Documented Savings

Health Management Technology, Oct, 2001

Replacing paper with the right document imaging solution can have a profound effect on the bottom line.

If it's true that good things come in small packages, then it is also true that better things come when small packages turn into big packages. That is the case at Lourdes Hospital, Paducah, KY, where a single-hospital solution has proven so successful that the plan is to extend that solution to 28 hospitals in an integrated delivery network--all different, all with individual IT systems and all capable of using the same document management solution. Projected total savings for the network will exceed $10 million--and that's a Big Package.

PROBLEM

Lourdes Hospital is a licensed 389-bed hospital with a five-star ranking in heart surgery, 1,400 employees, 10,257 annual inpatient visits, 5,400 outpatient encounters and 3,600 annual surgeries. Until recently, it also was a hospital with thousands of forms--more than 1,500 different paper forms, either printed in-house or purchased independently, and stocked in quantity--that made administration and clinical document management miserable for our employees.

Our problem was simple. As a precursor to electronic medical records, we wanted to eliminate pre-printed and stocked paper forms and move to an electronic document imaging system for the enterprise. As anyone who works in a hospital knows, every department uses forms--admissions, accounting, materials management, to say nothing of documentation forms for treatment. We also wanted to eliminate the infamous address-o-graph machine apparatus that clinicians know--and loathe--only too well.

We wanted to add bar code capability to our system for use on patients' medical records, account records and physicians' forms, and to be able to scan forms into our system that could then become automatically archived and available for use in our planned electronic medical record implementation. We wanted to free up our 400-square foot forms storage room. Most of all, we wanted to streamline and simplify record-keeping and documentation functions for the hospital staff.

SOLUTION

We chose Optio Software from our short list of two or three vendors. One of the main reasons was because Optio would allow Lourdes Hospital to maintain full control over the system. The abilities to print on demand, to customize individual forms and to develop new forms were significant to us. We wanted a system where we didn't need input from the vendor each time a form was amended, but rather a vendor who would install the system, train our staff to utilize it fully and let us manage it.

We also wanted a solution we could implement enterprise-wide that would allow us to develop forms in Microsoft Word and one with modest staff requirements to support it.

IMPLEMENTATION AND TRAINING

Implementation of a forms management system is relatively easy and, frankly, training staff to utilize it and support it isn't a major hurdle either. Internal logic and pre-installation assessment, however, are critical steps in a successful roll-out.

Before Optio was in stalled, Lourdes created an internal needs assessment committee to review and rank forms, and to eliminate unnecessary forms. With assistance from Optio we determined which forms to start with (registration forms and specific patient records forms), and demonstrated how to create form templates and customize existing forms to our staff.

RESULTS

Today the entire Lourdes enterprise uses this solution. We have eliminated paper and supply costs that saved us in excess of $120,000, and we warehouse virtually no preprinted forms. (We have turned the forms storage room over to housekeeping for linen supplies.) Forms are electronically stored and delivered over our network on a d server to anywhere in the enterprise and printed on demand in front and back as multipart forms or even in NCR style.

The number of forms we used was initially reduced by 200 or 300, to about 1,200 forms. That number has crept back up to around 1,500--in part because our staff can now easily create forms without having to establish a preprinted quantity or develop a storage plan for unused copies. The number has also increased because our physicians are now using the Optio system to develop their own forms based on individual preferences and/or on a condition-specific basis. This has created a more accurate tracking system for our hospital as conditions, treatments and lab needs are now easier to follow, input into the system and ultimately bill.

Tracking and accuracy within the system have also improved with the use of a bar code system on the forms. The code includes a number that identifies the type of form, a patient identification number and an account number. Now we can easily input the information on the forms into our new electronic medical records system.

Lourdes supports the Optio system with 1.5 FTEs and maintains control of its utilization. Staff who need to generate and customize forms have been trained to do so. On the "soft savings" side, our nursing staff have enthusiastically supported the demise of the address-o-graph machine, and all clinical and support staff are more efficient now because they are not perpetually hand-carrying forms from point A to point B. If authorized they can simply logon, access, customize if necessary and print forms on demand and on location.