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.

In 2009, Wythe had a total of 7,200 inpatients and 37,300 outpatients, performing 3,300 same-day surgeries and treating 15,000 people in the ER. With so many patients coming through the doors, digitizing medical records with an agile ECM system from Laserfiche has been a huge time saver.

“When you’re living in a paper world, it takes time to track down patients’ records. Laserfiche makes it instantaneous,” said Patty Hall, Wythe’s Privacy Officer and Director of Health Information Management (HIM).

With Laserfiche, outpatient EKGs and ER reports can be viewed electronically, charts are organized and accessible in a centralized location and patients’ Advance Directives can be identified immediately. In addition, the system facilitates HIPAA compliance with security controls that make it impossible for unauthorized people to view information they’re not allowed to see.

“I’ve been in HIM since 1986, and I have to tell you that having an agile ECM solution in place makes things so much easier,” said Hall.

Other 2010 Run Smarter winners include: Central District Health Department of Boise, ID; City of Maple Grove, MN; Dallas Associated Dermatologists; 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; and the Virginia Port Authority.

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.

“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.”

“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.