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RM: tackling the volume and persistence of paper

This article appears in the issue May 2013, [Volume 22, Issue 5]


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With an estimated 2.5 quintillion bytes of data each day, according to IBM estimates, new rules for healthcare records and the need to quickly search growing amounts of data, new records management technologies and techniques are emerging to answer those challenges.

Beyond the IBM research, a recent report from the Association for Information and Image Management (AIIM) shows that despite all the discussion of movement to electronic records, the volume of paper records is increasing in 42 percent of organizations and decreasing in 34 percent.

Although many companies are stuck in old methods of paper or electronic records management, some companies are making significant strides in that area.

Managing workflow

Executives at Markham Stouffville Hospital, an Ontario-based community hospital, saw the local population nearly triple in the 20 years since its founding and knew they needed a major expansion, which finally came to fruition earlier this year with a doubling of the hospital's size.

In anticipation of the growth, hospital executives recognized that they had to become more efficient in all aspects of their operations, including records management. When they started planning for expansion, they wanted to not only reduce their paper printing, but also go a step beyond just converting paper documents to electronic ones, says Tim Pemberton, the hospital's director of IT and communications.

The hospital sent out RFPs for solutions. "We were looking at cost avoidance. We were growing our printing exponentially," Pemberton explains. "In 2009, we printed 5.6 million paper documents; in 2010, we printed 6.5 million. We could see that that was going to continue to grow."

But the critical factor in awarding the bid to Lexmark in 2011 was that it was more than just a printer company, Pemberton explains. Lexmark also offers workflow through its Perceptive Software solution. The system, for example, enables a healthcare provider to scan a barcode that goes directly to the hospital pharmacy to order a prescription. That helps ensure the patient receives the right prescription and reduces the time and potential errors of writing a prescription order and having it forwarded to and filled at the pharmacy.

Other benefits

The Lexmark system offered some additional advantages as well. If an authorized user requests a printout of a document, the printer doesn't produce the document until a staff member goes up to the printer and taps it. That prevents someone from requesting a printed document and failing to pick it up—a common occurrence in a hectic hospital environment, according to Pemberton. If the report isn't printed within an hour, the system overwrites the print request.

The solution includes the ability to print out records and other information on preformatted forms, meaning boxes of forms are not ordered and thrown out if the form changes. Now a hospital health forms specialist can change the formatting to revise forms on the fly. As a result of those new capabilities, Markham Stouffville Hospital has reduced its overall print volumes by 18 percent year over year—the equivalent of 243 cases of paper.

The hospital is looking at how to expand the integration of the Perceptive Software solution further into the hospital's workflow process, Pemberton says. Among the possibilities is incorporating faxes or additional printed documents from other healthcare providers into the hospital's workflow system, much like the prescriptions.

Controlling mortgage fraud

Macomb County, Michigan, was among the earliest Midwest counties with computerized imaging and indexed records, including documents for the purchase and sales of real estate. But even such a relatively advanced system was not robust enough to catch the mortgage fraud that is an issue not only in Macomb County, but in other parts of the country as well, says Carmella Sabaugh, the county's register of deeds. As national press coverage about mortgage fraud gained traction, the fear of being on the wrong end of a fraudulent deal kept some real estate sales from being finalized.

Indexing could provide some help, but the reality is that "nobody indexes the information," Sabaugh says. So the county sought a solution that would enable interested parties, including law enforcement, title companies, attorneys and other professionals, as well as consumers, the ability to search by any word or other variables rather than by index fields.

The county discovered that Google had an application that could provide the desired search capabilities, but it was too costly to use before it was thoroughly tested in a live environment. So Macomb County turned to Xerox, which had provided its electronic documents for several years.

Xerox in turn negotiated with Google to obtain a discounted price for the Google Search Appliance, as well as an 18-month proof-of-concept to create testing, identify different types of searches and design the interface with the standard Google search. The fees will be paid by revenues the county receives for searches ($6 each). The county historically has more than the number of searches it needs to cover the fees. If the number of searches increases due to the ease of the system, the county and Xerox will share in the revenues.

Super Index

During the proof-of-concept phase, the county's own digital land records were combined with more than 200 years of property indexes to complete the Macomb County Super Index, which was then loaded onto the Google Search Appliance. Macomb County started with a soft rollout of the searchable Super Index in January. During the trial phase, county officials discovered that searches could be done in seconds. Prior to the Super Index system, a user, such as a buyer or an attorney, would have to go to the county office and search through mountains of paper records.

The full solution went live in mid-March. "We don't know yet if the system will prevent fraud," Sabaugh admits, "but if someone knows they're more likely to get caught in Macomb County, they're more likely [to attempt fraud] in a county where they are less likely to be caught."

While many companies are still trying to find more efficient ways to manage records, some organizations have improved the way they handle an escalating amount of data, and they can provide some insight for better methods of records management.


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