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.”

A new healthcare-focused Webinar breaks down how ECM systems enhance Electronic Health Records (EHR) systems, improve efficiency and ensure compliance without raising costs.

Attend “Why Do We Need ECM If We Have EHR? Introduction To ECM For Medical Groups and Practices” on November 17 on 8:30 am to learn how ECM can help your medical group:

• Complement EHR initiatives by linking scanned paper charts to structured patient records.
• Redact EOBs to safeguard PHI when submitting claims to secondary payers.
• Simplify accounts payable processing.
• Streamline the credentialing process.
• Automate contract management.

Sign up today.

When Eastmont Towers’ Health Care Administrator Beth Nelsen RN, CHPN, began exploring enterprise content management systems, she soon discovered that “paperless” meant a lot more than just empty file cabinets. “First, we looked at outsourcing to a company that would scan our records onto disks,” remembers Nelsen, “but we were concerned about how we’d be able to use the information once it was digitally stored.”

Not to mention, outsourcing may have gotten rid of the paper—but it created an entirely new set of compliance concerns. Nelsen next began to explore solutions the agency could configure, use and administer in-house.

Quick Fields and Workflow: impressive possibilities

Kathy Gentile of Laserfiche reseller Bishop Business Equipment had worked with Eastmont Towers as an MFP hardware provider. Gentile, Bishop’s Laserfiche Document Management Specialist, invited Records Management staff from the agency to attend a workshop to see Laserfiche in action. Nelsen and her staff saw how Laserfiche Quick Fields could create files on the fly. Once files were created, Workflow could then notify decision makers of pending approvals and track those approvals throughout multiple business processes.

Nelsen was impressed. “We fell in love with Workflow,” she says, citing how it could help the agency:

• Transmit insurance information to the billing office.
• Send lab results to physicians.
• Route medication orders to the pharmacy.

“We’re a multidisciplinary team caring for people across a continuum, so that ability to share documents between departments, reduce paperwork and improve communication would greatly increase efficiency and positively impact patient care,” she adds.

Thus inspired, Nelsen and her team purchased a 30-user Laserfiche Rio pilot system and have spent the first half of this year preparing to roll it out. “Laserfiche Rio made the most sense in terms of meeting our immediate needs. It includes Workflow and the Records Management component to work with our EMR, as well as unlimited servers.

“As we progress, we can just add users to grow the system to meet our future needs and goals. Scalability was a big factor in choosing Laserfiche Rio,” Nelsen explains.

Goodbye filing cabinets, hello automated patient charting

Eastmont Towers’ medical records staff is now halfway through a backlog conversion process that Nelsen anticipates will eliminate at least four filing cabinets by the end of the year. Meanwhile, Nelsen and her staff have been analyzing business processes to guide the upcoming implementation. “After we had our initial training, we sat down to map out what exactly we do with our documents, where they are sent and why,” she says.

Initial focus has been on automating the patient charting process to compile and distribute client records and information as they enter Eastmont Towers from hospitals and other healthcare agencies. “We have several departments we need to route various information to, so we needed a way to streamline and simplify everything coming in and have it work with our EMR so staff could find everything in one place,” explains Nelsen.

Eastmont Towers is currently working with Gentile and Laserfiche consultants Our Support Services to automate and streamline the patient charting process:

• When a patient transfers to Eastmont’s Skilled Nursing facility, Quick Fields generates a chart by recognizing document types from an Excel spreadsheet.
• Quick Fields then populates metadata template fields according to patient name and ID number.
• Quick Fields then builds the folder structure out according to what documents fall under respective chart headings.
• Workflow then notifies the pharmacy and dietician according to document type (nutrition information, etc.).

Prior to implementing Laserfiche, paper files all had chart tab dividers. Every time a document was added to that tab, all documents had to be removed from the file so new information could be filed in the appropriate spot, then documents would be replaced in the folder and the folder refiled. A new feature in Laserfiche 8.2, dynamic fields, greatly simplifies this process, Gentile explains.

“When a ‘tab’ item is selected from the ‘Chart Tab’ field drop down, the ‘Chart Doc Type’ drop down list automatically populates to correspond with the documents that fall under that ‘Chart Tab’ category,” she says. “It’s saved staff a lot of time.”

Immediate practicalities, limitless possibilities

As Nelsen and her team continue to come up with ideas for future process automation, she sees even more potential for Laserfiche. “We wanted something that was would be fairly easy for the end user to learn but that also could streamline our processes better, and Laserfiche has met and exceeded our expectations,” she says.

Next up, she says, are integrations with the agency’s Keane clinical and financial software to support current EMR deployment and refine and automate processes in the Accounting Department. “We see a lot of value in having an ECM system that’s flexible and adaptable enough to meet clinical and non-clinical needs throughout our agency,” Nelsen adds.

“We have a lot of time and resources invested in our existing technology, so it’s important that Laserfiche enables us to build on the progress we’ve already made without interrupting the ways we’re used to working. Plus, the way Rio’s set up, we can keep building with it, which is very appealing to us. Technology’s always changing and Laserfiche is a great tool to adapt along with it.”

Screenshot of Eastmont Towers' table used to populate the template's dynamic fields by chart type.

The drop-down menu where users select Chart Doc Type to automatically populate the list with specific documents, instead of having to manually sort through tab dividers to find the paper file.

We’re excited to hear about the creative ways users have implemented Laserfiche to reduce storage, simplify business processes and save time and money across their organizations. Don’t be shy—take a moment to fill out the nomination form and tell us what “Run Smarter” means to you!

Nominations are due August 26. Please e-mail Melissa Henley at melissa.henley@laserfiche.com if you have any questions.

Challenge: Document management efficiency

Located across three campuses, Indigo North Health operates on a tight budget, balancing the provision of quality services with a streamlined yet highly efficient staff and infrastructure. Not surprisingly, internal efficiencies that contribute to improved services are a high priority for the organisation’s CEO, Cameron Butler; and high on the agenda in late 2009 was document and file management.

“We rely heavily on suppliers and contractors,” Cameron says. “So it’s important for everyone that the flow of information, whether in the form of general correspondence or finance-based documents is incredibly efficient. Unfortunately, this wasn’t the case; and with the business having doubled over the past five years, we were in the position of having to identify and implement a more efficient means of managing our documents and files.”

Answer: A Laserfiche solution

In partnership with Copy Print Scan (CPS) Albury, a Ricoh Business Partner, Indigo North Health sought to evaluate the suitability of a Laserfiche and Ricoh MFD (Multi-Function Device) solution. Following an extensive evaluation process, Cameron gained approval from the organisation’s board to partner with CPS on the solution’s implementation.

“The first and most important aspect of our document management on which we worked with the CPS team was our accounts payable invoice approval process,” Cameron says. “And by the first of July 2010, we had a streamlined workflow that’s nothing short of fantastic.”

Saving a day every fortnight

Streamlining the accounts payable workflow for invoice distribution and approval has delivered an immediate saving of eight to ten hours every fortnight. On that alone, it’s a saving that represents a near full return on investment in barely 12 months.

So where does that saving come from? Firstly, as invoices are received—either electronically or in hard copy—from suppliers and contractors, they are immediately transferred to the organisation’s Laserfiche system where they are assigned to a particular cost centre. At this point, the customised workflow developed by the CPS team kicks in and an email is automatically sent through to the cost centre’s manager.

The savings realised up to then are through:

• Eliminating the manual distribution of invoices.
• Reducing the instances of having to request misplaced invoices from suppliers.
• Removing the need to manage a large number of paper-based accounts payable files.

Next, it’s the Laserfiche-based approval process that adds even greater efficiency and savings. With the e-mail received, cost centre managers receive an embedded link to the invoice, which, when clicked, displays the invoice on their screen along with the ability to approve or deny the payment, specify an expense code and add notes for the accounts payable team if required.

Once closed, the approved or denied invoice is sent immediately through to the accounts payable team who then take the appropriate follow-up action. Again, the savings accumulate. This time, though, through:

• Streamlining the invoice approval process.
• Achieving instant transmission of approvals from the cost centre manager to accounts payable.
• Fully eliminating instances of invoices lost in transit.
• Dramatically reducing the “chasing up of approvals” by accounts payable.

“Laserfiche has delivered even more in cost and time savings than we initially expected when it comes to the accounts payable workflow,” Cameron states. “For cost centre managers, invoice management has become a simple and straightforward process, and for the accounts payable department, there are new high levels of accuracy, accountability and time efficiency.”

A well-defined audit trail

What then of purchase orders that relate to the invoices? “Quite simply, we have a Laserfiche folder containing invoices and another for purchase orders,” Cameron explains. “When the invoice is filed, it’s matched with any corresponding purchase orders so when the invoice is sent through, the cost centre managers are immediately able to verify its details against those stipulated in the purchase order.”

A key enabling factor in the matching of invoices to purchase orders is the advanced and highly accurate OCR (Optical Character Recognition) capabilities of the Laserfiche solution. Whether invoices are scanned in at the MFD or received by fax, the solution automatically scans and translates each word on the document, then updates an integrated index database.

“When we need to locate any document, whether it’s an invoice, purchase order or anything else that we’ve filed in the Laserfiche system, it’s a simple case of entering a supplier’s name or any other search criteria into the search field, and it’s there immediately,” Cameron says.

“The time this is saving everyone is definitely one of the key reasons this solution is being so well accepted and utilised by our organisation.”

An extended application

Having recognised the document and file management benefits of the Laserfiche solution, Cameron was quick to take the lead within Indigo North Health and initiate Laserfiche filing of business correspondence, patient records, and Board documents and meeting minutes.

“We’re a relatively small organisation, and even as the CEO I don’t have the luxury of a personal assistant,” Cameron states. “For my correspondence, one of the admin team uses the Ricoh MFD to scan in everything and drop it into my correspondence folder. From there, I’m able to browse through it all, search for any related documents and file it into my own Laserfiche file folders.

“For the admin team, all that’s required is to stack the correspondence into the MFD’s document feeder, press a couple of buttons and that’s it,” Cameron continues. “In a matter of a minute or so, all my daily correspondence is scanned, filed and available online.”

Understanding the business

It’s well worth noting that while the Ricoh MFD and Laserfiche are the two core elements that have supported achieving those early savings, the equation is significantly more than being simply the sum of the two. It is the tight integration existing between the two technologies, along with the high levels of customisation and integration that enabled the CPS team to create workflows that have proven to be precise matches for Indigo North Health’s business needs.

“When the project commenced, we had in our minds what we wanted to achieve,” Cameron explains. “But then, there are workflow requirements that are specific to our business and to the industry in which we operate. Bringing our ideas and goals to reality was only achieved through committed work from the CPS team to understand our business, talk to our administration staff members, thoroughly document the manual processes and then apply that knowledge to the solution.

“It’s that same commitment and expertise that we fully expect will underpin the growing range of applications we have in mind for the solution. For us, the Ricoh MFDs, Laserfiche, support and expertise are fundamental to our ability to improve efficiencies and deliver even better services to our community.”

By 2007, CapitalCare’s decade of growth had the side effect of generating more paperwork than the group’s 14 offices could efficiently manage—at least not the way they had been. “We were on our fourth expansion in our central office building in Albany; our offices were running out of storage and our CBO had rooms of files and boxes everywhere. So we asked ourselves, ‘Why all this space for storage? Why all this time to find things?’” says Charles Hagstrand, CIO of CapitalCare. “After 10 years, we needed a solution to move us forward.”

