Patient safety, quality and efficiency can all improve with better document
In a world where healthcare providers must respond rapidly to change, Californiaâ€™s
Prime Healthcare Services moves quicker than most. Ten hospital acquisitions
in the last few years will have that effect, as will the host of other
regulatory, economic and technology demands currently converging on the
organization and others like it.
Prime Healthcare has found that, despite its size â€“
14 hospitals comprising 2,400 beds and 9,000 employees â€“
and recent acquisitions, a strong healthcare IT base has kept it moving
ahead and effectively overcoming industry hurdles. Of these 14 hospitals,
12 hospitals are under Prime Healthcare Services and two hospitals are
under Prime Healthcare Services Foundation.
Document management is one area that Prime Healthcare has successfully
navigated on a system-wide scale. With hundreds of paper forms in use,
leadership identified numerous potential pitfalls associated with a manual
process. In fact, the organization’s rapid expansion has served
to highlight the need for a cohesive solution for document management
delivered throughout the entire network.
Finding the right partner
While the organization was beginning to reap the benefits of automation
via its integrated clinical and financial technologies, including electronic
health records (EHRs) and a health information system (HIS), Prime Healthcare
facilities were still heavily dependent on paper. The health system was
relying upon hard copies of admissions, clinical and operations forms
that needed to be converted to electronic format. Knowing that manually
completed forms and stacks of preprinted papers could lead to problems
in both patient safety and finances, IT leadership searched for a full-featured
document management system.
Prime Healthcare had specific demands of its solution. For one, it needed
a technology that could scale to its large, multi-hospital system to ensure
it had a consistent technology at all facilities, which would streamline
deployment and allow the seamless flow of data between hospitals. The
organization also needed a system that would enable it to quickly update
forms. Even when minor changes were required, such as an update to a HIPAA
authorization form that a patient receives upon check-in, staff needed
to discard all the old, preprinted documents and generate a new batch
of forms, adding expense and wasting employees’ time. Prime needed
to eliminate this misuse of resources and ensure accurate information
across its facilities.
After searching for a document management solution, Prime Healthcare came
across FormFast’s logic-based, on-demand workflow and print management
system for automating medical records, revenue cycle and patient registration
documentation processes. This solution could be seamlessly integrated
with other healthcare IT applications, such as the HIS and EHR systems
already in use at Prime Healthcare’s hospitals.
Implementing the program
Prime Healthcare needed implementation to progress relatively quickly and
a strict timeline was developed. Rules-based functionality enabled the
IT staff to easily assign different rules to the various system users,
such as patient access personnel or emergency department (ED) nurses.
This made system management much easier for the implementation team at
Prime Healthcare, given the number of employees using the application
at any given time.
Following a rapid implementation process, IT leadership began training
clinicians and other staff. Executives were pleasantly surprised that
the organization’s 400-plus users could be fully trained on the
system in about 10 minutes per session. Demonstrating the new system to
several groups of individuals at once meant Prime Healthcare was able
to complete all training within just a few days.
Prime Healthcare also took advantage of the transition to create updated
new forms, optimizing an easy-to-use design feature developed by FormFast
specifically for medical facilities. It wasn’t long before Prime
Healthcare had eliminated pre-printed forms for many purposes throughout
the multi-hospital system.
The process in practice
When a patient is admitted, staff is able to quickly select and print out
the appropriate forms for each individual’s situation. If necessary,
forms are completed manually by the patient and signatures are obtained.
These documents are then digitized using a high-speed scanner. Once documents
are scanned, the data is electronically routed to the correct place in
the medical record, guided by barcodes that identify the patient and type
of documentation. This prevents time lost in entering data and eliminates
errors that can be introduced in data entry – a definite patient
Meanwhile, if nurses or physicians require a specific document, they do
not have to search for preprinted forms stored away in a filing cabinet.
The system intelligently tracks what forms are necessary for the encounter
by parameters designed by the facility. Users then log on and print the
specific form according to the exact patient requirements. Hospitals also
can set chart forms to be generated automatically in batches, freeing
unit clerks or nurses to focus on other tasks.
And since Prime Healthcare’s workflow processes and document management
activities are now tightly integrated with its EHR and HIS systems, users
can print forms or reports directly from these tools. If a clinician requires
a hardcopy of a certain document, such as a radiology report, it can be
sent directly to the nursing station and distributed as necessary. Hospital
staff in any department can also enter patient data, route the forms to
multiple departments and print the completed items when necessary –
without the delay and expense of routing hard copies.
All 14 facilities managed by Prime Healthcare are now taking advantage
of this automated workflow model, which can be easily scaled to accommodate
additional users and systems.
The ultimate reward: efficiency and patient safety
Prime Healthcare began realizing clinical and financial benefits soon after
organization-wide deployment of the document management system. For example,
when a clinical chart is scanned, data can be directed to both the EHR
and the hospital’s billing department. This means that when the
patient is discharged, financial services personnel can print out the
most up-to-date version of the patient’s bill. Similarly, more accurate
and timely claims can be generated, meaning the organization is able to
receive reimbursements more quickly, improving cash flow. Further, users
have reported that since they aren’t chasing down paper documents,
they are significantly more efficient and productive. And with less manual
data entry, clinicians have reported a noticeable uptick in the quality
of clinical information.
While cost savings and efficiency are, of course, some favorable outcomes
of Prime Healthcare’s investment in technology, they are not the
most important benefits. The organization’s standard for patient
safety and quality are paramount. The health system’s IT efforts
have decreased manual errors, helped to ensure accurate information and
freed staff to spend more time with patients.
Eventually, all paper forms may disappear from the hospital environment.
But, for the time being, every medical facility must deal partially in
paper documentation. Prime Healthcare has achieved many important efficiency,
quality and patient-safety objectives with the implementation of a comprehensive
IT strategy that includes document management. It is now clear that Prime
Healthcare’s ability to manage paper in the most effective means
possible has played a vital role in the organization’s success.