Approaches to finding a single vendor to provide an all-in-one solution.
Group practice filing areas often are brimming with patient charts, explanation of benefits, HIPAA forms and all the other documentation associated with such practices. The vision of a totally digital healthcare system is on the horizon for most medical groups, but today’s patient charts are often unwieldy and cumbersome. Lost charts and patient privacy are an increasing concern as HIPAA compliance requires proper security and authorization of all paperwork.
Finding a single vendor to provide an all-in-one solution can be difficult.
By Andrew Bailey
Group practice filing areas often are brimming with patient charts, explanation of benefits, HIPAA forms and all the other documentation associated with such practices. The vision of a totally digital healthcare system is on the horizon for most medical groups, but today’s patient charts are often unwieldy and cumbersome. Lost charts and patient privacy are an increasing concern as HIPAA compliance requires proper security and authorization of all paperwork.
As a practice grows, adding new support staff to manage patient charts is expensive; square footage spent on file storage is a cost better put to use as examination rooms for patients. Choosing software to accommodate patient charts and other practice functions, however, can be a time-consuming process. Frequently, finding a single vendor that provides an all-in-one solution encompassing everything a practice needs can be difficult.
Electronic health-record (EHR) solutions exist for each specialty, but sometimes using the best niche product can lead to problems. Often, silos of information are created because the EHR does not efficiently handle paper-based documents or other parts of the practice, such as back-office accounting and human resources.
These silos are stored in different software packages, and finding a complete view of the practice without using several different applications can be a challenge. Most of this information is stored as documents (EOBs, patient charts and employee records).
The practice of the future may rely on an electronic document-management system (EDMS) to store information in the most-efficient manner possible. A third-party EDMS can also be used to integrate the other applications and combine the documents into a single information repository.
The practice of the future may rely on an electronic document-management system (EDMS) to store information in the most-efficient manner possible. A third-party EDMS can also be used to integrate the other applications and combine the documents into a single information repository.
Efficiency is the watchword for any practice in today’s marketplace. Patients and insurance companies are examining all expenses and looking for alternatives or requesting changes. In order to remain competitive, practices should continue providing the same or better level of service with a reduced level of expenses. Here are four ways in which an EDMS can improve practice efficiency:
- reducing the labor involved in storing and handling paper documents (the largest component of the return on investment of an EDMS);
- reducing the space necessary to store paper documents;
- increasing the ability to comply with appropriate regulations; and
- allowing employees to collaborate and work remotely, thereby decreasing the amount of office space necessary.
Few practice-management or EHR applications incorporate a comprehensive document-management system within the confines of the application. This becomes a problem when trying to build a single information source for the practice. The following features are necessary in any robust document-management system:
- a repository of electronic documents;
- a mechanism for securing the documents;
- integration with other software solutions;
- a method for putting the documents into a defined work flow;
- audit data providing the four Ws (who, what, where, when); and
- compliance with regulatory requirements (e.g., retention, backup, security).
One goal is to have a single repository that contains all information about the practice, patients, staff, vendors and insurance providers. This system should integrate with the end product of the other applications being used. There are two integration points for any EDMS: getting documents into the system and retrieving the documents when necessary.
An EDMS should offer a number of document-capture solutions and multiple ways of getting electronic documents into the repository. Most are based on standard Windows techniques, and these methods can be used by any leading application. Other tools include optical character recognition, barcode reading and text indexing. These tools make automatic filing and document retrieval more efficient.
A champion should be designated who has ownership of the project, and doctors should understand the benefits offered by working without paper charts. The designated champion will help keep the project on track and resolve issues should they arise.
The other consideration a practice should address is how it will handle the existing paper charts. Specialty practices that may only see a patient once in their lifetime may elect not to scan all existing charts. Other practices prefer using temporary staff to scan in old charts.
One approach is to implement a day-forward scanning process. Practices who use day-forward processing will scan the next two weeks of scheduled appointments in advance of cutting over to the EDMS. During the first two weeks of going live, the next two weeks are scanned. This process is repeated until all necessary charts are captured electronically.
Day-forward processing breaks down the effort of creating electronic charts into manageable portions.
Walk-ins and other ad hoc appointments can have their charts created that day and, in many cases, before being visited by the doctor.
The EDMS selected should meet the needs of the practice and provide an ROI. It should provide a robust set of features, allowing the practice to set up the system to meet their needs, not force the practice to change the way it does business.
The EDMS should integrate with other line-of-business applications so it will be successfully adopted throughout the practice. Finally, the system should be designed and built from the ground up as
an EDMS.
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Andrew Bailey is president of Cabinet NG, Madison, Ala.
