The need to select, deploy and maintain systems that better manage patient information has dominated the healthcare CIO’s strategic plans for years now. As you would expect, most CIOs point to meaningful use as the driver for starting these projects in the first place. But as CIOs endeavor on this path to improved patient information management, they find that if they take a strategic approach to content management as part of these projects, the results could have implications – consolidating redundant imaging systems, centralized and shared content and more automated processes – that extend beyond a department to the whole healthcare enterprise.
Why is a strategic, enterprise approach to content management so relevant to healthcare CIOs today? In addition to meaningful use, CIOs are experiencing these IT and industry realities:
- Departmental document imaging systems have gone legacy: We’ve all seen this play out before – one department, say accounts payable, needs to image and store paper documents, so they get the budget to buy a rudimentary document imaging system. Other departments catch wind, and when they find that the system can’t be used beyond accounts payable, they too buy their own systems. Therefore, that content ends up stuck in departmental systems disconnected from the rest of the healthcare enterprise – and the CIO’s priorities. The result is document imaging systems that impede collaboration, tend to not be maintained by IT and can’t grow with the organization.
- Healthcare providers (usually) aren’t satisfied anymore with the scanning and archiving technology that comes with the EMR: Most EMR systems come with a scanning and archiving component. And most providers find that it just isn’t meeting their needs. Why? The EMR is capable of managing content only within the EMR, so patient-related documents and other content would be limited to those areas of the organization with access to the EMR. In addition to limiting access to content, other departments, such as patient financial services, have complex processes and content that they need to manage. The EMR simply isn’t designed to provide the requisite advanced workflow capabilities.
- Consolidation within the healthcare market: Healthcare providers have been hot on the acquisition trail with no end in sight. From an IT perspective, the result is innumerable systems that overlap and don’t work well together – not ideal for any organization looking to create a cohesive health system, especially if it intends to continue to acquire. As a result, providers not only need a content management system with enterprise scale, but they also need one that is flexible to grow and change with the organization, as well as integrate successfully with other systems, such as EMRs and ERPs.
In addressing these challenges, many healthcare organizations have turned to enterprise content management (ECM) technology. True ECM transcends simple document imaging. It offers the flexibility to capture and manage a wide variety of content typically outside the domain of the EMR system – from paper to electronic, faxes to EKGs. ECM offers a secure repository for content storage and automated workflow to direct content to appropriate staff in accordance with organizational processes. Functionality for records management helps ensure compliance with organizational and governmental retention policies. Support for electronic signatures and offsite access enables physicians to work from any location. And, when done right, ECM integrates content with your EMR, delivering that content within the environment clinicians already know and use. Again, as meaningful use is usually the primary driver of these projects, one of the biggest value propositions that CIOs see with ECM is a major enhancement to their EMR investment.
But while deploying ECM on the clinical side presents clear value, using ECM in financial and administrative areas of the organization maximizes this value, helping reduce costs and eliminate redundant, error-prone steps in complex processes. When hospitals and healthcare organizations choose to apply ECM as a true enterprise solution in all three areas – clinical, financial and administrative – they see a return greater than the sum of the parts.
Where to start
Even for those choosing an immediate, organization-wide enterprise deployment, implementing ECM in every single department simultaneously is impractical, if not impossible. The processes are too numerous and complex for such an approach. Instead, it makes sense to identify those departments and processes where ECM can do the most significant good. Moreover, this approach works well should an organization choose to purchase and deploy an ECM solution incrementally. In fact, many hospitals start with a smaller initial deployment only to grow into an enterprise solution over time.
In choosing which processes and departments to target first, some commonalities emerge. Areas relying on large amounts of transactional content present a good opportunity to start, especially when processes involve numerous repeatable steps. Managing and processing invoices in accounts payable is a good example. Scan or capture an electronic invoice, link it to the financial record and route it electronically to the appropriate person for approval.
But it’s not always as simple as looking at the quantity of paper you’d be replacing – or eliminating. Sometimes it makes more sense to look at the gap between your staff’s processes and the information they need, factoring in the resulting frustration in locating and accessing that information. If ECM saves physicians time by no longer having to track down a patient’s chart or sparing them from heading over to HIM to sign a deficiency in person, great. If it helps them become a believer in your EMR and broader EHR strategy (as it often does), so much the better.
Taking ECM beyond the department level
In healthcare, the responsibility for a given process lies with a specific department. The execution of that process, however, does not occur solely within the boundaries of that department. For example, analyzing charts, assigning deficiencies and completing medical record documentation is managed within the HIM department. But in facilitating this process, a HIM analyst will often need to work with physicians, nurses and other healthcare providers.
Moreover, so many processes are intricately interdependent. The content a patient registrar gathers at the point of registration – a process in itself – directly impacts both billing and care delivery. An ECM deployment designed to support any given process or department must bear these considerations in mind.
ECM’s core value proposition lies in its promise to connect people with the content they need to do their jobs, unifying disparate, isolated systems within and beyond the organization. Taken at an enterprise level, ECM does far more than unify people with content under the confines of a given process and system. Instead, it transcends a process or department. Rather than bridging the gaps among content, systems and staff, it bridges the gaps among interdependent processes. Everyone can see the information and part of the process that’s relevant to them, and everyone can access it when needed. And you have to store that content only once in a single, shared repository.
Key considerations in an enterprise deployment
Essential to unifying disparate systems at the enterprise level is ECM’s ability to integrate with your key applications. ECM solutions rely on a variety of methods to accomplish this, including HL7, API-level integration and even non-programmatic approaches. Being able to choose from a variety of options would be best, simply because what works well for your EMR system might not work as well with your ERP or billing system. Bottom line: ECM cannot live up to its potential if it cannot integrate well with the systems you have in place – or plan to implement in the future.
For an enterprise-level solution, here are some additional points to consider. The solution must be capable of growing as your organization grows, functioning effectively beyond the walls of a particular facility. It must be flexible, supporting your unique processes while helping you adapt to changes. The people who design and implement the technology should be familiar with the processes that the solution will automate – on both an organizational and community level. On a pragmatic level, enterprise licensing can offer an opportunity for significant financial savings, allowing you to take advantage of the same ECM platform without having to pay for additional licenses with each new departmental deployment. And IT staff benefit from supporting a single system, as opposed to unique ones for different departments.
Measuring value
An enterprise ECM solution can prove its value, but you have to know where to look – and what to measure. Before implementation, document key costs that you expect your ECM solution to address. Start with printing and storage costs, shipping expenses and staff time spent tracking down information. Quantify everything possible, but don’t be afraid to look at things that might seem more subjective, such as physician satisfaction. When done right, you’ll be able to make the case to ensure your ECM solution is delivering on its promise of reducing costs, heightening efficiencies and, most importantly, setting up your healthcare organization for long-term, sustainable content management success.
About the author
Susan deCathelineau, M.S., RHIA, is senior manager, healthcare solutions for Hyland Software. For more on Hyland Software solutions, click here.
