Hospital prescription: A healthy dose of content management
To speed the decision-making process and to better capture the reasons decisions were made, Partners turned to EMC’s Documentum and Web-based eRoom collaboration software. Some decision support reminders may have hundreds of rules linked behind them. The Documentum tools allow visibility into how those rules were set up and the metadata attached to each document.
Starting with a single online collaboration in 2005, the effort has now grown to 60 different eRoom groups holding both synchronous and asynchronous meetings. "It allows them at night to read e-mail messages noting which panel member made a comment on which topic in the eRoom," Hongsermeier says, "and it is all hyperlinked, so they are taken right to the most relevant spot in the discussion without having to search. It takes you back into the conversation."
The effort has both sped up the decision-making process and provided a repository for data and archived discussions, she adds, so if clinicians have questions about how or why certain decisions were made, they can easily research the topic and pose queries about it.
Hongsermeier says she gets calls almost every week from other providers asking how Partners did its implementation.
"Lots of healthcare provider organizations are sitting on top of this content maintenance issue," she says. "With pay-for-performance depending on decision support, there’s a greater push to digest all that content. Everybody’s running into this—how to create context."
Integration with EMR
A few years ago, as St. Michael’s Hospital in Toronto began planning a move to a new electronic medical record system, the Siemens Soarian platform, CIO Anne Trafford knew her organization would need an electronic way for clinicians to access information not created in Soarian. There were still many paper-based processes in the hospital, and the transition to Soarian would take several years.
After investigating offerings from several imaging and ECM vendors, St. Michael’s turned to IT services firm CGI. Its Sovera health information management solution now provides online storage and retrieval of patient health information to complement the real-time patient records in the Soarian system.
Physicians now log into Soarian and get an electronic view of patient information as well as any scanned information from previous visits. Trafford says, "They can see all that in Soarian, because of the integration with Sovera, which is now holding all the information that didn’t have an electronic home because it was paper-based."
Another impetus for the Sovera-based information repository was that the hospital was running out of space in health records. "We knew we had to get rid of all that paper," Trafford says. "Some of our biggest fans are our risk management group and research department, because they don’t have to have paper charts pulled for them. We have been able to reduce 22 FTEs [full-time equivalent staff members] in health information management because we don’t have to file all that paper and we don’t have to pull charts."
Cutting out the paper
Sometimes enterprise content management solutions develop on the administrative side of healthcare centers and then migrate to the clinical departments.
Simplifying the distribution of reports and cutting down on paper costs has long been a goal of Dartmouth-Hitchcock Medical Center’s finance team. With the implementation of Open Text’s Report & Output Management Suite, the multisite medical center in northern New England has been able to create a repository for its PeopleSoft reports that users can access via a Web-based front end.
Chuck Laufer, senior information analyst, said finance and IT staff found sending up to 3,000 monthly financial reports as e-mail attachments time-consuming, and printing out reports for distribution to as many as 300 departments was worse. The Report & Output Management Suite (formerly called Vista Plus) is integrated with DHMC’s PeopleSoft financial applications to collect and store those reports. Another big selling point is the ability to drill down into reports. Laufer says, "If someone is interested in where a particular number came from, now they can drill down and get more detail."