board members the ability to log into their secure laptops and review all of the relevant case materials through their Web browsers—any time, anywhere, without having to lug boxes of paper records into meetings or rely heavily on support from IT staff.

“With Laserfiche, the Texas Medical Board settles consumer complaints more quickly, allowing us to continually meet our legislative goals,” concludes Merritt. “This is definitely a case where technology has made life easier for us.”

Prior to the creation of the Central Contra Costa Sanitary District (CCCSD) in 1946, however, Contra Costa County—located east of San Francisco, CA—was in crisis. A post-war building boom had brought an influx of new residents, most of them relying on septic systems that didn’t take well to the area’s heavy adobe clay soil. With septic tanks overflowing and waterborne diseases such as typhoid becoming a potential threat, health authorities considered the polluted conditions in the county to be among the worst in California.

As a result, the CCCSD was formed as a special district, a sewer system and treatment plants were put in place, and the public received much-needed access to safe water and sanitation.

By 2002, CCCSD had expanded to meet the needs of 450,000 people by maintaining 1,500 miles of sewer lines and treating an average of 45 million gallons of wastewater per day. But with 56 years of service came 56 years of records—including permits, construction plans and Board documents. Storage space was at a premium, gaining access to information was difficult and time-consuming, and the district wanted to strengthen its disaster recovery plans.

“Over the years, CCCSD has created a reliable and efficient infrastructure to handle the wastewater needs of thousands of Central Contra Costa residents,” says John Phillips, IT systems analyst for CCCSD. “Laserfiche is helping to add similar efficiency and reliability to our IT infrastructure, allowing us to provide our staff with faster access to the content they need to do their jobs.”

Implementing ECM

The special district enlisted Laserfiche reseller ECS Imaging to build out its information management infrastructure with Laserfiche enterprise content management (ECM).

The first department to implement Laserfiche was the Secretary of the District, which converted critical Board documents from CCCSD’s inception in 1946 through the present into an easily accessible, digital form. The Permits operation was next, with a much larger and more complicated filing backlog of permits and record drawings. This conversion process is still underway today.

“It was important for us to select a system that could handle many different forms of content,” says Phillips. “Documents are simple. Maps and drawings are where things get more complex.”

Today, permit job files (including maps and drawings) are scanned into Laserfiche offsite by ECS Imaging. This practice centralizes content management, reduces the need for physical storage space, minimizes wear and tear on the originals and enables convenient access to them by CCCSD employees.

Since 2002, many other departments have begun using Laserfiche to manage a wide variety of content, including:

• Maps and drawings (Engineering Support)
• Right of Way agreement files (Right of Way)
• Employee and retiree files (Human Resources)
• Standard operating procedures (Lab)
• Discharge permit documentation (Plant Operations)

Expanding ECM by Integrating GIS

To further improve information access, the special district expanded its use of Laserfiche by integrating it with CCCSD’s GIS system, AutoDesk MapGuide. The in-house integration grants engineers, permit counter staff and field maintenance crews instantaneous access to scanned permits and record drawings. This is particularly important for CCCSD’s field crews, which operate out of a separate facility without convenient access to paper records.

“Prior to the integration of Laserfiche and the GIS system, field crews were unable to access any of these records directly,” explains Carl Von Stetten, information systems analyst, Engineering Support, CCCSD. “They had to take the time to retrieve copies from a variety of filing rooms.”

To access scanned permits and record drawings, users simply double-click on a parcel or pipeline within a map, and then follow the links in the subsequent reports to content stored in the Laserfiche repository. According to Von Stetten, “This has eliminated time spent looking up hard copy permits and drawings and enabled our crews to be more productive in the field.”

Business Benefits

“Our deployment has focused on achieving specific business goals rather than on technical bells and whistles,” explains Phillips, “which is why we’ve had so much success.”

