Winterthur Cantonal Hospital Digital medical records in rheumatology: efficient access to all patient data

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1 Winterthur Cantonal Hospital Digital medical records in rheumatology: efficient access to all patient data

2 Securely managing, quickly accessing and efficiently exchanging medical histories without any time and space barriers. On account of renovation work, Winterthur Cantonal Hospital (KSW) had to rapidly dismantle the physical archive of rheumatology at the previous location. To solve the space problem and support the electronic archiving processes, KSW tested the digitisation of the files in question. For the implementation of the project an external supplier was sought because neither the corresponding know-how nor the required infrastructure are available in-house. «The employees of Swiss Post Solutions have looked after us professionally and reliably. We received the offered service at an attractive price. This persuaded me.» Christoph Osterwalder Head of Business Management & Administration Department of Medicine Winterthur Cantonal Hospital With the tailor-made service package from Swiss Post Solutions (SPS), Winterthur Cantonal Hospital had the necessary staff and infrastructure resources available for this time-critical digitisation project. Thanks to the exemplary cooperation with KSW, the project went swimmingly. The physical archive was cleared in time and the around 15,000 medical records were available in the desired data format within six weeks. Since the SPS employees are subject to postal secrecy and the entire process was handled from a single source while maintaining strict security regulations, the high level of confidentiality required by KSW when dealing with sensitive data was able to be ensured at all times.

3 Strict schedule makes high demands Time played a key role in this digitisation project. Insourcing the scan process would not only have exceeded the short timeframe, it would also have meant high infrastructure costs for KSW and extensive knowledge outside its own core competences would have been required. To ensure the complete clearance of the physical archive by the deadline and to have the digitised records available on time in the electronic archive, Winterthur Cantonal Hospital therefore looked for an external service provider which fulfils the following criteria: Quick provision of the required resources Know-how and experience in the dismantlement and digital transformation of physical archives Tried and tested logistics concept State-of-the-art infrastructure Handling of sensitive records in compliance with data protection requirements For the evaluation of the ideal outsourcing partner, three other providers were asked in addition to Swiss Post Solutions. SPS fared the best when the submitted offers were examined and was awarded the contract. Decisive factors here were fulfilment of the requirements in terms of time, quality and quantity and, in particular, the trust of KSW in the guaranteed data security as well as the convincing references and record of achievement of SPS. Competence creates trust The «proof of concept» with 100 records and the corresponding completeness check by KSW ran smoothly. At the start of the project SPS had therefore already proved it can be trusted in its professionalism as a service provider for processing documents. To ensure production could begin on time four weeks after placement of the order, the created service package integrated various, project-specific special services. These included: Provision of emergency digitisation within an hour Customer-specific process for retrieving and registering the documents Retrieval of the records on-site at KSW by the SPS team Same-day retrieval of the current records in the secretary's office of KSW and express processing within five days Ensuring the transport logistics of the sensitive dossiers by taking them directly from KSW to the SPS Document Management Center (DMC) Continuous tracking of the records from retrieval on-site up to digital storage Creation of searchable PDF/A files with bookmarks per register and hybrid storage of the black and white and colour pictures (e.g. ultrasound images) Weekly reporting with forecast for production planning and also as information for KSW Cooperation hand in hand The smooth teamwork as partners with KSW made a decisive contribution to the successful implementation of this project. Competent contact partners were always available on the part of KSW to clarify logistical, technical and organisational questions. This meant the tight schedule was able to be observed and the project implemented without any bottlenecks and delays from the definition of specifications, the testing and the production phase onto the provision of quality-assured data on Swiss Post Solutions own secure sftp server. Reference project for other areas Outsourcing this project to SPS was worthwhile in every respect for KSW. The initial concerns of the doctors were dispelled. The digitally archived medical records of rheumatology are often used. The feedback on the remote access and the searchable PDF/A files is extremely positive and led to quick acceptance by the doctors. At the moment the procedures are being tweaked by an internal committee. KSW s satisfaction with the implementation of the project and the associated process optimisations for storing, managing and exchanging information is so high that this digitisation project is being used as «best practice» for other areas.

