New York hospital discovers joy of optical imaging - Southside Hospital

Healthcare Financial Management, Jan, 1993 by Bill Siwicki

Paper--a word that can strike terror into the hearts of healthcare financial managers everywhere.

At Southside Hospital in Hollis Hills, New York, Director of Patient Financial Services Paul Cheng, Jr., CMPA, president-elect of HFMA's Metropolitan New York Chapter, discovered a method for taming the paper beast: optical imaging.

State-of-the-art optical imaging technology is similar to the technology used to create compact discs (CDs) of music albums. Hard copy (paper documentation) is fed into a scanner and transformed, through an optical reader/writer, into bits of electronic memory that are stored on a disc. The original hard copy can then be discarded, though the information can be reprinted from the disc at any time.

The element that differentiates optical imaging technology from CD technology is the end result--instead of preserving recorded sound, optical imaging preserves words and illustrations. The net benefit of employing optical imaging to store business records and documentation is freed storage space and a lot less paper.

The idea of using an optical imaging system at Southside Hospital actually came about by accident as Cheng was trying to find a better way of storing his department's records.

"I literally ran out of room for my records," states Cheng, "so I started considering options for storage. I began by looking at microfiche, and decided to consider purchasing the materials needed to convert our files into microfiche. At the time, there was a computer show in Manhattan, so I went to the show figuring I would just see microfilm and microfiche storage systems.

"It happened that there were two or three booths at the show featuring optical imaging. After I read all the 'propaganda' the companies gave me at the booths, I realized that this was the way to go and that optical imaging is technology that will blow microfilm and microfiche out of the water. I quickly started doing research on the technology and the available products; I then presented my findings, and the administration bought off on it. We haven't regretted it."

The optical imaging start-up package that Southside Hospital purchased for the patient financial services department cost around $60,000. The package included a personal computer unit and keyboard, a high-density monitor, a laser printer, a dual scanner (with flat-top and automatic feed), and an optical reader/writer.

The hospital made the decision to start out small and let the patient financial services department serve as a testing ground for the new technology.

"Federal requirements require us to keep all of our records for six years," says Cheng. "I add one year to that requirement, just in case. We turned the system on in the patient financial services department in August 1991 and decided to go back and store all of our 1991 records on the system. All records created prior to January 1, 1991, will remain on paper and will be thrown out after seven years while all records created since that date will be stored on the optical imaging system on a daily basis.

"In making the switch to optical imaging, we have already freed thousands of square feet of storage space at the hospital. We have saved a lot of money, too. For example, we now only have one file clerk instead of two. But a lot of the savings have come from eliminating unproductive work time, especially the time it takes to retrieve documents for audits.

"Blue Cross, Medicare, Medicaid, and external auditors come in with huge lists of closed accounts for which they need documentation. Prior to optical imaging, three or four people--billers or collectors had to find the accounts. Now, if the accounts in question are from 1991 or 1992, we just enter the optical imaging system, request the account, and the system prints it out.

"A perfect example of this new process was provided recently when a list of 300 accounts was requested by a peer review organization for auditing. Normally, finding the accounts would have taken four people several days. But it took us only four hours to work through the list, from the time we requested the accounts from optical imaging disc storage until we had them printed out and stapled together."

Once the new technology had proven itself efficient and valuable, Southside Hospital staff decided to expand its use. Nevertheless, Cheng asserts that it

is imperative to start out small with optical imaging technology.

"We in patient financial services were the guinea pigs," Cheng explains. "The hospital decided to start small, which, I believe, was the best thing to do. Other hospitals have explored optical imaging and decided they would turn the whole hospital on at the same time. Often this did not work--many hospitals bit off more than they could chew.

"With a technology like this, you must start off small, go through your growing pains, fix what goes wrong, and then expand. Hospitals cannot do all of these things at the same time because they do not initially have the resources, personnel, knowledge of the technology, or capital to do what is necessary. So Southside started small and it paid off.