The key benefits CCCSD has realized as a result of implementing Laserfiche include:

• Increased efficiency. Today, all employees have easy online access to current and historical records, which are centralized in the Laserfiche repository. Access to additional content such as permits, HR files and operating procedures is granted to authorized users based on Laserfiche security protocol. Laserfiche search tools enable staff to locate information quickly, so time is no longer wasted on finding, copying and distributing content. The system has also reduced CCCSD’s need for storage space.
• Easy integration with GIS. By linking Laserfiche to its GIS system, CCCSD engineers, permit counter staff, and field maintenance crews can instantly access scanned permits and record drawings. This is a particular timesaver for CCCSD’s field crews, which operate out of a separate facility without convenient access to paper records.
• Improved disaster recovery. In the past, disaster protection focused on preserving and protecting vulnerable paper copies. The installation of Laserfiche, with redundant off-site storage, has greatly improved the district’s ability to protect historical and vital records. “We hope we never face an emergency that will demonstrate the benefits of having Laserfiche,” says Phillips, “but we have to be prepared.”

“My best advice for companies that want to extend their information management infrastructure with ECM is to talk to other users who’ve done what you’re trying to do,” concludes Phillips. “Leverage their experience to ease your implementation and achieve your goals.”

As a contract manufacturing company that specializes in medical device implants and surgical instruments, precision is a chief concern for RMS. For over forty years, the company has ensured the accuracy and quality of its products, spurring expansion and business growth. But as the organization grew, some of its processes failed to evolve along with it.

“As a contract manufacturer, we fulfill a substantial number of jobs every year,” explains Michael Eklund, information systems coordinator at RMS. “We used to place all of the order information into a file folder and pass it around to multiple teams throughout our 155,000 square foot machine shop. As you can probably guess, files went missing and people spent a lot of time trying to track them down.”

In order to improve the efficiency of its manufacturing processes, RMS began to look for a technology solution that would:

• Store information in a reliable, consistent form.
• Electronically route orders to multiple manufacturing teams.
• Increase employee accountability and decrease wasted time.
• Automate repetitive manual tasks.
• Guarantee that essential, job-related information could always be found.

After considering multiple technology vendors, RMS selected Laserfiche because of its comprehensive capture, search and workflow functionality, as well as the strength of Laserfiche reseller Crabtree Companies.

Leveraging Laserfiche Workflow for Business Process Management

RMS relies heavily on Workflow to accelerate shared business processes across its plants in Minnesota and Tennessee. “Our biggest accomplishment is our ‘green folder system,’” says Eklund. “It’s what we use to distribute the information that’s necessary for creating every instrument and every device.”

As the first step in constructing the green folder system, key RMS stakeholders came together to define and standardize the sequence of steps necessary to electronically distribute new order information to machinists and engineers.

“From a management perspective, developing the green folder system helped us to identify inefficiency and created consensus around the best way to eliminate it,” says Eklund. “It was clear that using Laserfiche Workflow to electronically route information was the best way to accomplish our goals.”

Using Workflow’s graphical user interface, RMS configured the system to perform activities based on the newly defined steps and sequence. When a new product is requisitioned:

• Order information including POs, prints, quotes, and manufacturing data is scanned into Laserfiche.
• Order information is electronically—and automatically—delivered to the departments involved in the manufacturing process.
• Department heads digitally sign off on the information.
• Supervisors can log into Laserfiche and see which departments have acknowledged receipt of the information.

“In the past,” says Eklund, “employees would physically walk hard copy folders between departments on the plant floor. It was hard to figure out which departments had seen what, and where exactly each order was in the manufacturing process. Thanks to Workflow, information now has a clear and consistent path around the factory floor. It never gets lost and it’s easy to track exactly what’s going on at any given time.”

Today, RMS has eight major workflows in effect across the company. According to Eklund, it only took a matter of weeks to get the primary workflow written and running. “From an IT perspective,” he says, “one of the best features is how easy it is to change and test the various workflows. Four of our major workflows could halt production if they stopped working properly. Because it’s so easy to make adjustments, we never have to worry about downtime.”

Ensuring Access and Saving Time with WebLink and Quick Fields

Aside from using Workflow to automate and streamline key business processes, RMS employs Laserfiche WebLink to provide employees with immediate access to job-critical information; it also leverages Quick Fields to cut down on manual data entry and save staff time.

WebLink is a secure Web publishing tool that distributes information to authorized users. Designed to protect the core content repository, WebLink prevents users from altering, deleting or tampering with digital data. At RMS, WebLink has made life much easier for machinists, who now have instant access to engineering blueprints and specs from virtually any computer on the factory floor.

