EMRs and capture solutions: The total cost of system ownership

Healthcare providers are tasked with the operational pressures of reducing costs, increasing staff efficiencies, and protecting patient health information while improving care and delivering better patient outcomes. The good news is that numerous productivity, organization, and management tools have been developed to address these challenges, including document capture solutions—the data on-ramp to electronic medical records (EMRs).

By Pamela Doyle,Director of Education, Fujitsu Computer Products America

For most healthcare organizations, EMR systems have become the hub for access to patient information, and the value they provide can’t be denied. The system adoption decision is not taken lightly, and cost-benefit analyses are carefully crafted for organizations’ specific needs. But healthcare organizations sometimes neglect to scrutinize the capture portion of the data workflow process, resulting in surprising hidden costs and unrealized benefits. For example, if staff have to manually search alternate sources of information such as email, fax servers, clinical resources, and paper-based charts, the value of the EMR system is diminished as time is wasted and the holistic view to the complete patient record goes unrealized.

To bridge the gap between EMRs and other sources of patient information, more and more healthcare organizations are turning to capture solutions to integrate these other sources of patient information into their EMR systems. Capture solutions are typically a combination of hardware and software that digitize and/or import electronic content, clean up, and extract data from the content. Once captured, the information can be routed into EMR systems. Automation can be so effective; in fact, 60% of adopters have seen return on investment on their paper-free projects within 12 months and an impressive 77% within 18 months. Faster response to customers and higher productivity are seen as the biggest benefits, along with improved remote and mobile availability.¹

First, let’s explore the functionality of capture solutions that enable healthcare professionals and systems to do the following:
capture content in a wide variety of formats including paper, electronic documents, email, faxes, and images;
capture all types of documents including, but not limited to, patient medical history, insurance and ID cards, consent forms, and billing and payment documents.
capture content on a wide variety of devices, including dedicated document imaging scanners, MFPs, and mobile devices such as smartphones and tablets;
automate image enhancement to improve the quality and clarity of captured content; and
tag and extract metadata to ensure proper classification with the appropriate EMR.

By complementing EMR systems with capture solutions, healthcare organizations can achieve invaluable benefits such as:

extending access to all related patient information across the entire care continuum,
enabling collaboration using information that is easily located and shared,
expediting access to information to demonstrate compliance and to enhance business processes,
significantly improving staff productivity,
reducing operating costs, and
enhancing the security of all patient information.

If this sounds like something you might be interested in, you are probably wondering what type of investment you would need to make. At a bare minimum, organizations will need the following:

scanning hardware and image processing software to digitize paper-based information,
scanning software to import other patient related content,
either a package integration with implemented EMR system or an application program
interface for customized integration, storage and infrastructure enhancements.

While the volume and scale of integration will vary greatly depending on the size of the healthcare organization, there are three main cost areas to consider:

Acquisition and customization costs:

software licenses—consider all potential users and all potential third party-products, carefully evaluate different vendor pricing models for hidden fees;
hardware—new investments in scanners, MFPs, and mobile/tablet devices;
service contracts—maintain support for software and hardware products;
infrastructure—additional investments that may be needed to expand storage, servers, and networks bandwidth and capabilities;
integration—establish if the capture vendor already has an integration with your implemented EMR system or if customization will be required, also consider what resources will be needed for properly extensive testing; and
procurement costs—evaluate if you will need the services of third-party consultants from vendors or system integrators, as well as the cost of your internal resources.

Operating costs:

ongoing subscription services for maintenance and support;
backup and recovery tools and processes; and
other management costs such as software releases, audit, and escrow.

Change management costs:

migrations from existing information sources;
decommissioning old systems; and
training for scanning and indexing agents, systems administrators, and end users.

It’s recommended you consider these costs over a period of three to five years to fully assess the value of the investment.

Evaluating the costs is actually far easier than evaluating the benefits. While the benefits are far reaching, it is not always possible to associate a quantifiable dollar amount with each benefit. Here are some quantifiable and nonquantifiable benefits to consider:

recovering and repurposing premium office space,
reducing off-site storage costs,
reducing administrative time to file and pull patient charts,
reducing staff time searching for associated electronic content,
reducing human errors due to manual processes,
faster access to all relevant information required for compliance and discovery
initiatives,
centralized storage that enhances the ability to secure patient information, and
enhanced response time to patient queries.

Though the upfront costs of capture system ownership can be staggering, the benefits of effective document management are significant and provide needed advantages in addressing the challenges faced by the healthcare industry.

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