Three steps to achieving document efficiency in healthcare

Hospitals are under pressure to increase efficiency and reduce costs as the industry moves to value-based care models, yet few organizations recognize the potential of evaluating their print environments in support of these goals.

In fact, in the era of Electronic Health Record (EHR) systems, many would be surprised to learn that printing in hospitals is actually on the rise — and as volume goes up, so do the costs.

Why print persists in healthcare

EHR systems represent a significant investment that provides a great service related to accessing, routing, storing and securing patient health information. Ideally this system by itself would dramatically reduce the need to print a physical record, but in reality the EHR and related systems collectively, and significantly, contribute to the fact that the volume of healthcare printing is growing faster than any other major industry. Experts suggest that a staggering 60 percent of print volume originates from hospital EHR systems.

While the advent of Meaningful Use and other regulatory requirements are partially to blame, as they contribute to an increase of roughly 11 percent in annual print volumes, the surge in hospital printing can also be attributed to interoperability challenges. There are numerous systems that connect to a hospital's EHR, but the processes of sharing information across those systems often leave much to be desired.

Our research found that the average 1,500-bed hospital prints more than 8 million pages per month, with an average cost of $0.04 per printed page (costs include hardware, supplies and service), equating to $3.8 million dollars of spend per year. This provides a great opportunity to drive out costs by improving efficiency. However, even hospitals that pursue this opportunity seldom reap the rewards they anticipate. The primary reason for this is most organizations approach this space with an RFP concentrated on achieving the lowest cost per unit for devices, rather than on the full value associated with volume and device reduction.

A recent study by Photizo found that nearly 40 percent of the healthcare industry is looking to re-engineer document workflow in an effort to drive cost savings upwards of 30 percent. This article provides a proven three-step strategy that will help hospitals get on the road toward achieving desired outcomes.

Step 1: Know your opportunity

It is always important to clearly understand the opportunity an organization wants to pursue, and to at least estimate the anticipated impact before setting out on the journey. Assessing the print environment means inventorying and assigning costs to all of the varying components of the printing environment, including:

• Printers (acquisition and replacement costs and volumes)
• Copiers (lease or own costs and volumes)
• Fax machines (device costs and volumes)
• Label printers (device costs and volumes)
• Supplies (toner, parts and supplies)
• Services (break/fix)
• Secondary resources (help desk, network, server, etc.)
• Shredding services
• Document storage services

Looking at the print environment in this holistic manner provides a much more complete understanding of the organization's total cost of ownership, which is typically expressed as a comprehensive cost per page. This number serves as the baseline of expected savings and efficiencies.

Conducting this inventory and analysis also presents an ideal opportunity to conduct a security assessment of the print environment and its related infrastructure, workflows and processes. Print security is often discounted, but it is a highly vulnerable area for hackers to exploit. Print devices also frequently contain Protected Health Information (PHI), opening up the hospital to costly HIPAA violations.

Step 2: Define, align and implement

Once the assessment is completed (either internally or through a third-party provider), the next step is to develop a plan of action. Since print is one of the few business processes that touches everyone in the organization, and the responsibility or financial accountability for print is usually spread across many areas, a valuable best practice is to create a committee of leadership representatives from all of the most impacted areas in the organization, including I.T., security, supply chain, finance and operations. The goal of this committee is first and foremost to review the assessment and recommendations, define business objectives from the information gathered, and assign a leader to drive the initiative forward.

When developing a plan for optimizing the print environment and associated workflows, another best practice is to ensure that the plan aligns with well-defined and agreed upon business objectives, and that any vendors invited to participate have the right experience and services. Too often, managed print services (MPS) RFPs focus just on devices, features and cost per device, rather than on addressing how to reduce volume and costs, improve efficiencies, decrease the total number of devices, and secure the data and devices included in the print processes. The most successful print management plans align with organizational business objectives and include the following key areas of focus:

• Strategy to achieve volume reduction vs. device functionality
• Elimination of fragmented program management (I.T. owns printers and Supply Chain owns MFDs)
• Simplification of invoices
• Reduction of devices leveraging digitalized workflows
• Security of devices and data
• All-inclusive cost per page including device acquisition/lease, supplies, break/fix
• Complete coverage of all print-related devices
• On-site support with aggressive, healthcare-specific Service Level Agreements

Step 3: Capture, analyze and optimize

When print remediation plans are too narrowly focused on devices themselves, they aren't nearly as valuable as they could be, and hospitals miss out on key benefits, such as optimal cost savings, right-sizing of devices, increased customer satisfaction, and most importantly, visibility and transparency into the volume and costs associated with print-related workflows.

By concentrating on achieving significant volume reductions and improved workflows, the best programs provide hospitals with utilization data that is not simply black and white vs. color or printer vs. copier, but actionable data that can impact total output. This information, when coupled with a deep understanding of hospital application inventory and third-party software options, can be used to maintain data in a digital format, integrate it across systems, secure it against harm, and eliminate unnecessary print output and costs, all while improving operational efficiencies.

Specific examples of how organizations can save time and money through better understanding and more efficient use of print include:

• 10 percent of hospital print volume may be related to fax. Automated fax solutions can easily be introduced in most healthcare environments.
• 76 percent of the organizations using one of the most common EHR platforms continue to print consent forms when eSignature applications have been around for years.

The upshot of all this for hospitals is that evaluating print environments and optimizing document workflows represent some of the greatest opportunities available today to reduce costs, improve operational efficiency and maintain the highest level of security and compliance.

The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.

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