“Prior to Laserfiche, our machinists had to wait for engineers to show them the prints and specs for the various parts they were responsible for producing,” explains Eklund. “Today they can access that information directly. It saves a lot of time.”

Quick Fields is another time-saving tool for the company, one that enables automated data capture and indexing. According to Eklund, the company uses Quick Fields for a variety of tasks, including:

• Creating Device History Records (DHR). Contract medical device manufacturers are mandated by the FDA to create and preserve DHRs indefinitely. Employees used to generate these records manually, and because RMS processes so many jobs each year, this meant hundreds of hours of employee time spent on data entry. Today, the company includes barcodes on job-related paperwork so that when a device is shipped, a DHR is automatically generated by scanning the barcode and ensuring that the record is properly named.
• Electronically filing accounts payable paperwork. RMS uses barcodes on accounts payable paperwork so that it is electronically filed after it is scanned into the system. This practice saves the accounting department two hours every Friday.

RMS also appreciates how much more quickly employees across the company can locate indexed information contained in the Laserfiche repository. “Nobody has to search through filing cabinets anymore,” says Eklund. “With Laserfiche, it only takes 30 seconds to find exactly what you need.”

Moving Forward

Although Eklund acknowledges that it is difficult to put a dollar amount on the savings RMS has experienced over the last four years as a result of implementing Laserfiche, he believes that the company recouped its initial investment within the first year.

To get the most out of the system, the company is currently in the process of upgrading to Laserfiche 8, which features:

• Greater interoperability with Microsoft Office applications.
• An enhanced system architecture that simplifies firewall configuration and improves performance over wide-area networks.
• A redesigned Workflow module that’s built on the Windows Workflow Foundation engine and uses the .NET framework.

Eklund’s parting advice to IT professionals who are interested in implementing Laserfiche is to “be patient. Users will follow your lead once they realize how good the system is. Laserfiche is the heartbeat of our company. It’s a great system to administer, and a great system to use.”

Such was certainly the case for Dr. Brian Hanson’s gastroenterology (GI) practice in Ukiah, CA. One of just two GI doctors within a 90-mile radius in rural northern California, Hanson at times may see more than 200 patients a month. He’s a member of several boards and committees, and his practice is affiliated with three different hospitals, two ambulatory surgery centers and two rural healthcare clinics which serve patients in both Mendocino and Lake Counties.

On any given day, Hanson might be found performing outpatient endoscopic procedures, providing acute inpatient gastroenterology services, or seeing patients for consultations at one of the outlying rural health clinics or in his private office. His practice offers patient education programs, educational material, hospital consultations, 24-hour coverage in case of emergency, multiple offices located near local hospitals, and billing.

Stacie Sturges, Hanson’s practice manager, has worked for the gastroenterologist since before he started his own office in 2004. “Dr. Hanson does everything in his power to put his patients first,” Sturges explains, “but staying on top of such a huge volume of paperwork made everything more complicated. Having accurate, up-to-date information at our fingertips is essential, and paper-based records just weren’t getting the job done.

“Before Laserfiche, a simple phone call from a patient triggered a lot of extra work for the office staff,” she adds. “Hunting around for the patient’s paper chart, paging through it to find the relevant information, noting the phone call in the record and then presenting everything to the doctor. It took a lot of time.”

The practice had considered implementing a traditional electronic medical records (EMR) system, but, as Sturges says, “EMR is so complicated. Everyone knows that.”

Indeed, traditional EMR has a number of serious drawbacks, including:

• Prohibitive costs.
• Overly involved requirements for customization.
• Complicated changes to the existing clinical workflow.

The Natural Approach to EMR

Wary of disrupting patient care in service of complex EMR technology, Sturges discovered a more natural solution to the practice’s information management challenges one day while reading Healthcare IT News: “I saw an ad for ‘document management’ and I knew that this was what we desperately needed.”

Best-in-class content management software—with its ability to digitize, organize and store content from across the entire practice—is being adopted by many small medical offices that want an affordable and easy-to-use alternative to traditional EMR. These “hybrid” solutions (so named because they combine content management with other applications such as practice management and e-prescribe) provide a simple, centralized and secure means of managing patient records without complicating the clinical workflow.