Hagstrand envisioned a true enterprise content management (ECM) solution from the start, one that could manage CapitalCare’s spectrum of information needs, including 700,000 patient encounters a year being stored remotely to over 280,000 EOB documents generated annually, as well as other documents and business records associated with its various practices. Eventually shared back-office business processes would be automated, beginning with AP processing.

“Initially we looked at a lot of vendors who had products that handled specific document types, but we were looking for something that wouldn’t pigeonhole us,” recalls Hagstrand. “You see a lot of departmental applications in larger organizations. We wanted a single system that could fit a variety of needs in different departments, and that ultimately could grow with us.”Hagstrand found what CapitalCare was looking for when his evaluation team discovered Laserfiche through reseller JPI Data Resource. “It was the product’s versatility that really won us over,” he says. “We liked that Workflow was a push technology that could keep things moving more effectively.”

Adds Jason Wicks, business analyst, “Laserfiche was like one-stop shopping as far as addressing the range of projects we were looking at, from HR files to Accounting and through-processing contracts and invoices. It’s very flexible.”

Wicks worked with JPI and CapitalCare department heads to design and deploy a pilot 20-user Laserfiche system with Records Management Edition (RME) and Workflow. They mapped out a multi-phase implementation that would eventually include using RME to automate retention and compliance, as well as Workflow to route invoices from CapitalCare’s central business offices in Albany to the group’s various remote locations for AP processing.

The first order of business was addressing Hagstrand’s storage and access concerns. “We took the approach that we should start by working with the items that didn’t involve Workflow first,” Wicks says.

Implementation began with backlog conversion of a decade’s worth of historical files in the HR and Medical Management departments, “just taking paper and getting it in Laserfiche to get people used to archiving,” as Wicks puts it.

The impact was immediate. “Our first touch is our site managers who are working with our patient encounters—that totals over 700,000 documents a year,” Wicks explains. “We used to have to process those in our central business office, then send them back out to the sites to store for seven years. Now they’re all inputted when received from the site and accessed as needed through Laserfiche.”

Standardizing to streamline AP processing

The next phase of implementation deployed Workflow to help automate AP processing for CapitalCare’s accounting department—which has seen the number of sites it supports grow from 14 to 27 in the four years since Laserfiche was acquired in 2007.

“Before Laserfiche, AP processing wasn’t very efficient, nor was there a common practice for approving invoices,” Wicks explains. “Some bills were received at the site, approved and forwarded; others came to the CBO and were distributed for approval and return. Laserfiche allowed us to standardize the process, and that’s been a big time saver.”

Thanks to Laserfiche, turnaround time for AP processing was reduced from 7–10 days to 2–3:

• Invoices are now captured and sorted centrally using Quick Fields in CapitalCare’s Albany office.
• Workflow then automatically routes the invoices to the appropriate site managers, who are notified through email that they have a document to approve with a shortcut link to retrieve the document.
• Working in conjunction with a custom file export tool developed by JPI, approved documents are then automatically pushed from Laserfiche to CapitalCare’s Great Plains accounting system via QuickLinks and PaperSave.

“Accounting now knows what documents need approval and which documents are in a queue once the site has approved the document,” Wicks says. A backup copy of the exported document is created using Workflow, which, after 30 days, is automatically deleted by a Workflow activity.

The next phase, Wicks adds, will be to establish a centralized shared service center, where invoices will be processed directly from the central business office. “Workflow will set up queues for each of our sites’ accounting departments to process invoices,” he says.

An overall benefit, Wicks says, has come from the time saved making action items more available to site staff. “Although we have a separate solution to store patient medical information for continuity, middle management at each site—typically one or two employees—utilizes Laserfiche to access past patient encounters, approving invoices and coding corrections, and this has eliminated a lot of lag time.”

The future of the future: Workflow

Future projects are already slated—including implementing RME. “The functionality of Records Management Edition will assist with purging documents once they have reached their shelf life, while Audit Trail will help keep us in compliance,” Wicks says.

Hagstrand says even the IS Department has its own ideas for how to utilize the system. “We’re actually hoping to use Laserfiche to manage our service agreements, so we’ll be able to run queries and see what’s going to expire in the next year.”

“The system keeps evolving as we bring on more documents and processes,” add Wicks, pointing out that Workflow will play a more leading role in future deployment. “I’d say we’re at the grassroots of pushing information between sites and departments. Right now, I’m looking at any situation where we have an opportunity to push documents and how we can utilize Laserfiche to automate additional functions between our practices and our central business office,” he continues, noting a recent meeting with a business unit to discuss improving billing and coding through automation. “Workflow has really worked out for us because we can take the visual process of scanning documents and apply that to designing workflows—it’s very intuitive.”

This versatility, says Wicks, is why Laserfiche use continues to evolve. That, and Wicks makes sure CapitalCare’s 50 named users know just what’s possible using the system that solved their initial storage problems.

Says Wicks, “We need to do more education within the company to say ‘This is a lot more than just a scanning solution’ and hold a ‘Did you know?’ session.”

For example, Spindletop Mental Health Mental Retardation (MHMR) Services has integrated Laserfiche with its Microsoft SharePoint portal to enable case management. According to Spindletop CIO Jerry Carnley, “With Laserfiche, 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 upward of $2,000 each month on offsite storage facilities.”

Meanwhile, Molina Healthcare has decreased the turnaround time for credentialing by 44% while doubling number of applications processed per month through its use of Laserfiche. According to Ryan Boe, Corporate Credentialing Manager at Molina Healthcare, “With Laserfiche, 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.”

Agile ECM systems from Laserfiche allow healthcare organizations to store, locate, route, approve and review both paper and electronic content—including medical records, lab results, signed privacy acknowledgments, explanation of benefits (EOB) forms, invoices, purchase orders, personnel files, compliance records, referrals and more.

Additionally, Laserfiche provides comprehensive security that protects sensitive information while still allowing authorized personnel to instantly access necessary files—protecting the integrity of patient information and facilitating HIPAA compliance.

Detailed case studies outlining the success of Spindletop, Molina Healthcare and more are available at the Laserfiche booth (#4131). A comprehensive white paper outlining the benefits of agile ECM is also available to all HIMSS attendees.

About Laserfiche
Since 1987, Laserfiche® has used its Run Smarter® philosophy to create simple and elegant enterprise content management (ECM) solutions. More than 30,000 organizations worldwide use Laserfiche software to streamline document, records and business process management.

The Laserfiche ECM system allows healthcare organizations to securely manage patient records, accelerate payment cycles and decrease costs. It enables organizations to more easily comply with HIPAA privacy rules and Joint Commission patient safety goals—all while accelerating business processes and making staff more efficient.

Laserfiche is a registered trademark of Compulink Management Center, Inc.

“Providing state of the art care isn’t just about attracting the best doctors and staying abreast of the latest medical developments. It’s also about implementing innovative technology that helps your practice run as smoothly as possible,” said Bill Duke, Executive Director of Dallas Associated Dermatologists.

The practice knew it wanted to transition away from paper charts, but it also wanted its electronic records to mirror its paper charts. “There aren’t many solutions out there that are flexible enough to do that,” Duke said.

According to the Executive Director, “Laserfiche lets us do exactly what we want to do, in exactly the way we want to do it. It allows us to bring our documents to life without having a negative impact on productivity or patient relationships.”

Other 2010 Run Smarter winners include: Central District Health Department of Boise, ID; City of Maple Grove, MN; Durham County, NC; ECOM Atlantic; ESSAR Group; Hamilton-Wentworth School Board; London Borough of Tower Hamlets; Long Beach Police Department; Mille Lacs Band of Ojibwe Indians; NE Metro Intermediate Schools; Pulte Mortgage; South Essex Partnership NHS Trust; Spire Investment Partners, LLC; Texas A&M University Kingsville; Virginia Port Authority; and Wythe County Community Hospital.

About Laserfiche
Since 1987, Laserfiche® has used its Run Smarter® philosophy to create simple and elegant enterprise content management (ECM) solutions. More than 28,000 organizations worldwide use Laserfiche software to streamline document, records and business process management.

The Laserfiche ECM system is designed to give IT managers central control over their information infrastructure, including standards, security and auditing, while still offering business units the flexibility to respond quickly to changing conditions.

Laserfiche distributes its software through a worldwide network of value-added resellers (VARs), who tailor solutions to clients’ individual needs. The Laserfiche VAR program has received the Five-Star Rating from Computer Reseller News/VARBusiness magazine.

Laserfiche is a registered trademark of Compulink Management Center, Inc.

Chuck Beard, president of DynaSource, credits a year-long sales strategy leveraging the high-visibility success of its Spindletop Mental Health and Retardation Services account (which uses Laserfiche and SharePoint to support its Anasazi EMR system) with closing the deal.

“We put our efforts into making the Spindletop account the best it could be—for the client and for us,” says Beard. This meant spending early 2010 expanding Spindletop’s use of Laserfiche to several non-clinical departments (HR, Accounting, Admissions, etc.) using Quick Fields, Workflow and Web Access.

Beard points out that a major catalyst for the sale to ETBHN was a presentation given by Spindletop CIO Jerry Carnley to a statewide group of 40 CIOs in June. “He had the enthusiasm and tenacity to say ‘Here’s what we’ve done, we need to get this out to everybody,’” Beard explains.

ETBHN spent the summer assessing solutions before choosing to adopt Rio—and the Laserfiche/SharePoint integration—for all its agencies in late December. “ETBHN wanted a standardized application for each department that would offer standardized deployment across locations,” Beard explains. “Out of multiple competitors, Laserfiche was the only one with a single point of contact to access patient records through SharePoint.”

Beard is confident DynaSource can continue to build on this exponential success in 2011. “We used to focus on implementing cookie-cutter solutions; this is more like whole bakeries,” he says. “Spindletop represented not only a county-wide opportunity, but one that’s now regional, statewide and, ultimately, national in scope.”

Laserfiche’s natural approach to EMR allows medical groups to automate medical records capture and processing in a way that’s not overwhelming, complicated or cumbersome for doctors and staff. In addition, the flexibility of the software extends its usefulness to many other areas of the practice, including Accounting, Admissions, Billing, Credentialing, Human Resources, Legal and more.

According to Bill Duke, executive director at Dallas Associated Dermatologists, “EMR systems are focused exclusively on patient records, but Laserfiche gives us the infrastructure to streamline operations across the practice.”

To learn more about how Laserfiche can help your practice intuitively and easily manage both patient and back-office information, stop by booth #628 for a demonstration of the software, your free copy of “A Guide to Hybrid EMR” and the new Dallas Associated Dermatologists case study.

About Laserfiche
Laserfiche creates simple and elegant enterprise content management (ECM) solutions that help organizations run smarter. Since 1987, more than 28,000 organizations worldwide—including medical groups, hospitals and managed care organizations—have used Laserfiche software to streamline document, records and business process management.

The Laserfiche ECM system allows healthcare organizations to securely manage patient records, accelerate payment cycles and decrease costs. It enables organizations to more easily comply with HIPAA privacy rules and Joint Commission patient safety goals—all while accelerating business processes and making staff more efficient.

Laserfiche is a registered trademark of Compulink Management Center, Inc.

“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.”

