Enterprise Content Management on the Cloud: Yuma District Hospital Case Study

When many people think of health information technology, they think of electronic health records, health information exchanges, mobile health and cloud computing. While all of these things are HIT, many healthcare professionals may forget about content and information management systems. Using information systems to automate and digitize insurance records, billing and other areas of a hospital's operations is an important aspect of HIT as well. The U.S. is spending nearly 18 percent of its gross domestic product on healthcare expenses, and administrative costs are a major contributor. While HIT can help improve quality and lower costs for clinical services, it can also help hospital administrations achieve better results. Information systems, especially those on the cloud, can be a great resource for hospitals looking to improve efficiencies in areas outside of the operating room.

Yuma (Colo.) District Hospital: The situation
Yuma District Hospital is a 12-bed critical access hospital serving a population of approximately 7,000 people. The hospital includes acute inpatient health services, the Yuma Clinic and the Center for Specialty Medicine, a practice location for a wide range of medical and surgical specialists. Yuma sees 3,000 patients annually, and its medical records department receives around 225 information requests every month.

In 2001, Yuma had 1,200 large file boxes with 30 years of records stored in offices, hallways, basement crawl spaces and in storerooms. According to Gina Eastin, director of revenue cycle services, "documents were everywhere."

Yuma District Hospital needed an effective, flexible system that eliminated storage space and saved time. Due to the overwhelming amount of information stored in filing cabinets, finding records and fulfilling patient requests for information was a time consuming process for hospital staff. Nine department employees — two of which were dedicated document specialists — spent the majority of their time looking for information. Some documents took as long as two hours to retrieve because Yuma's records system slowed patient record retrieval and stymied billing processes. In addition, maintaining the paper system was costing $3,600 annually in office supplies.

"The physical space that we were losing was a huge issue. We were planning on building a new facility, but we wanted to keep our costs down. We didn't want to have to build storage for paper records. In addition, we knew we needed to speed up our record process and become more automated — not only for costs but to improve our patient service. Saying 'I have to call you back' or 'hold on, let me pull that information,' did not allow us to accommodate patient needs quickly and efficiently," says Ms. Eastin.

In 2001, Yuma District Hospital transitioned the record and insurance payment system in their business office to a cloud-based information system. They worked with Rocky Mountain Microfilm & Imaging, a software reseller, to implement Digitech Systems' ImageSilo and PaperVision Enterprise. These systems help hospitals manage their administrative, medical and clinical records — whether paper or electronic. PaperVision Enterprise is an on-premise system while ImageSilo is cloud-based.

"Data is stored with a unique patient identification number [in ImageSilo]. With the proper clearance and login information, a physician or hospital staff member can access the data anywhere in the world," says Sean Morris, director of sales at Digitech.

Due to the immediacy of Yuma District's file overload problem, the hospital initiated the cloud-based information system software for the medical business office first. According to Ms. Eastin, almost immediately after the business office transitioned to a cloud-based content management system, other departments wanted the system as well. "The other departments saw what we were doing and how it was immediately improving our processes. They wanted the same software for their department," says Ms. Eastin.

"The system is simple. We could set search criteria based on how we search [for documents or records in our department.] Since the software allows you to base [the system setup] on your workflow, it makes logical sense to the staff," says Ms. Eastin. "As far as implementing, it was a huge relief compared to how we had been operating. Since the system was easy to use, the fear factor wasn't there," Ms. Eastin says.

What about security?
Many times security is a big concern when it comes to HIT, especially with technology that is cloud-based. However, Yuma District Hospital has had a great experience with the security of its health information on cloud servers. "Many people still talk about gray areas in cloud security. We have had this software for close to 10 years, and I don't have any concerns about the security of our data. We can control who sees what and what they can do with the information when they have access. We can even control who has the rights to print the data or put notes on it for future use," says Ms. Eastin.

According to Mr. Morris, Digitech Systems software uses a variety of security levels for health information, including document level security. "Document level security is helpful for when a physician treats a patient at the hospital and then needs to see them for a repeat visit at their independent practice. They could use the information system to pull up the patient record even if 30 miles way. The document level security would require a username and password supplied by the hospital, rights to the patient file in the cloud and clearance for the patient record," says Mr. Morris. In addition, the data can be protected at rest — on a server or in a storage unit — and in transmission using encryption.

Key outcomes/benefits
Yuma District Hospital has experienced a great deal of benefits due to transferring their record system to a cloud-based information system. The hospital has eliminated paper storage, improved records retrieval times and accelerated cash flow.

"I would say we have seen great benefits in space and storage, data retrieval time and patient service. Patents have a greater level of confidence and trust in the hospital because our ability to answer questions and show them information on the screen gives them a sense of security," says Ms. Eastin.

According to a case study, Yuma has experienced the following quantitative outcomes:

• Eliminated more than 1,200 large file boxes needed for paper records storage.
• Cleared 3,100 square feet of storage space.
• Reduced file searching by 1,100 hours every year since 2001.
• Saved $300 every month on office supplies.
• Reduced records retrieval times from one hour to less than 5 minutes.
• Accelerated secondary payment processing by three to four claims per day and improved cash flows.

Although cloud technology may leave some healthcare professionals uneasy due to the vulnerability it could introduce to important and protected health information, it is becoming an increasingly important element of health information technology. In fact, many professionals suggest moving billing and insurance records to the cloud first because of its lower sensitivity and complexity. Yuma District Hospital demonstrates the value a hospital could receive from a cloud-based information system.

More Articles on Health IT:

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5% More Missouri Hospitals Adopted EHRs Since Last Year

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