Rx For Healthcare Facility: Online Document Management

Anyone who has ever requested medical records either for personal review or to take to a specialist has probably experienced a great deal of frustration with the whole process. Above and beyond the various chains of command that the records must go through before getting to their rightful owner, there is the archaic method of filing many healthcare facilities use - the ole manila folder and filing cabinet system. The system wouldn't be bad if one person could visit one doctor for every ailment but that's not how things work, especially nowadays. There are specialists for everything. From dermatologists to podiatrists to ear, nose, and throat specialists, it's unlikely that the average person has less than half a dozen different doctors. Moreover, none of them are located in the same building, but all need the same patient medical history.

Paper-Based Record Keeping Wasteful And Disorganized
Northwood Health Systems (NHS) (Wheeling, WV) faced this same problem. NHS is a behavioral health organization that offers counseling, case management, and crisis intervention for children and adults with chronic behavioral health problems or mental handicaps. NHS has 20 sites in the West Virginia area - six of which are primary clinical sites and 14 of which are smaller medical offices. Because of the nature of its business, NHS has detailed records of each of its patients, which grow to be several feet thick over the years. Additionally, it is not uncommon for a patient to see a therapist at one facility and meet with a caseworker at a different site. Initially, NHS had to hand deliver the patient's records to the site where the patient's next appointment was to be held. "Some of our sites are 40 miles apart," says Ed Nolan, MIS director at NHS. "When you multiply this scenario by dozens of patients, you can see how much time it takes to coordinate this process. Additionally, if the patient's previous clinician had not returned the patient's record to the filing cabinet, there would be even more time spent trying to find the record." On numerous occasions administrators from one facility would not give adequate notice to another facility that it needed a patient's records and they would not arrive in time for the patient's office visit. "Things would get stressful at that point," recalls Nolan. "The doctor or caseworker from the other facility would call over and say, 'I need that chart. We can't see this person until we have his records.'" The patient would end up waiting much longer than expected, the doctor's/caseworker's appointments were all pushed back to compensate for the delay, and most likely the doctor/case worker would feel rushed to try and get back on schedule. At one point, NHS was at risk for losing state funding because of lost or misfiled documents. Initially, NHS tried to alleviate the problem by making hard copies of patients' key information in their records and storing that information at a central location, to cut down on transportation time and problems with patient records that were signed out for long periods. "Before long we had over a million duplicate documents to keep track of," says Nolan. "Extra rooms had to be set aside to store all the documents, and our record keeping staff was constantly growing."

Documents Online And On Time
It became painfully obvious to NHS that it needed to find a better way to manage its documents. After researching several options, NHS chose an online document and content management solution from IDP (Sudbury, MA). NHS began working with IDP in January 2000 and within a couple months had installed the software and rolled it out to each of its clinical sites and medical offices after a four-week test at a pilot site. "Now clinicians use their PCs to access patient records," says Nolan. "The patients' records are password-protected for better security. The system allows clinicians to search records by patient name, time period of treatment, and even by services performed." The way the process works now is that when a patient visits one of the clinicians, the clinician fills out a form online via the organization's intranet and the form is instantly added to the patient's records. "Because the state of West Virginia currently does not accept electronic signatures, we still have to print out forms, have the clinicians sign the forms, and then scan the forms into our database," says Nolan. "Down the road when the state changes its ruling on this matter, this step will be eliminated."

Since NHS installed the MEDItrieve software solution, it has been able to reduce its record keeping staff from 12 to two. Additionally, the organization is in better standing with the medical records auditing board and is now ready to go to the next level of care, which is managed care. "Within a year of installing the document and content management software, we have realized our return on investment," says Nolan. Besides saving money and increasing its status as a behavioral healthcare provider, NHS' clinicians are happy they don't have to hunt down patient records that are miles away or try to manually dig for patient information embedded in a one foot stack of paper. And while the medical field has yet to find a cure for the common cold, there is great hope that the cure for duplicating data is a step in the right direction.