“Pressured by regulations and driven by a clear need to streamline operations, healthcare organizations are standardizing on enterprise content management to improve data governance,” said Tom Wayman, vice president of product strategy at Laserfiche. “Agile ECM systems are extensible and interoperable, so they are a natural complement to EHR, HIS and other clinical back-office applications.”

Enterprise content management (ECM) allows hospitals, healthcare practices and medical billing companies to store, locate, route, approve and review both paper and electronic content—including medical records, lab results, signed privacy acknowledgments, explanation of benefits (EOB) forms, invoices, purchase orders, personnel files, compliance records, referrals and more.

An agile ECM system is one that balances central control with local flexibility. It grants individual facilities and departments the ability to modify their own filing structures and business processes, so that they can respond quickly to changing conditions. At the same time, it also provides central control over content, uniting data stored in disparate filing systems, protecting confidential information and ensuring compliance with industry regulations.

“The ability to react quickly to changing conditions is pivotal in healthcare,” said Wayman. “Organizations that employ an agile ECM strategy not only complement their existing IT infrastructures, they also improve operational efficiency and responsiveness by eliminating data silos, automating core business processes and minimizing ongoing maintenance demands for IT personnel. ”

About Laserfiche
Laserfiche® creates simple and elegant enterprise content management (ECM) solutions that help organizations run smarter. Since 1987, more than 28,000 organizations worldwide—including medical groups, hospitals, surgery centers, laboratories, medical billing companies, health insurance companies and more—have used Laserfiche software to facilitate compliance, simplify integration with clinical and back-office applications and establish an enterprise-wide information management architecture.

The Laserfiche® product suite is built upon Microsoft® technologies to simplify system administration, supports Microsoft SQL and Oracle® platforms and features a seamless integration with Microsoft Office® applications and a two-way integration with SharePoint®.

Laserfiche is a registered trademark of Compulink Management Center, Inc.

In the past, the organization had a records room for films, reports and patient files, and a number of filing cabinets to store billing-related documents. Although staff had devised a fairly reliable indexing system for each of these items, lost and misfiled documents were a significant problem—and a definite drain on resources.

“Around thirty percent of the time, we’d need a document that was misfiled or ‘temporarily lost,’ meaning that it was probably sitting on somebody’s desk,” Oliveira remembers. “Searches for these documents could take anywhere from five minutes to three days. We had several staff members who became so skilled at hunting down lost documents that we started calling them our ‘sleuths.’”

With an eye toward streamlining work processes and eliminating misplaced paperwork, Central Oregon Radiology Associates developed a plan for digitizing nearly every aspect of its operations. This initiative involved three key components: a picture archiving and communication system (PACS), to store and manage radiological images; a radiology information system (RIS), to manage appointment scheduling, transcriptions and billing; and a digital document management system, to store and manage consent forms, explanation of benefits forms (EOBs) and other documentation.

Oliveira says that selecting the right document management system was one of the easiest parts of this initiative. “Our Laserfiche reseller, JPI Data Resource, did a demonstration at our RIS vendor’s user group meeting, and we recognized that Laserfiche was precisely what we needed. We saw that the system’s security features and auditing capabilities would help us meet HIPAA requirements, and the ability to store documentation electronically fit perfectly with our decision to ‘go paperless’ throughout our organization.”

Staff now scan a number of items—from patients’ drivers licenses and insurance cards to consent forms, EOBs and order-related paperwork—into the Laserfiche repository, where they’re stored as easily-accessible TIFF files. As part of the scanning process, staff apply an electronic template to each file to record the metadata that will be most useful for search purposes. “For registration-related documents, we capture such metadata as the patient’s name, Social Security number and date of birth, as well as the date of service,” Oliveira says. “For billing-related documents, we capture additional information, including the document’s type, the date the document is posted and the batch number.”

Thanks to the system’s search tools, staff can now easily locate relevant documents when patients, physicians or insurers call with questions. Staff also appreciate the system’s “fuzzy” search functionality, which enables them to find documents containing words that partially match the search terms they specify. “These searches are particularly useful when I don’t know the precise spelling of a patient’s name,” Oliveira says.

In addition to its powerful search capabilities, Laserfiche includes a number of other features that help staff work more efficiently. For example, the Quick Fields module minimizes data entry errors by automatically populating template fields with information captured from the document. Electronic redaction tools enable staff to obscure sensitive information, which is especially useful when they need to send EOBs—which typically contain information related to multiple patients—to a secondary payer. “In the past, we’d usually photocopy the EOB form, manually black-out information that applied to other patients, and then photocopy the ‘doctored’ document,” Oliveira says. “Now, we can easily redact this information in Laserfiche, which not only saves time but helps us ensure that we don’t inadvertently release sensitive patient information.”

Oliveira also appreciates the system’s ease of use. “Going digital with our radiological images was quite a hurdle to overcome,” she notes. “After that, Laserfiche was a cakewalk. It’s very user-friendly and easy to learn.”

Oliveira recently transitioned to a new position as the organization’s human resources director, and she notes that Laserfiche delivers the same benefits to the HR department that it’s brought to the rest of the organization. “We manage all of our personnel files in Laserfiche, and we scan payroll and credentialing documentation into the repository as well,” she says. “Thanks to Laserfiche, we have less paperwork to handle, we make fewer photocopies and we spend less time searching for documents. Most importantly, sensitive information is a lot more secure than in the past, when we stored everything in filing cabinets.”

Central Oregon Radiology Associates is currently in the process of upgrading to a newer version of its RIS software; as part of the upgrade process, they’re working with their Laserfiche reseller to integrate this software with their document repository. When the integration is complete, staff will be able to access Laserfiche documents from within the RIS application. “We can’t wait for this integration,” Oliveira says. “The time savings will be enormous, especially for billing-related processes, such as looking up claims.”

Oliveira doesn’t equivocate when asked to describe the benefits that Laserfiche has brought to her organization: “I can state without a doubt that Laserfiche helps us put our energy into serving patients, rather than into searching for lost documents.”

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.”

“Because it took so long to find charts, we always had a large backlog of lab reports, test results, physicians’ notes and other documents we needed to file,” explains Jo Wells, the group’s operations director. “Physicians would become frustrated because charts often didn’t include the most up-to-date information. Our system clearly wasn’t working.”

The organization’s CEO, Todd Blum, first learned about Laserfiche at a meeting of the American Otolaryngology Association, and he immediately saw that it would help staff manage patient charts more effectively. Laserfiche stores both scanned and electronic documents in a central repository, where they’re immediately available to authorized staff members. To help staff get up to speed quickly, Laserfiche includes a number of familiar Windows features, such as right-click menus and flexible folder structures. Perhaps most importantly, Laserfiche readily accommodates additional users and high-volume repository growth, making it easy for organizations to roll the system out to new users, departments and locations.

Prior to scanning documents into the repository, Wells and her colleagues created a Laserfiche folder structure that mirrors the group’s current filing system. Each patient has his or her own Laserfiche folder, and the documents within each folder are organized by type. “Our paper charts had multiple tabs, such as ‘Demographics,’ ‘Office Notes’ and ‘Labs,’” Wells says. “Because staff already knew which documents appeared under which tabs, we decided to reproduce this structure in Laserfiche. Now, staff simply log in to the repository and browse to the documents they need—it’s like working with the paper chart, only much, much faster.”

When staff add a document to the repository, they also apply an electronic template, in which they record such metadata as the patient’s name, physician, account number and date of birth. They can also use templates to record and track more specialized information; for example, the group created a referrals template to capture each referral’s type, its beginning and end dates, and the number of authorized visits. All this metadata proves extremely useful for search purposes, allowing staff to quickly locate all the documents in the repository associated with a certain patient, physician or account.

Wells notes that Laserfiche not only helps staff and physicians simplify everyday tasks—it also helps them provide even better patient care. When patients arrive for an appointment, front desk staff use Laserfiche to quickly verify that the chart contains all the necessary information, from demographics to consent forms to insurance details. Prior to calling patients into the exam room, nurses use Laserfiche to review patients’ allergies, medical history and current medications. When physicians arrive, they review test results, lab reports and notes from previous encounters; they can also easily highlight important details and add notes for future reference. Finally, billing staff use Laserfiche to review insurance information and encounter details, which helps them promptly generate claims and respond to billing-related questions.

In the next phase of the group’s Laserfiche implementation, staff will begin scanning explanation of benefits forms into Laserfiche, further streamlining the collections process. In addition, physicians will create visit notes directly within Laserfiche, making them instantly available to other providers. And the group plans to expand its use of the Audit Trail module, which monitors all user activity in the Laserfiche repository.

Wells is pleased with everything the group has already accomplished, and she looks forward to continued success in the future. “Laserfiche has definitely helped us become more productive, and I’d recommend it to any healthcare organization. It’s clearly one of the best investments we’ve made.”

Please join us as we congratulate this year’s winners: the City of Lynwood, CA; Thurston County, WA; the City of Okotoks, AB; BC Biomedical; Berger Financial Group; Texas A&M University; Jamestown, NY, Public Schools; and the Minneapolis Star Tribune.

We’d like to thank everyone who submitted nominations for this year’s award—and we’d like to invite you to join us at the Conference January 12-14 in Los Angeles to congratulate this year’s winners.

City Government: City of Lynwood, CA

Lynwood was a city in transition: the community, attorneys and staff wanted things quicker, yet storage space was maxed out. Legal expenses rose, customer service dipped, productivity slowed and documents were misplaced as storage overflowed.

Laserfiche increased internal productivity, while shortening request times by the public for resolutions and agendas. The finance office knows if old bills have been paid by looking up scanned checks, while staff no longer have to make trips to the clerk’s office for copies of resolutions, agendas or agreements.

Staff has decreased actual paper printing: instead of mailing documents to vendors, they just e-mail them, saving on postage. Litigation is now smoother—and less costly—because overtime hours aren’t being spent digging through files during discovery, and the city isn’t paying fines for taking too long to find submit them. Instead of delivering bulging binders for court cases, now they get all the documentation they need on a single CD.

But perhaps the biggest accomplishment of adopting Laserfiche was Lynwood’s ability to win over its not-so-tech-savvy public.

City IT staff used Laserfiche to create a custom interface for the public to access documents called MYDOCSPOT which uses a virtual mascot, Spot, to fetch agendas, resolutions and other documents as a dog might fetch a stick. He’s not the only one wagging his tail; morale’s up amongst city employees and last but not least, the city is intuitively working towards a greener, paperless environment.

Read the full story here.

County Government: Thurston County, WA

The sheriff’s office used to have to transport 14 heavy-duty filing cabinets up and down the elevator to jail to access the civil orders and warrants issued by district and superior court judges to make sure a warrant was still active—a process both cumbersome and dangerous. The elevator broke down frequently and workers would get injured hauling the cabinets.

Prosecuting attorneys and assigned counsel trying cases couldn’t share client folders, while the payroll department would need days, sometimes weeks, to verify length of employment for retirees.

Now civil orders and warrants are scanned into Laserfiche for remote access, so there’s no more hauling file cabinets up and down the elevator and a lot fewer worker’s compensation claims. Attorneys on both sides can pull up their client cases remotely, even in court. And the payroll department can verify retirees’ work history faster, while storage costs are way down and employee morale is way up.