4 Efficient production cycle The documents were retrieved by correspondingly trained staff from SPS directly at the premises of KSW. Here for each record a unique ID (barcode) was generated which was stored in a central SQL database. Scanning the barcode before filling the transport boxes enabled complete tracking of every single record from retrieval at KSW, external processing up to the provision of the quality-assured data on the sftp server. The retrieved records were delivered in special transport containers to the SPS Document Management Center (DMC). Here the records were first of all prepared and indexed using the record structures specified by KSW. This means the generated PDF/A files can be quickly found at any time in the electronic archive of KSW. The fully automatic removal of blank pages, ongoing quality controls on the screen, running a temporary database with a cross-check function and the continuous monitoring of the scan jobs guaranteed FINMA- and ISO-certified quality and security standards in the subsequent digitisation process for KSW. As soon as a record was finished being processed, KSW was able to access it via the secure sftp connection and store the data in the electronic archive. For the temporary storage of the physical records, SPS set up a client-specific short-term archive for KSW. After the expiry of the agreed period, this was destroyed in compliance with data protection requirements. Original documents which could not be scanned were given an ID and sent back to KSW. Prepared for any eventuality An elaborate «emergency scenario» ensured that during the production phase urgently required records were available via express scanning within an hour after being requested via sftp server or secure connection. The process sequence at a glance... Preparatory work Provision of data Retrieval of the physical records Scanning SPS sftp-server Short-term archiving of the original documents and data for 90 days Automatic data collection Legally compliant destruction SPS Document Management Center

5 About Winterthur Cantonal Hospital For Winterthur Cantonal Hospital, Swiss Post Solutions retrieved and scanned more than 15,000 medical records with a total of almost one million sheets of paper and made these available as searchable PDF/A files for entry in the electronic archive and it did all this within six weeks. The switch to digital archiving processes in KSW therefore reached another milestone: Access to all medical files of rheumatology is now possible from any location and at any time. This makes it easier for doctors to study records and relieves the burden on the secretary s office. Technical and administrative processes in everyday work at the hospital are therefore much simpler. The controlled and mobile access increases data security because sensitive medical records can neither be mislaid nor damaged. During consultation hours, online access to medical histories provides advantages in terms of time and, with ability to provide information promptly, also increases the service quality for patients at the same time. From an organisational perspective the digitisation creates free space. This has a positive effect on costs and enables an optimised space concept. Winterthur Cantonal Hospital (KSW) is one of the ten biggest hospitals in Switzerland and treats around 200,000 patients a year. With 3,000 members of staff and 530 beds, KSW ensures primary health care for the inhabitants of the hospital region. Beyond the region KSW works together with regional hospitals to provide specialist medical services. Winterthur Cantonal Hospital fulfils an important training assignment. Thanks to the «healthy size» and management structure, communication channels are short and clear. The culture of cooperation is of great importance. Creativity, flexibility and personal initiative are actively promoted at all levels. Further information Winterthur Cantonal Hospital Christoph Osterwalder Head of Business Management & Administration Department of Medicine Telephone christoph.osterwalder@ksw.ch Swiss Post Solutions Andreas Kaeser Business Development Health Telephone andreas.kaeser@swisspost.com

6 About Swiss Post Solutions Part of the Swiss Post Group headquartered in Bern, Swiss Post Solutions (SPS) is a leading outsourcing provider of solutions for paper-based business processes and innovative services in document management. SPS 7,400 employees support business clients in the areas of insurance, banking, telecommunications, media, retail, energy supply and travel & transportation with their digital transformation. SPS has an active presence in all important international economic regions and works with specialized partners in selected countries. Swiss Post Solutions AG Pfingstweidstrasse 60b 8080 Zurich CHECS KSW SPS201