1 5 PLACES IN YOUR HOSPITAL WHERE ENTERPRISE CONTENT MANAGEMENT CAN HELP
2 WHAT IS ECM AND WHY MIGHT YOU NEED IT? Although technology continues to improve how healthcare organizations share information both within and outside their own walls, providing the right information at the right time to the right people is still often difficult. In any given department, there are documents and data not managed by a core application, making the information in those applications difficult to securely access, process and share. This unmanaged information is known as unstructured content. It s the paper, faxes, forms, photos, clinical images and other content that comes from multiple sources (devices, patients, referring physicians, etc.) that your EMR, HIS, billing system or ERP don t handle well. To manage this information, healthcare organizations are increasingly turning to enterprise content management (ECM). ECM provides the means to capture unstructured content, store it, and make it available as needed to the right people within the processes and systems they already use, like your EMR or ERP. As a result, processes run more smoothly and crucial information is readily accessible within core information systems. With so much content to manage, where do you start? This ebook will give you five key processes where ECM can have the greatest impact in the shortest amount of time. It also provides the most important questions to ask yourself as you determine ECM s potential in your organization. These five processes fall into three categories and include: Clinical and Health Information Management 1. Care Delivery 2. Chart Analysis and Deficiency Completion Revenue Cycle 3. EOB Processing and Payment Posting 4. Patient Admissions and Registration Administrative Departments 5. Invoice Processing
3 1. CLINICAL: CARE DELIVERY To treat patients effectively, physicians, nurses and other staff need access to relevant information. If that information isn t accessible from their everyday systems and processes, they waste time trying to find it or worse, they don t know it exists and treat patients without it. ECM integrates with your EMR to provide a single place to go for patient information. Take a look below for some guiding questions that can help you decide whether or not an ECM solution can help support care delivery in your organization and to what extent: How much information currently resides outside your EMR and in what format? For many organizations, up to 75 percent of patient information exists outside the EMR. The more content outside of the EMR, the greater the need for ECM. And it s not always paper. Faxes, patient forms, EKGs, radiology interpretations and photos are just a few examples. If content is not readily accessible, integrating ECM allows users to access it within the EMR so caregivers have a more complete patient record. How much time do your clinicians spend locating and retrieving patient information? The more time your physicians, nurses and staff spend searching for information, the less time they spend collaborating with fellow clinicians, attending to administrative functions, and most important, caring for patients. However, clinicians at organizations relying on paper-based patient content often find it difficult to locate the physical chart or they re waiting for someone else to finish with it. Even if the information is electronic, they waste time as they navigate multiple systems. If these issues remain a point of concern for your organization, ECM may offer a solution. A strong ECM solution takes content that was disconnected from patient records and unites it within the EMR, minimizing the time caregivers spend hunting for information. Where do you stand in terms of clinician and physician adoption of your EMR? No IT investment trumps the EMR in terms of cost to purchase, deploy and support as well as its potential to support patient care. If physicians and staff fail to use it, however, it is impossible for the EMR to deliver full value. ECM can often help make the transition easier. With all relevant information available within the EMR, clinicians will be more likely to see its value, especially if it means information is easier to find and processes are faster.