“At first I wasn’t sure if everyone in the county was prepared to use this tool—and boy was I wrong! Now everyone wants it and they want it yesterday,” says IT Consultant Bonnie Hilyard.

Read the full story here.

International Government: City of Okotoks, AB, Canada

Okotoks was a mid-sized but quickly-growing municipality preparing to consolidate staff from three buildings into one new administration building with considerably less storage space. In preparation for this move, and in consideration of a corporate goal to reduce paper, Safety Codes—the town’s building inspection services—embarked on a scanning project at the beginning of 2007.

The challenge of scanning new building and development permit applications that could contain anywhere from two to 297 pages each into Laserfiche became even more challenging once prime building season came around in April. Right away it was obvious that finding permits was a lot easier, and with approximately 3,026 images scanned, Safety Codes saw they were saving on paper supplies with reduced environmental impact.

But the real impact was on time spent looking for documents, as Laserfiche made the documents readily accessible to Safety Code Officers in the field and provided real-time information, enabling the staff to make more accurate decisions.

Now the benefits are rippling out to builders, contractors and residents. Safety Codes staff are now able to e-mail approved documentation back to an applicant as well as receive the initial applications over the Web. The level of automation saves builders time and money because they don’t have to visit the town’s office to drop off or collect documentation, plus they receive an immediate response. Likewise, homeowners can now have instant copies of their permitting and inspection process documentation.

As Laserfiche is a new product to Western Canada, this success has drawn attention from other departments within the Town and also from other Canadian municipalities. Perhaps most enduringly, it’s empowered staff to meet the town’s sustainability and environmental guidelines, as well as streamline its work processes.

Read the full story here.

Healthcare: BC Biomedical – Surrey, BC, Canada

BC Biomedical Laboratories Ltd. is the largest physician-owned and operated lab in British Columbia, with more than 1.8 million patients visiting one of its 43 patient service centers. For 50 years, its medical diagnostic services have been an integral part of the province’s healthcare system.

But its system left room for improvement. Patient requisitions for test results needed to be photocopied and sent out, while phone calls to the Patient Services Center for requisitions were a constant if necessary interruption.

Now with Laserfiche, all requests are scanned in to a central database and requisitions can be made available online. Paper storage costs have been eliminated, the 28 hours of staff time it took each day to either file, re-file, fax or mail documents has been eliminated, and the phone isn’t ringing off the hook anymore with requisitions requests.

Read the full story here.

Financial Services: Berger Financial Group, Inc. – Medicine Lake (Plymouth), MN

As Berger Financial Group, Inc., (BFG) evolved over 30 years from a CPA firm into a full-scale financial services firm, so did the complexity of its files.

Since implementing Laserfiche in 2003, BFG has transformed its daily work processes, fueling the firm’s rapid growth. Instead of digging through file cabinets, its 14-member staff retrieves client information, spreadsheets, e-mails, even phone messages from their computers, while the front desk clerk scans printed mail as it’s received.

Quick Fields automatically processes 8,000 pages of incoming monthly electronic statements into individual well-organized client folders, saving staff hours of sorting. “It’s not just a benefit for us,” says Principal Mark Berger. “Our clients don’t have to fill their basements with old statements, reports and tax documents, because we store all those for them.”

Audits are easier; instant access means staff no longer have to search through file cabinets or off-site storage.

“Increased overall office efficiency and auto-sorting of statements are something all firms can benefit from. Not to mention that Laserfiche has enabled us to grow our practice at a much greater rate than our staff,” says Berger. “We’ve been able to provide a greater number of services for our clients that just wouldn’t have been possible before.”

Read the full story here.

Higher Education: Texas A&M University AgriLife Department and Health Sciences Center

Moving documents scattered throughout a state as big as Texas was cumbersome. And costly, especially if disbursements relied on other documents that had to be sent overnight, or if payments were held up because of a need for additional paperwork. Redundancies in the state-wide filing system abounded and countless workers’ hours were spent matching and filing documents.

Laserfiche allowed for Work-in-Progress folders to be set up in a central repository for the 300 or so units of Texas A&M AgriLife spread out over 86 locations. Disbursements could obtain invoices and other paperwork for quicker processing and payment. How much quicker? What used to take eight days now took just one. The system-wide automation has reduced and in some cases eliminated work hours spent matching documents into single case folders, and all but eliminated the need to print paper records. With the new file sharing comes the peace of mind of enhanced security with assigned users and assigned user groups. If someone leaves a user group, they leave their access rights as well.

When the Texas A&M Health Sciences Center was planning to build its 200-acre new central campus, it wasn’t planning on using space that could house students and labs to house file cabinets. Add to that a system that spanned the state and often required costly overnight delivery of paperwork to its central office, then a need to duplicate and store copies of that paperwork, and Laserfiche was just the cure Project Manager Kristin Nace was looking for.

“We’ve already seen a cost savings by reducing our overnight delivery charges for sending documents, which also translates into a smoother more efficient business process,” she explains. “But our largest unexpected benefit came in realizing how popular Laserfiche has become within our organization.”

Explains Nace, “I’m regularly getting requests from our departments to set up additional folders, processes, or even repositories. I knew people would love the product, I just didn’t expect they would love it this much. In the planning stages I remember wondering what I was going to do if our departments didn’t buy-in to Laserfiche. How was I going to get them to use it? I’m so pleased to say they bought in after the first training class. As a matter of fact, I’ve not had to convince anyone to use it, if anything I cannot keep up with all of their requests to bring more documents into the system. We are excited it has taken off as quickly and easily as it has.”

K-12 Education: Jamestown, NY, Public Schools

The Jamestown City School District’s Human Resources Department began looking at document imaging in 2003 as a way to solve what had become an increasingly varied set of paper management problems for their personnel records, employment applications, Freedom of Information requests, and reports regarding civil rights, unemployment and worker’s compensation.

Employees on different floors had trouble accessing files; multiple users sometimes needed to access a single file, and then would make copies of confidential files, which then were re-filed with the originals creating potentially confidentially problems and extra paperwork taking up extra space.

Once Laserfiche was chosen, personnel records were organized into separate folders with different sub-headings depending on who needed access to them and how confidential they needed to stay, which added a level of security without adding need for more file cabinets. In fact, the city’s HR Director is now so confident in Laserfiche’s abilities, hard copy records are being permanently moved off-site and a new HR and payroll package has been implemented, saving both time and money but also ensuring continuity, effectively disaster-proofing the district’s vital data and its ability to work no matter what.

Then Jamestown really started to discover what Laserfiche could do. The district saved money by not having to hire a third party to scan to scale architectural drawings, schematics and building maintenance manuals. Board of Education meetings became paperless, doing away with the need to produce and distribute hundreds of pages of documents for each board member. Contract negotiations with the seven unions the district deals with are smoother now that Laserfiche can trace the evolution of contract provisions from every contract they’ve worked from in the past 25 years. And Laserfiche’s powerful redaction tool allows Freedom of Information requests to be fulfilled without compromising confidential information directly or indirectly in compliance with the New York State Committee on Open Government.

Read the full story here.

Commercial: The Star Tribune – Minneapolis, MN

The newspaper needed to replace their legacy document imaging system—one with no support or upgrade path—with one that could migrate massive databases from shared servers.

During the migration process more than 25,000 missing files were found. Now, database fields in Oracle and SQL associate a PeopleSoft record with a Laserfiche document. By integrating PeopleSoft, RightFax, Oracle and Laserfiche, the Star Tribune was able to automate workflow.

For example, an expense report entered in PeopleSoft has a bar code, which RightFax sends to a network folder where Laserfiche Quick Agent recognizes the bar code, files the receipt in Laserfiche and then notifies PeopleSoft that the expense can be reimbursed.

What started as an Accounts Payable solution is now being used by Circulation, HR, Asset Management and Interactive Media, with Laserfiche Records Management Edition on deck to manage contracts for the entire company.

That’s BC Biomedical’s motto. And since implementing Laserfiche four years ago to manage its sprawling information network spread out over 47 patient service centers (PSCs), you can add “embracing technology” to its motto.

Headquartered in Surrey, British Columbia’s second-largest city, BC Biomedical (BCB) has been privately owned and operated by laboratory physicians since Dr. C.J. Coady founded it 50 years ago. In its half-century of existence, BCB has grown to comprise more than 40 leading practitioners in all disciplines of laboratory medicine. BCB’s pathologists are among Canada’s top practitioners in their fields, and their model for health care and community service is recognized and respected worldwide.

BCB’s service centers rely on Laserfiche to manage a broad range of documents, explains Business Systems Analyst/Project Manager Chris Fiorucci . “We have more than 700 employees, administer 440 types of tests, and see about 6,000 to 8,000 patients daily, so we desperately needed a document management system that would enable us to store and retrieve vital patient information instantly and across our multiple centers,” she says. “Laserfiche is our lifeline.”

Because Fiorucci has worked with BC Biomedical for 38 years, she knew how important a strong family feel is to her organization. BCB, in fact, has been voted one of Canada’s 50 Best Employers for seven consecutive years according to Hewitt Associates Annual Study. So when BCB first looked into Laserfiche, they knew they’d discovered an organization with values that mirrored their own. “We pride ourselves on our commitment to our patients and community,” she explains. “Laserfiche shares our core values. Their community focus and strong software product are a winning combination.”

But if BCB’s great to work for, it’s also great to be one of its patients. BCB’s commitment to its patients is embodied in its core values of delivering quality service, maintaining professional and ethical business practices, and being responsible and accountable for actions. “Above all, we’re dedicated to providing diagnostic health care of the highest quality to our patients. We respect each other and work together effectively and relentlessly to constantly improve. Laserfiche is in line with our goals, and with 47 patient PSCs, we rely on Laserfiche to sustain operational efficiency and flexibility,” Fiorucci explains.

BCB made its name developing timely, meaningful diagnostic information for physicians and responding to patient needs for laboratory services. As services spread across British Columbia, that benchmark of the BCB brand became more and more challenging to maintain. Pre-Laserfiche, an office would receive one patient requisition form at a time that then needed to be physically stored at the PSC for three months before being sent to offsite storage for at least another six years. “The paper trail was huge, and the storage costs came to a pretty penny,” Fiorucci says.

BCB’s goals were to decrease photocopying, eliminate off-site storage, automate printing of requisitions for send-out tests, reduce costs and improve efficiencies, while adhering to the Canadian Medical Services Commission’s (MSC) Electronic Storage of Requisitions—all of which and then some have been met since implementing Laserfiche in 2004.

The main Surrey office uses an area setup exclusively for three scanning clerks to onboard the approximately 10,000 patient requisitions delivered daily. “We no longer need to photocopy requisitions,” Fiorucci says. “With access to the on-line patient requisition repository using WebLink, we’re truly paperless.”

The Surrey office houses human resources, finance, and business account teams for non-medical testing. “With so many PSCs and branches, Laserfiche is essential for our internal communication and business continuity,” remarks Fiorucci.

And besides improving communication, BCB eliminated more than 25 hours a day spent filing original documentation, retrieving information and re-filing, and faxing or mailing documents—not to mention all the time wasted trying to find misplaced documents.

“The old way of doing things around here was extremely time-consuming and ineffective, especially when you would get phone requests for additional information. It definitely took staff time away from our patients,” Fiorucci says. “We now have a total turnaround time of four hours because Laserfiche has helped us multitask across several departments. I cannot stress enough how reliable, fast and easy the system is. Laserfiche has impacted our entire organization in a positive manner.”

