The management of documents and data were among the key subjects discussed during an Executive Roundtable hosted by Canon USA, held at Becker’s Hospital Review’s 10th Annual Meeting in Chicago.
Hospital leaders are seeing an explosion in the amount of data they must capture and manage. They are also seeing continued growth in the amount of office equipment throughout their organizations. This growth in equipment is occurring even as some hospitals and health systems increasingly outsource aspects of document-intensive back-office processes, including portions of revenue cycle management, coding, access registration and certain accounting functions.
Think “input and output”
Canon account executive Randal Kendrix advised hospital leaders to think about the input and output of documents, noting that “the input of documentation is critical in how you get paid.”
Today, many hospitals input paper documents into electronic systems, particularly their EHRs, via scanning. Specifically, roundtable participants mentioned scanning documents into Epic and Cerner systems.
In some hospitals, the task of scanning is handed off to a centralized hospital information management (HIM) department. In others, it is distributed, with scanning taking place at various nursing stations. One roundtable participant mentioned having both centralized and distributed scanning at her hospital.
Once information is captured and input into electronic systems, it is stored, shared and accessed when needed, and can be output onto paper when necessary for patients or clinicians. Mr. Kendrix observed that when an organization has a good input process, the information is better organized and requires less physical output. He noted, “Input and output, when we put those together and the strategy is properly aligned, we’re seeing a dramatic drop [in hard copies].”
In today’s litigious environment, inputting documents into a centralized system dramatically reduces an organization’s legal exposure and risk. Mr. Kendrix described aggressive litigants who bring cases against hospitals based on the premise that the hospital won’t be able to easily find the appropriate documentation to refute a claim. These litigants know that, in many instances, hospitals simply find it easier and less expensive to settle a claim than dig for the documents to fight it. The paper documents needed for legal discovery may be located in off-site storage warehouses and may not be well organized. This makes it even more expensive and difficult to find the appropriate documents if they are not digitized.
By inputting all documents into an electronic data storage repository, hospitals may be able to save millions of dollars by easily producing the necessary documents to dispense with baseless claims. Mr. Kendrix shared an example of a hospital CEO who didn’t blink at spending one million dollars on a system to manage documents because he believed it could save his organization $25 million in legal claims and related costs.
While the benefits of systems and processes for inputting and outputting documents are clear, two challenges were highlighted.
One relates to ongoing issues associated with a lack of interoperability between EHR systems. As health systems consolidate, it is increasingly common for hospitals and clinicians within the same health system to use two (or more) types of EHR systems. As a result, a clinician using one system may not be able to access documents scanned and stored in another system.
The second issue is that the vast majority of senior hospital leaders have no idea about their organization’s printing volumes or costs. They don’t know what they are spending per month, per year or per employee.
A C-level conversation
Given the importance of document-related processes and systems, as well as the potential risks when documents are not easily available, Mr. Kendrix sees the need for conversations about this topic to take place at a hospital’s C-level. This dialogue — which focuses on improving efficiency, lowering costs and decreasing risks — typically involves IT and purchasing, and it can also include vendors. In addition, the perspective of those who actually use these systems daily should be considered.
In discussions about transforming healthcare, more effectively managing the input and output of documents is rarely mentioned. But the efficient management of documents is a critical prerequisite that makes other parts of this massive transformation possible.