4 2. Clinical/HIM: Chart Analysis and Deficiency Completion The health information management (HIM) department, sometimes called medical records, represents the information nerve center of the hospital. HIM staff ensure a complete patient record and enable timely billing for services delivered. In a paper world, tasks like chart analysis and deficiency completion quickly become time-consuming, requiring coordination of many departments, people and processes. ECM provides a central, electronic location to store patient records and ease chart analysis and deficiency completion. When evaluating ECM s potential impact on this process, here are a few questions that can help guide you: How much patient information resides outside the EMR? In what formats? When it comes to analyzing and completing the patient chart, HIM analysts need to see all information related to that encounter. The longer it takes to locate it, the longer it takes to identify deficiencies, address them, complete the chart, and ultimately, bill for that encounter. If a large amount of information resides outside the EMR, DNFB rates can suffer. By placing that content within the EMR (and other key applications), an ECM solution gives analysts one place to go for information, reducing those delays and, in turn, DNFB rates. After patient discharge, how long does it typically take to analyze a chart, complete the deficiencies and close the chart? This is a deeper question, but at its root is the assessment of your processes efficiency and how happy you are with it. If you aren t content with how long it takes to analyze and close patient charts, ECM technology can help. It automatically directs charts requiring analysis to appropriate staff based on rules you define (by expertise, encounter type, workload, productivity, time out of the office, etc.). It also automates worklists and chart assignments, directs information to the right people at the right time, and provides clear visibility into the process itself. By adding automation with ECM, charts close quickly and more accurately. How quickly do physicians address deficiencies? How satisfied are they with the process? Because physicians are focusing on patient care, things like deficiencies often have to take a back seat, but that doesn t mean they aren t important and don t require attention. And the harder it is to complete charts (appearing in person, logging in to multiple systems, etc.), the longer the process takes. An integrated, well-designed ECM solution enables physicians to receive alerts within the EMR s messaging system, access relevant content and sign deficiencies electronically. Charts are completed faster and easier for both HIM and the physician.
5 3. Revenue Cycle: EOB Processing and Payment Posting Although electronic transactions are fast becoming the norm, EOB paper documentation remains a cumbersome issue for many organizations. Hundreds of pages long, EOBs make it difficult and time consuming to locate a specific patient and match it with the appropriate encounter. And paper or electronic, you need to accurately associate EOB information with the right record. Doing so manually takes time and increases the risk for error. ECM captures both paper and electronic EOBs, divides them by patient and encounter and matches them to the right patient record automatically. Below you ll find a few questions that will help you evaluate if ECM can help you improve revenue cycle processes, empowering staff to work more efficiently and effectively: How many paper EOBs does your organization receive and how often? Electronic ones? The more financial information that enters your revenue cycle, the greater the potential for improvement. Eliminate some of the more labor-intensive elements of your process, and you ll be able to redeploy staff and resources to more productive ends. ECM technology helps you accomplish just that, extracting essential information, storing it, and linking it with the appropriate record. And, you eliminate the costs and risks associated with storing paper documentation, not to mention the time required to retrieve it. Does your organization post payments manually? Payment posting, whether the data originates on paper or electronically, is labor intensive. In either instance, ECM eliminates the need to handle this process manually, automatically extracting data and associating it with the correct financial record, saving time and resources while significantly reducing the potential for error. How many different billing systems does your organization use? For larger organizations, especially those that have grown through mergers and acquisitions, working with a variety of billing systems is not unusual. Passing information between them can be a challenge. ECM solutions integrate with multiple applications, tying them together and uniting them with content and data. How do you assess the health of your revenue cycle? Admittedly, this is a big question the revenue cycle is inherently complex. However, a strong ECM solution provides you with a comprehensive set of analytical and data mining tools that will help you assess individual processes and the overall state of your revenue cycle. With a high level of visibility, you ll be able to identify opportunities for improvement and make the necessary adjustments.