More recently, BCB was the first user to implement the beta version of Laserfiche Bar Code 2-D. Now, after a patient request is received, staff use the lab information system to print out bar code labels containing PSC information such as the request number, patient’s first and last name, personal health number (PHN) and service date. Patient and barcode labels are placed on the patient’s requisition and a scanning clerk then picks up all requisitions for scanning.

In order to automate work processes even further, BCB’s developers were able to take the request number scanned into Laserfiche and look up the patient request number in the lab information system to determine if any of the tests ordered needed to be sent to a different testing facility. “If they do, another program runs to retrieve the image from Laserfiche and prints it on a printer in central processing,” Fiorucci says. “This was definitely a win-win situation for all of us.”

Additionally, departments can now view patient requisitions online, which streamlines procedures such as phoning the PSC for test confirmation of doctor information and diagnosis. “As a seasoned BCB employee I can tell you that life after Laserfiche is greatly simplified!” Fiorucci says. “Now that we’ve improved office efficiency, we can focus on our goal of advancing health one patient at a time.

“Implementing Laserfiche was the best decision we ever made,” she adds. “We’ve reduced wasted office space required to store forms, saved time retrieving documents, saved money storing documents offsite, and more importantly streamlined our workflow processes enterprise-wide.”

“Ignorance of electronic document management is costing medical groups millions of dollars in extra payroll costs and hurting the morale of office staffs,” Lafayette said. “It is relatively easy to demonstrate immediate return-on-investment (ROI) for converting traditional files to electronic images to practice administrators; I have numerous references ready to share their successes, too.”

Lafayette said most medical practices began introducing automated billing and scheduling software within the past 10 to 15 years. Many have since introduced electronic medical records systems (EMRs) as well. But the key to streamlining offices staffs and improving productivity is to tie those technologies together with Laserfiche, a sophisticated electronic records management system enabling office staff to access all stored records on their computer desktops.

Physicians Support Group next intends to launch a regional educational program to show medical practices how to use technology to improve operations. Lafayette is planning an ambitious campaign throughout the Sunbelt to advise specialty groups how to securely convert every paper document, including patient identification, explanations of benefits, “superbills” (which itemize all services, diagnostic and medications) and medical records, into searchable electronic records.

“My goal is to show that creating the ‘ideal medical practice’ is within the grasp of any group willing to employ today’s technology.” Lafayette said. “This will allow physicians to devote their full attention to patient care, reduce the number of support staff while improving the morale and productivity of those processing documents for payment and eventual archiving. This is really a win-win for medical groups.”

Many medical groups around the nation have in recent months explored and selected Laserfiche for compliance with federal HIPAA (Health Insurance Portability Accountability Act) requirements, according to Stephen Wheeler, Laserfiche’s National Health Care Sales Manager. Laserfiche’s advanced security features are critical in that regard, but Wheeler said integrating document management with other office automation products provides the comprehensive solution required in today’s health care market.

Lafayette’s ROI calculations factor in Laserfiche’s ease of installation and short training cycle, which means workers become quickly productive when using the software. The Laserfiche intuitive interface, combined with its filing structure which mirrors traditional filing methods, make immediate sense to workers.

“Clinic administrators like the idea of replacing copiers, which spew thousands of pieces of paper a day, with affordable scanners, which generate electronic images for paperless files,” Lafayette said. “Once an electronic file is created, it is stored on a hard drive, where it can’t be lost and can be immediately retrieved without time-wasting trips to dusty file rooms. And all electronic records can be backed up and stored off site, providing desirable disaster recovery requirements.”

Then they got Laserfiche.

“You can’t imagine how much time this saves us,” says Medical Records Supervisor Brenda Glover. “Four hours a day, at least.”

That’s because the Stanford Blood Center is not your average blood bank and the people who donate there are not your average donors. Each year, tens of thousands of donations are made there, many by donors who extend their arms for others up to a dozen or more times a year.

The Blood Center’s donors are dedicated donors who often give just a portion of their blood called the platelets, which are vital for cancer victims undergoing chemotherapy. With the platelets removed, the rest of the blood is returned to the donor’s body, enabling them to donate again much sooner than if they had donated whole blood. Some of them have donated up to 500 times, according to Glover, who has donated her own blood 68 times.

“For a blood bank to be a success, it has to have repeat donors,” Glover says. “These donors are very dedicated, and they are usually back within one or two weeks.”

Unfortunately, this act of charity comes with a price: paperwork, and lots of it. The Blood Center can’t determine if it’s safe for a donor to give without knowing first a lot about that individual’s health history and past donations.

Each donation requires filling out a history card, whether it’s an individual’s first or fiftieth time at the Blood Center. These cards provide vital details which may affect an individual’s eligibility to donate. Staff then have to make sure that information is complete and has been reviewed by the medical professionals drawing the blood before any donations can be collected.

Before Laserfiche, paper history cards were filed in Glover’s office. Whenever a repeat donor came into one of the Blood Center’s collection locations, Glover’s staff had to pull that individual’s file down, package it, deliver it and then pick it again at the end of the day. They went through the same process even when there wasn’t a donation being made, such as when a doctor just needed to update a file, investigate past donations or double check information.

“Then there are the calls we’d get every day looking for special requests for these documents just for history information add-ons,” Glover says. “It was just a big, long drawn out process for each donation.”

With 55,000 to 60,000 donations annually, Blood Center staff spent much of its time hand-delivering paperwork around town. The Center bought its Laserfiche license and had the software installed last year, but needed a new server to really get up and running.

When that server arrived this year, all the Blood Center’s computers at remote collection locations were networked into the Laserfiche system at on-campus headquarters. Since staff began scanning all new history cards and back-scanning the old ones, they’ve begun to realize the labor savings tens of thousands of Laserfiche customers across the country have enjoyed for years.

Donor documents scanned into Laserfiche are now instantly available for nurses in the satellite offices through a password-secured Website. When a donor walks into one of the remote locations, a number assigned to his or her file is typed in and the person’s entire donation and health history is instantly available.

“We’re no longer pulling files down and putting them into a bucket to be sent out to the donor locations,” Glover says. “And we don’t have to wait for the charts to return or wonder where the charts we’ve already sent out are. If a doctor needs a chart right away, we’re not scrambling around. Thanks to Laserfiche, doctors can access these charts without any waiting.”

This is particularly helpful, Glover says, when it’s discovered after a donation is made that reporting inconsistencies on the history files should have disqualified a donor. Time is a factor in such cases, and accessing information instantly is a huge help. Staff can also scan documents from histology department and e-mail the images immediately if the Blood Center’s director is out of the office and in need of information.

Once the cards are scanned into the system and the images are inspected for accuracy, the hardcopy is sent off site and eventually destroyed, so Laserfiche is not just freeing up time, it’s also freeing up space.

So, what is Glover doing with all her free time now that the Blood Center has Laserfiche? What every other Laserfiche customers does once they’ve got their system in place—expanding its use into other areas of office operations.

“Soon we’ll be moving into employee records, machine maintenance records, and contracts procurement,” she says. “Anything that can be filed into a filing cabinet will be going into Laserfiche.”

“Within our storage area,” recalls Dubon, “you frequently had to move a lot of boxes out of the way to get the one you wanted. If they were overhead, you had to call someone to help you. With boxes that heavy, it would be really easy for someone to get hurt. It was a worker’s comp claim waiting to happen, which would not only mean injury for an employee, but also an unnecessary expense for the department.”

The department’s storage space filled up quickly, so Dubon was forced to rent off-site storage space, an added expense for the department. “Someone would have to carry boxes out and transport them off-site” says Dubon. “Even if I decided to spare an employee’s effort, I’d have to hire a courier, so that was another expense.”

With the goal of freeing up storage space and protecting her staff’s time and health, Dubon began looking at digital document management solutions. She relied on Systems Analyst Nelson Munguia to do some initial investigation. He looked at four products, with an eye toward reducing necessary storage space, minimizing data latency, providing easy retrieval of information and spending funds wisely. “We were looking for something that we could implement without increasing the staff workload and that would give us easy access to the data,” says Munguia.

“I really needed something that would be HIPAA compliant. That was my number-one priority,” adds Dubon, whose staff is required to protect confidential information contained in billing and Explanation of Benefits (EOB) forms.

With the help of reseller American MicroImaging, Inc. (AMI), Munguia narrowed the choices to two. After a Laserfiche® demonstration, Dubon was sold. “We could see how easy it was to use,” she says. “It’s a very user-friendly system.” Dubon made the decision to outsource the scanning of older documents to keep her staff free for day-forward scanning and locating documents using the new system.

Munguia recalls, “It took about two months to complete the installation of the server and scan six months worth of documents.”

Within a week or two of installation, the Laserfiche system was up and running, solving the problem of searching through boxes in the storage space. Instead of hefting bulky boxes to find documents, staff just calls them up on their desktops. “It took a huge headache away from me and my staff. It’s just easy—you can take something like an EOB and e-mail it to someone, or print it and mail it. We’ve eliminated the lag time for each collector.”

Laserfiche also eliminated misplaced files and batches of files. “Nothing is misfiled anymore,” says Dubon. “If we have an issue with something not being in a batch, which happened before we had everything fine-tuned, we resolve it right away. But now I don’t find that anything’s missing.”

Dubon even finds that Laserfiche can save patients some grief. “If a patient calls with a problem—for example, ‘My secondary insurance hasn’t paid’ or ‘I’ve been billed for charges that aren’t mine’—we don’t have to tell the patient that we’ll call them back the way we used to when it took so long to search for files. We can locate the file right from our computers and see the problem. That saves the patient a lot of worry.”

Locating EOBs quickly, whether there’s a mistake or not, saves Dubon from having to hire additional staff. “If I didn’t have Laserfiche, I would have had to hire someone full time to pull all those EOBs. I don’t have to move to pull files anymore. I just move my fingers to access the system and it takes seconds.”

Because the department uses Laserfiche, charges rarely get posted to the wrong account. “That would happen all the time in the past,” recalls Dubon, “and it was a big effort to correct. Now we’re doing more of an electronic interface for charges, moving more toward being paperless, so that’s happening a lot less—and it takes a lot less time to correct. Before installing Laserfiche, it could take up to two hours just to find the invoice. Now it takes seconds.”

Radiology needs to share patient data with other USC departments that also use Laserfiche, particularly demographic and insurance data, but they also need to protect sensitive information. That’s why HIPAA compliance was so important to Dubon. And Laserfiche security features enable her to control access to confidential data.

“AMI helped get everything up-to-date—I could set the access controls so that only authorized people have access to sensitive information,” says Dubon. While other departments use Laserfiche for many reasons—for example, USC also uses Laserfiche to manage clinical data—staff in those other departments may not have the proper clearance to view confidential information. “When we send out files to other departments,” she continues, “we frequently use redaction to block sensitive information, such as charges or the reason a patient came to see the doctor.”

Munguia appreciates the reduced turnaround time between service and payment, as well as the reliable backup that Laserfiche provides. He sees an added benefit as well, noting that timely document delivery no longer stresses out staff. “I notice it every time we get a subpoena for medical records. Localization of documents is no longer a chore. Staff is smiling and they don’t look menacingly at the process servers anymore.”