“Most doctors’ offices like ours do not have an IT expert in their back pocket,” explains Sturges. “The fact that Laserfiche is so user friendly made it very appealing to us.”

In December 2008, Hanson’s practice purchased and installed the Laserfiche Avante suite from Laserfiche reseller AMI – The Paperless Company. In less than one week, AMI had installed the software and hardware and trained Hanson’s staff. According to Sturges, Hanson’s practice is using Laserfiche to “make our own EMR.”

In terms of the installation process, “The guys at AMI were awesome,” says Sturges. “They listened to what we had to say and organized our solution in a fashion that matched the way we wanted to work. Most importantly, our transition to a paperless office was effortless! The install was completely smooth.”

Today, with Laserfiche and three Fujitsu FI 6140 scanners in place, the office is running like a well-oiled machine. Hanson carries his Fujitsu Tablet PC wherever he goes so that he has real-time access to patient information. This enables him to immediately respond to issues that need attention instead of waiting to get back to the office and dealing with a pile of paper charts.

Technology that Adapts to the Practice

The more closely a software solution mirrors the day-to-day realities of a practice’s working methods, the more likely it is to deliver value. Sturges appreciates the flexibility of the Laserfiche solution, stating, “This isn’t one of those cookie cutter systems that you have to conform to. Most doctors like making their own decisions, and they don’t like being told what to do. Laserfiche allows them to decide how they want to work.”

Hanson’s practice has configured Laserfiche to handle a number of patient-related tasks, including:

• Storing scanned records. The folder structure in the Laserfiche repository is organized by patient. Each patient has a folder that contains subfolders for test results, surgical procedures, X-ray information and so forth. This keeps the information organized and easily accessible by authorized employees.
• Automatically routing information. Using Laserfiche Workflow, test results and other important patient updates are automatically sent to Dr. Hanson as soon as they are entered into the system. This speeds Hanson’s response to patients and saves staff time.
• Rapidly processing records. Hanson’s office has customized the document templates in Laserfiche Quick Fields by adding a status field that enables staff to quickly and easily identify urgent messages, call backs and real-time progress notes. In addition, automatic information capture and indexing cuts down on manual data entry and gets information into the system swiftly.
• Facilitating compliance. Laserfiche Audit Trail ensures information security and simplifies regulatory compliance. Hanson’s practice uses it to stay HIPAA-compliant by following the flow of information, keeping track of changes and noting what needs to be done next.

To Sturges, this is a clear-cut case of technology adapting to the flow of the practice, rather than the other way around. “We don’t need all the bells and whistles associated with traditional EMR,” she says. “Laserfiche has been a ‘meaningful use’ solution for us because it gives us exactly what we need to manage our office and improve patient care.”

Passing the Benefits Along to Patients

For Hanson’s practice, Laserfiche has decreased the costs associated with storing and handling paper records, ensured the safety and accessibility of those records, and increased the efficiency of the practice’s day-to-day operations and employees. Some of the chief benefits of the system include:

• Comprehensive search functionality allows staff to locate records within seconds.
• Remote access to the Laserfiche repository over a secure private network (VPN) gives Dr. Hanson the ability to instantly locate and amend records without pulling other staff members away from their jobs—even when he’s not in the office.
• Multiple people can access the same digital record at the same time.
• No electronic records ever get lost.

All of these benefits, however, would be meaningless if they didn’t ultimately enhance the quality of patient care.

“Providing top-quality care is of the utmost importance to Dr. Hanson,” says Sturges. “We’re always asking ourselves, ‘How can we better serve this patient?’ Many of them are facing really difficult decisions regarding their healthcare. They deserve answers, and they deserve them quickly. With Laserfiche, we coordinate care much faster because patient information is so much easier to find.”

For the people who struggle with these issues in southeast Texas, Spindletop Mental Health Mental Retardation (MHMR) Services has the resources to support their recovery and relieve their distress. But with over 8,000 patients every year and upwards of 400 employees, Spindletop’s ability to respond promptly to records requests—and, by extension, to patients—was being compromised.

Over 80,000 files resided in a hardcopy storage facility that cost more than $2,000 a month to maintain. And even with six full-time staff members dedicated to managing hardcopy documents, some records took as long as three days to locate and cost $4 each to retrieve and deliver; others were lost for good.

