Document management gets personal

May 22, 2014
Now more than ever, healthcare providers must do more with less. Tighter budgets, stringent government legislation and increased patient demands require medical professionals to find new ways to be efficient and cost conscious, without impacting the quality of care.  Providers faced with these challenges need to implement strategies to help optimize their day-to-day processes while reducing cost.

The ascent of intuitive document-based technologies can help to alleviate these demands. Deployed correctly, they can not only help satisfy regulatory, operational and the bottom-line mandates, but can also help improve productivity, foster security and increase profitability. 

While it may seem simple, investing in basic document and data capture strategies can help transform a medical environment. Many healthcare providers are using these strategies to help turn uncoordinated and redundant processes into streamlined and automated workflows.

As healthcare providers continue on their journey toward Meaningful Use in connection with electronic health records (EHRs), here are some strategies for efficient document and output management to consider.

Implement efficient hybrid workflows

The role of paper in healthcare environments has changed dramatically in a relatively short amount of time. No longer are hard-copy documents required for every engagement. Instead, information can live in EHRs so data is accessible to healthcare providers with the appropriate clearance, when and as needed. As physicians, nurses, pharmacists and other medical providers share protected health information (PHI) through a health information exchange (HIE), the result is higher-quality patient care that often translates into improved diagnoses, and can assist in reducing medical errors and patient readmissions.

However, paper still has its place in healthcare, and for good reason. Some registration documents, consent forms and referral forms still require the use of hard copies. Because of this, hybrid work environments are becoming more prevalent in the healthcare setting; this fusion of electronic data with hard-copy documents can help providers create an efficient workflow that is a welcomed evolution of, not a replacement for, current systems and processes.

As providers rapidly adopt EHRs, it is important to understand that documents need to be scanned and incorporated into patient records via a seamless process. These documents can be sent either directly into an EHR or through a document management system. With EHR integration technology, providers have the ability to quickly scan hard-copy patient records through the use of connectors or transmit metadata directly into EHR systems as a standardized HL7 Clinical Document Architecture (CDA) message. Scanning can take place at multiple different touch points throughout the practice as centralized or decentralized scanning processes.

For centralized scanning, production scanners are available, enabling the integration of unstructured documents directly into EHR systems. For example, once a clinical note or discharge summary is created, that piece of paper can be transported to the scanning department and added to the electronic record. With centralized scanning, which has a single optimized workflow process, records are less likely to get lost in the shuffle. Health information management (HIM) professionals who work in this centralized department are charged with adhering to internal standards when translating information from paper documents to the appropriate fields in the EHR. And since only a few people are responsible for scanning paper documents in a centralized scanning system, healthcare providers can feel more confident that they are meeting patient privacy and other Health Insurance Portability and Accountability (HIPAA) standards.

It can be difficult to know where important information should live in the EHR. Those working in the centralized record-scanning department may have to spend valuable time tracking down clinicians for clarification if they encounter ambiguous statements in the paper documents. Because of these concerns, information technology professionals often advocate a decentralized scanning approach where clinical staff scans paper documents at or close to the point of care. For example, a nurse or doctor jots down a few notes after meeting with a patient and then walks up to a local scanning device, such as a multifunction printer (MFP) or scanner, and scans in the document.  This solves the time issue in the centralized approach, but it requires careful attention to who has access to the scanning application as well as how the information is categorized and added to the electronic record.

Given the abundance of paper in healthcare, the optimal approach to paper documents is not an either/or solution, but rather may be a complementary workflow that includes both centralized and decentralized components, especially as organizations make the shift to hybrid paperless systems.

Ensure security, manage output and cut costs

While the benefits of electronic data are significant, so is the need to implement strict security safeguards and monitored access with respect to this data. HIPAA was originally enacted to ensure confidentiality and availability of patient records, but has recently evolved with the Omnibus Rule, which adds data privacy regulations and stricter penalties. With these changes, those impacted by non-compliance now include business associates of medical offices, and civil penalties can reach up to $250,000 for first-time offenses, and up to $1.5 million for repeated offenses.  For healthcare providers, this means added incentive to ensure all electronic health records and information are secure and meet applicable compliance standards.

The importance of safeguarding patient data, especially in the modern healthcare climate, may seem obvious. But understanding where information is accessible, and therefore potentially vulnerable, isn’t always evident. Printers and MFPs have hard drives that store data similar to those on computers and mobile devices. This means that residual data may remain on a printing device after recent tasks have been completed. Further, printed and faxed documents with PHI may be left on a MFP’s output tray, creating the potential for exposure to unintended personnel and possible serious regulatory breaches.

A few simple steps can help prevent such data breaches and should be standard practice for modern-day healthcare IT. For instance, authenticating MFP users through card or keypad access will help control who within the organization can use specific features like copy, scan, send and print. Each transaction can be recorded to make responding to a security incident a more informed process. In addition, consider encrypting your devices’ hard disks to protect the stored data and make it unreadable to unauthorized parties. This will help limit the amount of people who have access to data traveling into (or out of) your MFP. Further, features like secure printing allow employees to queue a document to print and then hold it until the user logs in at the desired device, helping to prevent patient data from sitting on a device’s outbox. Also, many network scanners offer added security with a fingerprint reader to verify the identity of registered users.

Features that ensure device security, such as authentication, also help health IT departments monitor usage and manage output costs. For example, output management solutions like Canon’s uniFLOW software provide a range of security controls, including detailed accounting and reporting. This allows for easy monitoring and management of networked devices, so printing, copying, faxing and scanning costs can be better tracked within a healthcare organization. In addition, health organization IT professionals can control an entire print fleet and quickly identify any cost-excessive or suspicious activity. 

Consider the growing role of mobile technologies

An increase in bring-your-own-device (BYOD) policies, and the rapid adoption of mobile technology, allow for the instant access of documents from anywhere employees are working. According to IDC, US-based clinical mobility spending is expected to grow from $2.9 billion in 2011 to $5.4 billion in 2016; a compound annual growth rate of 12.7 percent. Healthcare providers should harness this potential for greater productivity and provide employees with the tools and software necessary to integrate mobile technology into existing workflows. 

But while BYOD policies can create more productive and efficient employees, healthcare providers need to ensure these offerings are safe, secure and reliable. Significant security-related threats associated with a mobile workforce include the loss of a mobile device and unauthorized access to PHI.
When medical staff introduce their own devices into a network, the system is vulnerable to data breaches and information leaks. Adopting an output management and cost-control solution for those mobile devices can help promote secure mobile printing. These solutions require authorized users to register each of their identities in order to help ensure that the system will recognize them from any approved device and allow them to print.

Once their employees’ mobile devices are secure, healthcare providers should equip their employees with smart mobile printing solutions to unlock the potential of BYOD. The “follow-me” print technology mentioned earlier enables employees to print documents through a mobile device from virtually anywhere and then retrieve the items from any networked MFP. Whether on a separate floor, building or even hospital, employees can securely and conveniently print and retrieve their printed documents.

In addition to productivity gains, strategic BYOD policies have the potential to generate significant cost savings for healthcare providers. Empowering the workforce with mobile devices and supportive technologies can help health organization IT departments save on budget costs and employee resources. Employers should also enact and enforce strict policies to help ensure that employees are aware of and follow best practices and regulations for mobile device use in the healthcare workplace.

While the state of the healthcare industry is rapidly evolving, healthcare professionals can stay ahead of the curve with smart approaches to technology. By implementing efficient document-based workflows, maintaining strict security practices and inspiring productivity with strategic BYOD policies, medical providers can continue to work efficiently in the new age of healthcare.

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