Munguia first installed Laserfiche in the billing department. Accounting was so impressed by what the software could do that they soon followed suit. That department is now looking into expanding its use beyond auditing to creating accounting reports. Munguia looks forward to adding the administrative staff to the growing list of Laserfiche users.

There’s no doubt that Laserfiche has smoothed operations at USC Radiology. Dubon notices that in addition to sparing the staff heavy lifting and making their jobs easier, it’s also helped the department respond more quickly to patient requests. The installation is so successful, in fact, that AMI uses it as a demonstration model for potential customers.

Says Dubon, “The system is never down, it doesn’t have glitches and whenever something is not scanned properly, we’re able to flag it right away. I am very, very happy with it. It’s probably the best thing that my boss ever allowed me to do.”

The SurgiCenter performed its first procedure on May 22, 1989, and hasn’t stopped since. “We have 100 doctors and 35 staff members working together to provide superior patient care, with over 20 procedures performed on an average day,” says Jeffery Johnson, systems information specialist. “That creates a lot of information to manage.”

Relying on paper patient charts, however, was limiting staff’s ability to efficiently share that information. “Too many people needed records simultaneously, including clinical staff, the billing department, auditors and the medical records technician, who needed to file reports that came in days later,” Johnson says. “Staff didn’t take the process seriously, and there were constant filing errors.

“Around 30 charts per month were checked out just for auditing by anesthesia and nursing staff,” he continues. “If the charts were unavailable or incomplete, the billing department couldn’t do their work. And to make matters worse, we were more successful than expected—over a five year period, our case load grew from 5,300 to 8,600.”

Too much success is a nice problem to have, but the SurgiCenter faced its biggest challenge in managing paper patient records. The cost of storing records was rapidly increasing, and keeping up with records retention requirements was a burden. “Offsite storage was 5 miles away, so we were paying to store the records and wasting man-hours to retrieve them,” Johnson remembers. “Even before HIPAA passed, we knew we couldn’t maintain records integrity and patient confidentiality with paper records. We knew something had to be done.”

Staff initially considered implementing an electronic medical record (EMR) system, but rejected the idea because commercial systems didn’t meet the SurgiCenter’s needs. “As a surgery center, we typically only see a patient two or three times, so we didn’t need the functionality of a traditional EMR—not to mention the expense,” Johnson says. “We knew we needed to move to electronic record keeping, however, so digital document management seemed to be an ideal solution. We could eliminate paper, secure our records and easily locate information, which was just what we needed.”

When Johnson took over the medical records department in 1996, he agreed to manage HIPAA compliance only if he could deploy a digital document management system. “We experimented with another product that didn’t scan efficiently, wasn’t user-friendly and had poor retrieval capability,” he explains. “The clincher came when the manufacturer phased out the application, and they wanted us to purchase their replacement product. That’s when I began researching other document management applications and found Laserfiche®.

“We selected Laserfiche because we needed a solution employees would learn quickly,” Johnson continues. “We liked the quality of the scanned images, and the processing speed was superior. We also liked that we could run audit reports for accountability. Laserfiche had everything we needed.”

Implementation went quickly, with the repository going live after only one month of testing. “We initially scanned in three years’ worth of records,” Johnson says. “In phase two, we scanned another four years’ worth of records—about 31,000 medical records in all.”

Currently, the SurgiCenter uses Laserfiche to streamline workflow throughout the life cycle of patient records. When a patient pre-registers, staff create a paper chart that includes a bar-coded face sheet. After the patient’s procedure, they scan the chart into Laserfiche, using Quick Fields™ and Bar-Code Recognition™ to automatically create the digital patient record and populate each document’s template fields, simplifying indexing and chart retrieval.

The SurgiCenter’s billing department also uses Laserfiche to manage explanation of benefits (EOB) forms. Quick Fields automatically fills in the payor and date for each EOB in the associated template, which aids in tracking and retrieval. “Laserfiche has brought greater efficiencies in all departments, but especially in Billing,” Johnson says. “We’ve seen much faster claims processing and collections.”

Perhaps most importantly, Laserfiche helps the Center remain compliant with HIPAA regulations. “With Laserfiche, we can log in requests for records, track due dates and redact sensitive information, fulfilling release of information requirements. We also use the Audit Trail™ module to safeguard patient privacy,” Johnson explains. “Our administrator serves on a national HIPAA compliance panel, and she frequently invites confused hospital administrators to see how Laserfiche helps us meet these challenges.”

The Center also must remain compliant with Association for Ambulatory Health Care (AAHC) regulations. The AAHC conducts on-site evaluations every three years, and audited the SurgiCenter just a few months ago. “We passed with flying colors,” Johnson reports. “In a typical audit, they request random charts, but on this last audit, they got very specific, requesting two charts of patients who were also Wards of the State. This isn’t information we track, so it would normally be very difficult to find.

“Thanks to Laserfiche’s full-text search capabilities, we located these charts very quickly,” he continues. “The auditors also requested charts of cancer patients, which we found just as quickly. Needless to say, they were duly impressed.”

Laserfiche also helps the SurgiCenter easily complete state-mandated quarterly pathology reports of cancer quantities, broken out by type. “As you can imagine, this data was quite difficult to flag and track with paper, but with Laserfiche, the staff person simply searches on the specific cancer—like melanoma or carcinoma—for the relevant time period, and the results are right there almost instantly,” Johnson says.

The best thing about Laserfiche, according to Johnson, is that the Center can manage patient records with fewer staff members. “Before Laserfiche, we had separate departments for surgical scheduling, patient registration and medical records. We’ve merged the three departments and eliminated the medical records clerk position,” he says. “We originally had three scanning clerks, and when one left, not only did we not have to replace her, but the remaining two were able to take on scheduling and records management duties. We’re now down to a single full-time scanner.”

But Laserfiche has delivered more than easier compliance, faster reporting and staffing efficiencies. “We’ve had a lot of benefits that we didn’t expect,” Johnson says. “We used to have constant friction among departments who needed the same records or who were looking for missing records, but with Laserfiche, everyone who needs a chart can always find it. It’s dramatically improved the working relationship between departments.”

Johnson doesn’t hesitate in recommending Laserfiche to other ambulatory surgery centers. “In practical terms, we’ve reduced costs, improved collections and established peace of mind when it comes to record keeping,” Johnson says. “You can’t go wrong with Laserfiche.”

Processing the thousands of paper documents associated with these accounts, however, was limiting MDS’s productivity. “We needed a system to provide three key features: security, accessibility and accountability,” says Solutions Architect Matt Brown. “We also wanted to cut down on paper-related costs. We spent the better part of a decade looking for a system that could accomplish all these goals.”

MDS first experimented with a Web-based product in an attempt to eliminate paper documents and streamline work processes. “It did a very good job of storing and retrieving documents, but that was about the extent of its usefulness,” Brown says. “It proved difficult to administer. So we then built a second system ourselves, using Microsoft® SharePoint® as the foundation.”

This second solution provided a clear demonstration of the benefits of an enterprise-quality system. “We could see the possibilities, such as ease of retrieval, improved business intelligence and the efficiencies of automating work processes,” Brown explains. “However, SharePoint isn’t a document management system, so we were asking it to do something it wasn’t designed to handle.”

This experiment, however, helped staff envision an ideal solution. “Our immediate goal was to store billing records electronically, but our eventual goal was and still is a completely paperless workflow,” Brown says. “We needed to make sure that billing records were easily retrievable, that protected health information was secure and that we could account for all our documents, but we also needed a solution that was cost-effective and scalable.”

Laserfiche® fulfilled all these requirements—and more. Thanks to its open architecture, Laserfiche can serve as the document management back-end for many line-of-business applications, including Med/FM™, the application MDS uses to manage billing and claims processing. With help from their Laserfiche reseller, JPI Data Resource, MDS integrated the two systems so that staff can instantly access Laserfiche documents from within Med/FM. “That was the system’s number one selling point,” Brown notes.

After MDS selected Laserfiche, things moved quickly. “Installation was completed in less than a day, and training took less than a week,” Brown remembers. “We were able to initiate a completely paperless workflow for one of our clients by the week’s end. Then we started bringing our other clients online.”

MDS has two Laserfiche servers, one in each of their two divisional offices. Over 30 users in those locations—and in smaller offices throughout California—use the system daily to process billing documents submitted in both paper and electronic formats.

Some clients still send MDS paper billing documents, which must be processed manually. Staff scan those documents, separated by bar-coded index sheets, into Laserfiche. The Quick Fields™ Bar Code Plug-In™ reads the bar codes and automatically indexes the scanned files. “We simply attach the cover sheet to its corresponding billing record and Quick Fields does the rest,” Brown says. “Quick Fields fills in all the necessary document metadata—such as the patient’s name and identifying information—that is stored in the bar codes.”

When clients submit electronic documents, staff use the client’s daily log to create empty documents in the Laserfiche repository that serve as place holders for corresponding billing documents. Staff then use Snapshot™ to convert the electronic information into unalterable TIFF files and import them into Laserfiche, where they are matched up with the empty documents created earlier.

To further automate work processes, Workflow™ routes documents among the various departments that create the billable record and generate the final claim. If any information is missing, Workflow automatically routes the record to the appropriate department for further follow-up.

While Laserfiche speeds up the entire collections process, it has specifically streamlined the process for submitting claims that require supporting documentation. “Before Laserfiche, there was a delay of several days, given that a staff member would have to physically locate the billing record, pull it and copy it,” Brown says. “Now, we can send claims out the same day. Employees simply pull the account up in Med/FM and press a function key, which automatically generates a search in Laserfiche for the patient’s billing record.

“These efficiencies have enabled us to shift job priorities from one department to another—or eliminate tasks altogether,” Brown continues. “Before, we needed a rather large staff just to manage all the paper. Our medical records department has been completely transformed. Now, they simply handle scanning and document printing for claims attachment.”

In addition, Laserfiche has given MDS greater oversight of business processes. “We use Microsoft SQL Server™ Reporting Services to query the Laserfiche database, which provides us with a wealth of real-time data we didn’t previously have access to,” Brown says. “This data gives us greater awareness of our business processes, which helps improve decision-making.”

MDS’s clients benefit from this improved reporting as well. “The medical director at one of our client sites requests a monthly time study showing how many patients their physicians see each hour,” Brown says. “Before Laserfiche, this was a laborious process that required manually entering statistics into a spreadsheet. Now, we use Laserfiche to pull this information directly from the ER log and store it in the document template fields. Our reporting server queries this information and automatically generates and sends the report—with no user interaction required.”

In the future, MDS plans to completely eliminate paper from their billing processes. “We’re in the beginning stages of adding additional automation and integration with our billing management system that will eliminate manual demographic and charge entry. We also plan to implement a paperless workflow in our payment processing department,” Brown says. “We are constantly looking for new ways to extend our Laserfiche system with integration and customization—so we definitely appreciate the ability to purchase components separately and add new ones over time.”

Customizing MDS’s Laserfiche system comes easy to Brown, who values the flexibility of Laserfiche’s open architecture. “As a programmer, I appreciate the expansive features of the Integrator’s Toolkit™,” he says. “With the Toolkit, you can create additional functionality with just a little effort. I also enjoy interacting directly with Laserfiche Developers through the Laserfiche Institute Conference, the Support Site and the forums.”