Realizing that an enterprise content management system would ensure access to high-quality services in a more cost-effective way, the center turned to Laserfiche for help.

Complete Content Management within a SharePoint Site

Spindletop was already leveraging SharePoint for the company’s intranet site, but scanning and storing 80,000 documents in SharePoint required more comprehensive content management functionality.

“We wanted to centralize access to patient records without forcing our employees to go out of their way,” explains Jerry Carnley, CIO at Spindletop. “Our intranet seemed to be the natural place to do this, but we needed to implement a content management solution that would be easy to implement, easy to install, and eliminate extra work for the people who deal with patient documents every day.”

Spindletop selected an Agile ECM system engineered with Laserfiche and SharePoint, which met its content management needs in three key ways:

• Seamlessly added document imaging functionality to SharePoint with minimal requirements for installation, support and maintenance.
• Dramatically expanded the amount of content that can be stored online while also improving document security.
• Provided federated search across content stored in Laserfiche and SharePoint.

“Given Laserfiche’s experience and dedication to the Microsoft suite of technology, we saw that it delivers a complete offering to customers seeking an integrated content management and SharePoint solution,” Carnley says.

Specifically, Agile ECM engineered with Laserfiche and SharePoint enables Spindletop to:

• Bring comprehensive document imaging and records management functionality to Spindletop’s existing SharePoint intranet. Employees scan and upload documents directly through the SharePoint interface, then view and manage them with the easy-to-use Laserfiche document viewer.
• Supply superior security, records management and content distribution capabilities when content is moved between SharePoint and Laserfiche—manually, as part of a workflow process or automatically based on a SharePoint expiration policy.
• Provide the ability to retrieve content from both Laserfiche and SharePoint using Spindletop’s intranet search box.
• Automate content-related processes based on activities occurring in both SharePoint and Laserfiche with graphical, drag-and-drop .NET-based workflow configuration that makes workflow design simple for IT staff.

As a whole, Agile ECM provides a cost-effective complement to Spindletop’s SharePoint intranet site—with all of the content management capabilities the company needs.

Results of Running Smarter

With the assistance of DynaSource, a Laserfiche reseller located in Texas, Spindletop implemented Laserfiche and transformed the way it manages content, most notably in the four following ways:

• Instant search and retrieval. From any internet access point, staff can instantly locate scanned records by using the “Electronic Imaging” tab on the SharePoint intranet site. Offsite employees have
  access to the Laserfiche digital records repository through a password-protected Citrix site.
• Sure-fire security. Because Spindletop’s SharePoint intranet uses full Laserfiche security enforcement, employees are granted access to records by department. Employees can view the records for their
  own clients, but restricted patient, employee and financial information remains confidential.
• Easy and efficient scanning. Laserfiche templates enable employees to scan ten times more content than they could before the custom templates were implemented.
• Time-saving automation. When new content is scanned into the system, Laserfiche automatically populates template fields and generates and organizes new folders and subfolders. Because each client has between six and eight subfolders with a total of 25-52 documents to be scanned, this eliminates redundancy and extra work.

According to Carnley, implementing Agile ECM has had a number of noteworthy benefits. “We’ve increased productivity, and morale has jumped in every department that uses Laserfiche,” he says.

“There’s no more waiting around for days for hardcopy documents to be found, and no more lost or misfiled records resulting in huge institutional fines. And we aren’t spending thousands of dollars each month on offsite storage facilities,” Carnley adds.

But best of all from Carnley’s perspective as a CIO is that because Agile ECM engineered with Laserfiche and SharePoint supports developers who need to extend collaboration, scan images and set up workflows to quickly respond to business needs, deployment was quick, easy and affordable. There was no need to hire expensive programmers or IT consultants and no need to build customized plug-ins from scratch. In addition, the intuitive user interface makes the solution easy to administer, since drag-and-drop functionality enables IT staff to permit line-of-business employees to easily make changes to existing workflows and folder trees without IT staff assistance.

“Laserfiche provides a scalable solution that’s easy to install, easy to administer and easy to use,” concludes Carnley. “We’re very happy with the way Laserfiche has enabled Spindletop MHMR Services to expand our use of SharePoint and improve the way we manage content.”