ECM supports healthcare
Healthcare providers have a lot of data to manage. Although electronic medical records (EMRs) have taken hold, the integration of other information that helps provide a comprehensive view of the patient usually must be handled by an enterprise content management (ECM) system. The information might include medical images, correspondence and billing statements. Managing the information efficiently helps improve patient care by making vital records available immediately. In addition, it reduces the costs of storage, employee time and retrieval of hard-copy records, and the need for duplicate testing when information cannot be accessed by other facilities.
Methodist Hospitals is a non-profit, community healthcare provider located in northwest Indiana. It has two major hospitals as well as an outpatient facility that includes rehabilitation services. With a medical staff of about 400 physicians and 2,000 support staff, it provides services in 60 different specialty areas. In spring 2010, Methodist Hospitals launched an initiative to provide improved access to medical documentation throughout the organization by implementing an enterprisewide imaging system.
Options for robust imaging
The organization was already using EMR software from Epic for patient records. However, because EMRs are not designed to manage content such as X-rays and other large
images, or patient-related documents such as correspondence and billing statements, Methodist Hospitals was investigating options for imaging. In addition, much of the information the hospital relied on was still in paper form, which meant that a chart could only be seen by one medical person at a time.
“We wanted a very robust imaging solution to provide us with instant access to patient care information,” says Dawn Smith, director of medical records at Methodist Hospitals. “The medical record is a tool for a coordinated effort to deliver patient care. Everyone needs to be able to see what has been done, both to prevent duplicate testing and to make sure that everything that needs to be done for the patient is being done.”
Several aspects of Methodist Hospitals’ information system were being updated, including a modification to its EMR software that would allow cardiology diagnostics to flow directly into patient records. In addition, nursing care was being transitioned so that laptops would be used to enter data to track patients’ vital signs and the administration of medication. Finally, a legacy imaging system needed replacement. “Adding a new imaging system fit in with our strategic plan,” says Smith, “and would enhance both patient care and regulatory compliance.”
A selection team went into evaluation mode, and compared the functionality of a number of different products. Based on its ability to meet the requirements that were identified, ImageNow from Perceptive Software was considered to be the best match. “They were able to think outside the box in terms of what we wanted to do with EpicCare,” Smith says, “and the product allowed us to meet requirements for electronically signing and time-stamping documentation such as physicians’ notes.”
The system went live in August, and after that point, doctors could see all information for newly admitted patients. “Now, we don’t have to pass around a paper file from one physician to another when different specialists need to see patient records,” Smith explains. “Everything is available for immediate access. It’s right at our fingertips.” Methodist Hospitals also experienced an immediate improvement in the bottom line because of the reduced need for storage space of paper documentation.
The next step will be to expand the system into other functional areas such as the financial department and HR. “Those departments also have a lot of paper,” adds Smith. “Our priority was improving patient care, but when we deploy the system more broadly, the hospital will also experience greater efficiency in many other ways.” Smith looks forward to a time when patients will be able to enter their information electronically as they are admitted, rather than having to fill out multiple paper forms. “Our recent assessments show greater customer satisfaction,” Smith says, “and we think this may be related to the more seamless presentation of customer information we have been able to deliver. Our hope is that our ongoing improvements can continue to support this trend.”
Perceptive Software provides a suite of products including document imaging, document management, workflow, e-forms and records management. Solutions are available both in a variety of functional areas, such as HR and legal, and for verticals that include healthcare, financial services and education. “Our products are often used initially in the back office,” says Lauren Bellon, VP of healthcare solutions at Perceptive Software, “but we realized that customers had a unique opportunity with our product to strengthen support of electronic medical records with solutions built around coding and patient finance. Now, our customers find the patient-oriented applications to be very attractive.”
The more quickly patient information is available in an imaging system, the more effectively it can be used during the patient’s stay at the hospital. “If a patient completes an advance directive form and it’s in the system, for example,” Bellon says, “we know who the patient wants to be their spokesperson, rather than having to identify someone during a medical crisis.” Perceptive has also developed solutions for capture of digital photos such as pictures taken of wounds in an emergency room visit. Those are stored in the repository and linked to the electronic medical record, as part of a comprehensive view of the patient.
American Outcomes Management (AOM) provides home IV therapy for patients with chronic and acute diseases that require home infusion services. When the company’s nurses conduct home visits, they document the treatment provided to patients. Until last year, the information was recorded on paper forms, which were later turned in by the nurses. Subsequently, the patient data needed to be keyed into a database. The process was not completed as quickly as desired, and keeping track of the paper forms was time-consuming and inefficient.
AOM decided to develop an application that would allow the nurses to enter data as they provided patient services. “We wanted to eliminate the paper forms, expedite data entry and improve accuracy by eliminating the handwritten information,” says Kirk Graham, IT director at AOM. The company already had a medical application for storing patient records and identified three additional components that it would need for the system—a content repository, data entry device and an electronic forms capability.
The company selected CNG-SAFE from Cabinet NG to store content. “It could be more easily customized than some of the alternatives and was more suited to our user group.” CNG-SAFE has the look and feel of Microsoft Office, whereas other products AOM looked at were not as familiar. In addition, the concept of a filing cabinet with tabs, folders and documents was visually appealing and easy for users to understand.
The next step was to decide on a data entry device. After testing the existing medical records software with a netbook, AOM decided on an alternate plan. “The medical software did not perform the way we had hoped, and we were also concerned about getting Internet access and supporting a large number of netbooks,” continues Graham. “We opted to use the iPad and a data entry form.” AOM contracted with LincWare, which provides e-form creation and document automation tools, to develop a custom LincDoc application for the iPad. Connectivity for the iPad is through the 3G network, eliminating the problem of Internet access.