6 4. Revenue Cycle: Patient Admissions and Registration When patients present for admission and/or registration, they often bring a good deal of information with them patient documentation, orders from primary care physicians, diagnostic data, medication reconciliation forms and more. Most relevant to the revenue cycle, however, is insurance documentation, which has to be accurately captured for timely billing. And while accuracy is important, so too is speed. Long wait times in the admissions line negatively affect patient satisfaction. For ECM technology, the patient admissions and registration is an ideal use case. ECM easily captures, stores and distributes the clinical and financial information that arrives with the patient, speeding billing and shortening lines. Here are some ways you can assess ECM s potential impact on your admissions and registration processes: How much documentation typically arrives with the patient at admission? The more information the patient brings, the more time required to gather, process and distribute it to staff. When this outside information has to be entered manually, there is also a greater risk for error. An ECM solution automates the accurate capture of that information and integrates into your HIS, EMR or billing system. With accurate information readily accessible, processes run more smoothly and more quickly. How many processes rely on the accurate capture and distribution of information gathered at registration? Here we have a question of scope and magnitude. ECM can contribute in a way that transcends the registration process itself. For example, scanning an insurance card can automatically trigger an insurance validation process. On the clinical side, you could automatically direct documentation to the physician for review. How much time do patients spend waiting in line at admissions? If you find that patients encounter wait times longer than they (or you) would like, examine your processes closely and see if you can determine where the problem lies. It might be related to patient forms, or it might be that patients have to answer and address a number of issues that don t directly relate to registration. Or, maybe patients have to re-submit information gathered during a previous encounter, which can be frustrating. In each instance, ECM can help. Patients can sign electronic forms quickly, eliminating the need to print and file or scan them later. They can use a self-service kiosk powered by ECM that allows patients to fill out forms, access information and even make payments without waiting in line or taking up staff time. And finally, information gathered during a previous encounter is readily accessible, so staff don t have to collect it again.
7 5. Administrative: Invoice Processing Just like the clinical side, departments such as human resources (HR), legal, and accounting and finance have paper and content that exist outside of the primary IT applications (ERP, accounting system, HR system, etc.). These departments can operate more efficiently when they use ECM to integrate content into their everyday applications and automate processes. A prime example of how ECM can help is invoice processing. Many healthcare organizations find that processing a given invoice takes longer than expected. More importantly, they don t have the visibility into accounts payable (AP) processes they need to make more informed financial decisions. ECM helps ensure that your process runs more smoothly, quickly and transparently. In examining your process, here are some things to consider: How many invoices does your organization process in a month? How many of those do not exist in an electronic form? The more invoices your organization processes in a month, the greater the impact a process improvement will yield. If you deal with a good number of paper or faxed invoices, there s a good chance there s room to make the process more efficient. Information outside your ERP, including invoices, takes time to locate and retrieve. ECM stores those invoices in a central, electronic location and integrates them into your ERP, eliminating the need to store and retrieve them manually. A simple click of the mouse, and the invoice is right there. How many people are typically involved in your invoice approval process, and where are they located? For AP processes involving many different people, often at multiple locations, invoice approval can take days or even weeks. ECM offers electronic workflow to automatically send invoices to the appropriate person based on organizational rule sets so they move through the process quickly. Additionally, those outside the accounting office can easily approve invoices through a PC or mobile device, regardless of geographic location. How does your organization manage information involving a specific invoice or transaction? On its own, an invoice doesn t tell much of a story. Maybe an AP clerk called for clarification. Maybe the vendor changed names. Maybe the information on it was wrong. Attaching that sort of information to the invoice helps ensure that whoever accesses it understands the complete story. With an ECM solution, users can access more than a given invoice they can see all relevant information surrounding it. How much visibility do you have into your AP processes? It s imperative that management have transparency into invoice processes so they can make informed financial decisions and never get caught off-guard by an invoice or missed payment. ECM provides dashboard views of invoice processes so they know the overall financial health of the process and quickly find where any given invoice is in the process at any time.
8 Conclusion As your organization grows and evolves, a powerful ECM strategy will be a crucial component. These five areas are just a jumping off point. ECM is a foundational technology that supports today s current strategic initiatives, such as Meaningful Use, accountable care organizations (ACOs), health information exchanges (HIEs) and more. Just as importantly, ECM is a solution that will meet your needs in the future. In two, five, even 10 years down the road, you ll still need to manage the content related to your strategic initiatives, whatever they may be. ECM gives you the flexibility to meet them. By looking at ECM as a strategic, mission-critical solution from the very beginning, you ll create a solution that will advance your organization today and tomorrow. We hope you found this report and the information within it useful. For more information, visit. Hyland Software, Inc. All rights reserved.