Brown doesn’t hesitate in recommending Laserfiche to his peers. “I would unequivocally recommend it,” he says. “After years of evaluating just about every document management system there is—and there are a lot—none of them comes close to matching the breadth of features Laserfiche provides.

“Along with our medical billing system, Laserfiche is one of our core applications,” he continues. “We would be hard-pressed to function without it. Employees benefit from rapid access to the information they need to do their jobs, and management benefits from the peace of mind of knowing the documents that are integral to our operation are safe and secure. It’s a win all around.”

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

The Situation

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

The Solution

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

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

Up and running in two weeks

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

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

Seamless storage and retrieval without paper

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

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

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

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

Remote access and distribution

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

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

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

Beyond the ER

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

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

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

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

Compliance

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

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

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

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

High paper pressure clogs medical biller

Hospital emergency rooms (ERs) are extremely busy and generate a flood of paperwork – including medical charts, insurance information and demographic data (address, employer, etc.). Marina Medical Billing Service provides emergency room billing services for a number of hospitals and emergency room physicians. The California-based company needed a document-management system to quell the rising mounds of paper. “We were entering and filing and archiving too much cumbersome paper,” explains Senior Director of Information Systems Lisa Busch, Marina Medical. “Some of the ERs we work with were already going paperless. That meant we were buying more printers and using more paper, toner and energy to print out the incoming electronic data. We were converting electronic records to paper! At the same time, we were growing; we needed room for people, not for paper.” Based on their research of paperless solutions, Marina Medical determined that the Laserfiche document imaging and management system was a good fit for their requirements. “Our billing software company, CPU Medical Management Systems, had worked successfully with Laserfiche in the past,” says Busch, “so we knew the Laserfiche system would work with our billing software. Marina signed a deal with Laserfiche for a 90-day pilot project, which was successful. Laserfiche reseller JPI Data Resource understands the health care business, and they made the pilot successful.

HP/Laserfiche solution passes the “stress test”

Before they committed to go paperless at all the hospitals they work with, Marina needed to “stress test” the Laserfiche solution to determine if it could still do the job three years down the road, when Marina expects to have more hospitals using it. Marina put together a test team of HP, Laserfiche, JPI and Integrated Solutions Group (ISG), an HP systems integrator. JPI and ISG strongly recommended HP hardware as the underlying infrastructure for the document imaging and management system, and Marina had good experience with HP products. Says Busch, “We always liked HP’s reputation for hardware reliability and service support.” “Setting up and running the stress test turned out to be a huge project,” says Dan Lundy of JPI. “HP Services did a great job of expediting the hardware and pulling it all together.”

The trial simulated 60 million pages of records, load levels at double the projected peak, and 200 users logged on simultaneously performing continuous search requests. The team also tested redundancy and failover capability in case of a power failure or system outage. The HP/Laserfiche environment passed every assessment. Says Busch, “We suddenly pulled the plug on one HP server, and in less than five minutes it failed over to the other system – with nothing lost and no hiccups. We were very impressed with Laserfiche and with HP technologies and the support we got from HP, JPI and ISG.”

Clean bill of health since going live

The test platform included the Laserfiche and VMware virtualization and failover software running on two HP ProLiant DL380 servers, with SQL database software running on a third DL380. An HP StorageWorks 1500 Modular Smart Array (MSA1500) provided storage. Based on performance in the stress test, Marina chose to go into production with the same software and HP hardware platform.

The MSA1500 provides economical shared storage and, with redundant controllers and switches, the high availability that Marina requires. The ProLiant DL380 G5 servers perform up to Marina’s high expectations, says Busch: “We have had no hardware-related issues since our go-live date. One of the noticeable immediate benefits of the HP hardware platform is that the modular design of the hardware components, particularly the MSA1500, and the compact, all-inclusive rack assembly help us take advantage of our limited server room space.” The Integrated Lights Out (iLO) management functionality of the DL380 servers enables remote management – without requiring a keyboard or monitor.

Increasing vitality by going paperless

The conversion to a paperless workplace must remain a very systematic process. While Marina’s clients are ER physicians and medical practices, the processes and systems they work with are based on each hospital’s own individual medical-record system.

With the HP/Laserfiche solution in place, Marina started going paperless one hospital at a time. “Electronic files from the hospitals are tricky to work with, because they are all different,” explains Busch. “When we take a new hospital paperless, we first map their data into our formats and figure out how to modify their data and get it into Laserfiche.”

When data comes in to Marina, it goes to the Laserfiche system, which captures the data, creates patient registration sheet and sends it to the CPU Medical billing system, which then generates patientbills. As the paperless system grows at Marina, it will handle an enormous amount of information.

“On an average, a hospital sees 3,000 ER patients per month,” says Busch, “and generates six pages of documents per patient. When 100 hospitals go paperless, we will handle almost 2 million pages of

documents each month.” Busch expects that it will take about 18 months to convert all of the hospitals they work with to paperless.

Building a healthy corporate lifestyle and boosting higher availability

Going paperless is also a major factor in helping Marina Medical Billing become a “greener”, more energy-efficient company – reducing its consumption of natural resources while controlling costs. Eliminating the need to ship tons of paper documents to and from hospitals reduces both shipping costs and energy consumption. Enabling staff to work at home reduces energy used in commuting. More directly, eliminating printing of documents slashes the number of printers Marina needs, and cuts significantly the consumption of paper, toner and energy.

The automatic failover capability demonstrated so dramatically in the stress test is an important feature of the paperless system. In a paper world, if the power goes out people could still pull files and keep the process moving. In a digital world, Marina must be able to recover quickly from a power outage or other failure. The Laserfiche software runs on two HP ProLiant DL380 servers with VMware High Availability functionality. If a server fails for any reason, the system automatically fails over to the second server and reallocates resources.

To support their ability to recover quickly from any sort of data loss, Marina added an HP torageWorks Ultrium 960 tape drive, LTO-3 Ultrium data cartridges and HP StorageWorks Data Protector Express software for data backups and restores. “The data on the tapes is just as critical as the data on the hard drives,” says Busch. “Using HP LTO-3 Ultrium tape media in conjunction with the StorageWorks Ultrium 960 tape drive promotes compatibility and reliability.”

Faster invoicing for clients, lower cost for Marina Medical

For their customers, the paperless system makes Marina more efficient and speeds up billing. As a result, revenue comes in sooner. In addition, all electronic document management makes compliance with Health Insurance Portability and Accountability Act (HIPAA) regulations far more efficient.

Marina more efficient and speeds up billing. As a result, revenue comes in sooner. In addition, all electronic document management makes compliance with Health Insurance Portability and Accountability Act (HIPAA) regulations far more efficient.

For Marina, the big payoff is eliminating the costs associated with handling and storing a huge amount of paper. Previously, Marina had 30,000 square feet of space at $26 per square foot. About 20 percent of the space was dedicated to storing paper, and that was enough space for only six months worth of paper. After six months, the staff archived the “old” paper offsite or in a less expensive part of the building. The paperless system reduces people costs as well as space costs. Some Marina employees spent all day swapping in new paper documents and taking out old ones. As hospitals go paperless, Marina takes people from phased out departments and retrains them for new work, which reduces hiring and training costs for new positions. The paperless, all-electronic system also lets people work off site, giving Marina greater staffing flexibility.

Going paperless also helps Marina grow its business. “Now we can grow without adding people,” says Busch. “And we can operate worldwide. Geography and distance are not a problem because we no longer need to ship tons of paper documents.”

“We’ve hit a mother lode for productivity increases,” reports Bonnie Kelly, FCI’s IT supervisor and the overseer of their digital document management deployments. “The initial projects are succeeding to the point where you feel compelled to find more uses for this technology.”

The original initiative for FCI was to convert the processing of insurance company explanation of benefit (EOB) reports from paper to a digital system based on Laserfiche document management software. The new system is now fully implemented in the ten FCI clinics and two in-vitro fertilization (IVF) centers located in Chicago its suburbs.

As the EOB project proved itself, Ms. Kelly and FCI management decided to take on the more sensitive challenge of asking the medical staff to move away from using paper-based patient charts. A pilot project went live in late May at the FCI clinic in Glenview, which is in the same building as FCI’s administrative offices and IT department. That project is going so well that virtually every one of the other locations is clamoring to be next.

“It’s all about ease of use,” Ms. Kelly says. “In busy medical environments like ours, you want to feel certain that everyone, especially the patients, is going to be comfortable with the change before you bring in a new technology.

“When we switched from paper to Laserfiche for EOBs in May, 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 the patient charts.”

FCI had local and national goals in mind for the conversion to paperless patient charts from the start.

Within FCI, the immediate objective was to give their physicians instant access to patient charts from anywhere, including when traveling from clinic to clinic to see patients and when out of town. Other expected benefits included (1) Being able to get rid of millions of pages of paper and the accompanying storage needs; (2) Virtually eliminating the potential that charts would get lost; and (3) Establishing a secure, Web-based document repository that would make it easier to comply with HIPAA and other regulations.

More broadly, FCI looked at digitizing their patient charts as a way to get more value from their custom-built ARTworks™ EMR (Electronic Medical Records) system created by IntegraMed® America, Inc., (NASDAQ: INMD) a national network of fertility centers in nearly 90 locations served by reproductive endocrinology specialists and PhD-level scientists. The Laserfiche solution complements the EMR system by giving its users instant electronic access to important, externally-created records and images. Moreover, FCI was aware that their success with a Laserfiche-based solution could establish standards that motivated the rest of the network to move away from paper-based document management.

“The clinics that have a lot of dealings with insurance companies want to adopt our way of handling EOBs,” says Ms. Kelly. “Just about everyone, however, right up to senior management at IntegraMed, is interested in using us as a model for moving to digital patient charts. They are very impressed with how easy it has been for us to take this step.”

If IntegraMed America decides to convert the entire network to digital document management, it will be the culmination of a thorough search for the right system for their needs.

“We have been using the ARTworks EMR for three years and recognized the importance of transitioning to a totally paperless environment,” says Ms. Kelly. “Once a practice moves to an electronic patient record, clinicians quickly realize the need to have all information accessible from the EMR, any time, any place. The Laserfiche solution provides secure and easy access to patient health information, supporting data-driven clinical decisions.”

Ms. Kelly says that she felt that Laserfiche was going to be the right digital document management solution for FCI by the time the Laserfiche reseller, Jerry Breitbarth of TKB Associates in Westmont, IL, finished his initial presentation.

“He was very familiar with EOBs and EMR systems and had handled a number of similar situations,” she says. “Plus, it was proven software that stood out for being easy to use. As part of that, Laserfiche had totally open architecture, which was essential to us because of our interest in being able to integrate it with other applications.”

Hand in hand with that thinking, an integration of ARTworks EMR and Laserfiche is currently in progress and is expected to go live at FCI soon.
About Fertility Centers of Illinois

Fertility Centers of Illinois, S.C., is one of the nation’s leading infertility treatment practices, providing advanced reproductive endocrinology services in the Chicago area for over 25 years. FCI performs more IVF than the next nine clinics combined, conducting more than 2,500 cycles per year. FCI has more babies born than the next ten centers combined with high success rates that are recognized throughout the nation. In addition to a team of nationally recognized reproductive physicians who collaborate with each other to stay current on the latest technology and procedures, FCI patients have access to many other unique support services such as professional counseling from a licensed, Ph.D. clinical psychologist, patient advocates and innovative financial options. FCI’s multiple offices are conveniently located throughout the Chicago area.
About IntegraMed America, Inc.

IntegraMed America, Inc. provides business services to a national network of 30 fertility centers in nearly 90 locations across the United States; distributes pharmaceutical products and treatment financing programs directly to consumers; and operates the Web site www.integramed.com, a leading fertility portal. The IntegraMed network includes 160 physicians and Ph.D. scientists. Network membership is limited to one practice per metropolitan area, yet one of every five IVF procedures in the U.S. is performed in an IntegraMed practice, bringing over 5,000 babies into the world yearly. IntegraMed provides more services to both consumers and medical providers in the fertility field than any other consortium.

Sun Health chose Laserfiche because it was a simple way to digitize their billing processes. The interface was very intuitive, and employees quickly began using Laserfiche to perform daily tasks, such as searching for outstanding bills. The patient accounts department now tracks patients from the time they are admitted. Each patient gets a unique bar code, and, once processed, all patient information is instantly categorized. The bar code is then added to every document pertaining to the patient’s care.

As the word of Laserfiche’s easy integration travelled throughout Sun Health’s two hospitals, the new system was incorporated into active care. Advance directives used to be filed with patient charts upon admittance. This meant that if a nurse needed to refer to the directive during a critical moment, she would have to find the chart. Using Laserfiche, Sun Health now automatically adds advance directives to patients’ digital folders. Nurses can access the Internet from any network computer, login to Sun Health’s secure document repository, and instantly bring up the patient’s advance directive.

Previously, Sun Health required a full-time staffer to scan all patient charts upon discharge. This process was ineffective because the charts were not needed so much after the discharge as during the hospital stay. Now, patients have electronic files with up-to-the-minute care data, accessible to hospital staff throughout their stay. Not only can nurses access patient information from any workstation, but the full-time staffer is able to do something more productive than scanning the charts of recently-discharged patients. Now, when patients are discharged, their full file is already in the repository.

Human Resources also uses Laserfiche to keep employees updated with critical policy changes. They scan all HIPAA Privacy Notices and MediCare newsletters. As laws change and adjust frequently, Sun Health has a way to keep on top of the changes.

“Laserfiche has been handling EOBs (Explanation of Benefit forms) practically from the first day. The staff literally can’t believe how fast they’re finding patient information.

“One of St. Luke’s most interesting applications so far is in marketing, where one of the primary tasks is to put together visual presentations of their work, sometimes as a way to prepare patients for their surgeries.

“They’ve already scanned in thousands of photos. With the simple template that we built for them, they are able to find the shots they need in seconds. It used to take hours.

“With Laserfiche, they’re going to be using a similar template to archive video clips of actual procedures. It will make it practical for them to start producing full motion video presentations as part of their regular routine. The long-term potential is awesome.”

MBC Systems uses Laserfiche software and utilities to process 8,000 pages of billing records per day. Employees electronically route documents between four different departments (billing, payment/processing, collections and clerical), tremendously speeding up the billing process and serving clients faster. They use Laserfiche’s capture tool, Quick Fields, to ensure accuracy as the clerical department takes in thousands of bills per day.

The company also utilizes Laserfiche software as a management tool. With Audit Trail, managers can run field entry reports describing employee productivity and efficiency. They can also track the number of bills that complete the processing cycle on a daily basis.

“Creating a digital workflow environment has revolutionized our medical collection efforts by empowering our staff with patient files that have total availability in disparate department desktops simultaneously,” says MBC Chief Information Officer Mardi Morillo. “The ability to send documents electronically allows us to work smarter while still applying healthcare processes and rules.”

“We congratulate MBC Systems on becoming a standard by which all healthcare organizations should measure their technology initiatives,” says Dennis DiMarzio of Ricoh Business Systems. “They saw the value of taking the time to extend the Laserfiche software to multiple departments, and their hard work is paying off everyday.”

Dr. Thomas M. Keane, a board certified oral surgeon and head of Keane Oral & Maxillofacial Surgery P.A. in Edina, MN, is already HIPAA compliant-with an assist from Laserfiche.

Keane had been hoping to get all of his patient records digitized for quite a while. The HIPAA deadline became the impetus to do it. “We’re trying to be a totally digital office,” Keane said.

The staff at Keane Oral and Maxillofacial Surgery scan all patient records, files and forms into a central database managed by Laserfiche where they are available instantly through a keyword or phrase search.

As soon as all the back files are scanned into the system, Keane plans to make patient charts accessible online from any room of his practice.

The measures enable Keane to be HIPAA compliant with room to spare. HIPAA fundamentally requires healthcare professionals who handle patient records and information digitally to have safeguards set up to keep those records safe from loss or unauthorized
access.

Larry Phelps of EDP Computer Systems, a Laserfiche Value Added Reseller based in Plymouth, MN, provides Dr. Keane with technical support and continuing advice on HIPAA compliance.

“We added Audit Trail to our Laserfiche system,” reports the hospital’s plant operations manager, Dwaine Boothe. “We’d planned to add this module to ensure HIPAA compliance when we chose Laserfiche.

“We bought it in as soon as our repository of scanned medical records was large enough to start sharing files with other departments and medical professionals. With Audit Trail in place, we are confident that our records will be in compliance with HIPAA moving forward.”

At this point, Franklin Medical Center has scanned more than 250,000 pages of medical records into the Laserfiche repository, including all active files going back a year. Emergency room doctors now have the ability to refer to Laserfiche to review the medical records of incoming patients.

Boothe expects the hospital to soon have all its archives in Laserfiche as part of an intensive scanning program put together by his assistant, Judy Ogden. That program will enable them to remove the five portable storage buildings that currently house paper records and that were their chief reason for turning to Laserfiche in the first place.

“I’m a one person department servicing six very busy doctors,” Ms. Goodyear says. “Laserfiche enables me to handle my insurance paperwork in a few hours every week. It used to take me three days.”

Ms. Goodyear has already had a hand in convincing one other eye care practice in the area to convert to Laserfiche, and has prompted no fewer than seven other medical practices to ask her Laserfiche reseller, Jerry Breitbarth of Westmont, IL-based TKB Associates, for demonstrations.

In addition, Ms. Goodyear caused a sensation when she told of her experiences with Laserfiche at the Chicagoland Chapter of the Professional Association of Health Care Office Managers (PAHCOM). “When I told them how much time I was saving, they couldn’t believe their ears,” Ms. Goodyear says. “Some of them literally ran up to me afterwards to find out how they could get going.” Not surprisingly, she and PAHCOM invited Breitbarth to make a full presentation on Laserfiche at one of their meetings.

“I’m involved with my counterparts at other practices because I hope to learn things from them that will make my job easier and better,” Ms. Goodyear says by way of explaining her outspoken support for Laserfiche. “So when I have something to offer that I think will really help them, I’m not going to hesitate to let them know.”

“Laserfiche didn’t just meet my needs for a production system, it helped solve the big compliance problems we face,” Amir says. “It performed so well that I created a new division to sell and support it.”

Ashron has extensive experience installing and supporting Laserfiche software because its own use of the product is so prevalent. Multiple departments use Laserfiche to access financial documents and other materials.

Today, Laserfiche handles more than 500,000 documents per year, putting documents within easy reach and backing up all records for compliance and disaster recovery purposes.

Sean McElroy, Ashron’s Chief Information Officer, applies the software to everyday management concerns and has found that it stands up to strict record-keeping challenges. Ashron needs to consider HIPAA regulations, and they store all patient documents for seven years.

“Setting up a new user is straightforward, yet all HIPAA compliance issues can be satisfied,” McElroy says. “I know, as our needs warrant, we can derive further benefits using Laserfiche’s powerful automation and workflow capabilities.”

“Laserfiche software has impressed me with its flexibility and commitment to standards,” Amir says. “So many application programs are proprietary, and I know many horror stories regarding conversions. Another key was ease of use. The benefits received from our Laserfiche install were so great that I couldn’t help but invest to take advantage of this as a sales opportunity.”

A move to a larger office helped for only a couple of months. More file cabinets did not solve the space problem, and another move was out of the question. Accucode had 20 medical practices and the ability to handle more. They just needed a way to manage all of the paper.

After reviewing several document imaging solutions, Ms. Morgan determined that only Laserfiche provided a scalable, easy-to-use management tool with embedded security features vital to the medical billing industry. The need for comprehensive security was especially important for compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), which sets standards for handling healthcare information electronically.

“Doctors depend on us to watch what they’re doing with their billing and to make sure all claims are paid,” Morgan says. “We deal with thousands of documents every day. For every patient, we scan in an information sheet, a copy of their insurance cards and the charge slip. It all goes into the appropriate doctor file and categorical sub-file as soon as it is scanned in. The patient’s billing records are almost instantly secure and retrievable.”

Today, Accucode scans all documents into their Laserfiche repository and handles billing for 32 doctors. While the workload has grown, Accucode has saved “at least a half-time employee,” or at least $10,000 in payroll, since converting to Laserfiche, Morgan says.

The first had been about a year earlier. Doctors at Kaiser Permanente Medical Center in San Francisco saved him then, with cardiac catheterization and angiography: Carefully, they slid a thin, flexible tube, or catheter, through an incision in the patient’s thigh, up through the femoral artery toward the heart. With dye and X-rays, they located areas of fat and calcium that blocked off the heart’s blood supply. Then they sent small, tough, balloons through the same vascular tunnel, and, inflating them at just the right spots, relieved the obstructions.

But that was nearly a year ago and 1,000 miles away. Now the patient was having his second cardiac episode-often a killer-and there was no time for another catheterization. His present doctor had to find out at once what the earlier cardiologist had learned. He made one telephone call and within 10 minutes, had in his hand a detailed report, 10 to 20 pages long, of the earlier physician’s observations.

While this case is fictitious, it is typical of what happens about 280 times a month, according to Denise Dyer, office manager at the Kaiser Permanente cardiac catheterization lab, which has just installed Laserfiche, a sophisticated system of document imaging, retrieval and virtually instant relay of data, from San Francisco to anywhere in the world. It often takes place in a situation in which lost minutes can mean lost lives.

With the Laserfiche system, developed by Compulink Management Center, Inc., of Long Beach, California, and installed at Kaiser Permanente in San Francisco by Unified Solutions, of Santa Clara, printed documents such as the cardiologists’s report can be scanned into an optical disk and retrieved in seconds. The process begins with an operator running the paper through a scanner, at a speed of ten sheets per minute. The data, now on a NetWare server, is then indexed under the patient’s name, hospital-admission and lab case numbers and a brief description of the procedure, and written onto a 5 ¼” optical disk.

The optical disk is one of 32 nested in a “jukebox” roughly three feet by three feet by two feet-the size of a small typing desk. The jukebox has room for 50,000 patient records, the equivalent of about 500,000 sheets of paper. And once a patient’s records are stored, it only takes a minute for an operator to retrieve and fax the data anywhere.

“We service approximately 15 Kaiser Hospitals and Medical Centers in Northern California,” Ms. Dyer said. “We have patients coming from all over the Bay area, from 60 to 80 miles away, for tests. The last figure I heard was 2.4 million patients. Now physicians in the outlying areas, if they don’t have a report, they can have that information as soon as possible. Especially when a patient winds up on their doorstep at midnight. It’s a situation in which speed really can save lives.”