Imaging and document management

By Rick Rollins

Health care professionals know the value of the reams of paperwork they generate on their patients’ behalf each year. Insurance forms generated by patients take a great deal of time to process, expedite and file. But physicians’ offices also know they can reuse documents generated for one matter to speed execution of another, and then bill insurance carriers more efficiently and accurately.

Such documents contain a very real, albeit potential, value in the form of time that can be applied to managing paper flow and accessing forms quickly. Managing an effective system for insurance billing not only increases the physicians’ office productivity, it generates additional revenue streams as well.

Every minute physicians waste looking for information reduces time spent with patients. In a perfect world, necessary files would be consistently and immediately accessible, enabling physicians to maximize time spent.

However, nearly every physician has encountered the “missing file” syndrome. When mission-critical information is not in the file cabinet, it could be in a backfile, on an assistant’s desk or buried in the stacks of your own office.

Simple solutions like storing multiple file copies might work for other industries, but not for health care professionals, given the sheer volume of paperwork. Such a system would diminish value by multiplying overhead costs like clerical time, office supplies, space devoted to file cabinets and the life span of the photocopier. This approach assumes all information contains the same potential value. In reality, some files may be accessed frequently by many people and some not at all.

For health care professionals, current imaging and document management technologies address these issues, providing physicians with fast access to necessary information. Imaging is the process of scanning a document to create an electronic file, which can then be manipulated and stored. Document management describes the meaningful indexing, routing, annotating, archival and retrieval of electronic documents, which can include scanned pages, Web pages, e-mail messages, spreadsheets and word processing files.

Here’s how the technologies work together in a medical practice setting. First, clerical workers can use a scanner to create an electronic version of the hard copy original, just as they would use a photocopier. The original can be sent to permanent storage while the new electronic image of the document is manipulated online.

For example, the image can be cleaned up to eliminate unnecessary speckles that sometimes appear on photocopies, and so forth. In addition, optical character recognition (OCR) technology translates characters contained in the document’s image into meaningful text that can be cut and pasted into a word processing file.

Document management solutions allow health care professionals to enter information about the electronic document, such as its title, author, creation date and key words including a patient’s name, document description and so forth. Upon creation, the file is archived, perhaps in a folder of items pertinent to a particular subject, in a network storage device, such as a tape drive, hard drive or CD-ROM.

Some document management systems enable users to route the file to several associates, just as they would route a hard-copy original. Documents can even be faxed or emailed to patients, insurance carriers or other physicians’ offices directly from the system. In addition, some systems enable users to annotate the document, as they might use sticky notes, and track changes to clarify whose comments appear. Some systems provide information security features that restrict confidential annotations, documents or entire files for exclusive access by specific users, such as the medical practice’s principal associates.

When needed, documents can be retrieved by searching for key information about the document, such as its file type, title or key word. OCR-processed documents and other electronic text files can be searched for an alphanumeric string embedded within the document. Descriptions of documents that meet search criteria are presented, along with their location on the network, usually with a link that allows users to open the necessary file directly. Users can then print the document or search for additional information.

Imaging and document management systems can dramatically cut the time physicians spend searching for necessary information. However, medical practices must carefully evaluate certain aspects of an imaging and document management solution, as the wrong system may diminish its overall value.

Total Cost of Ownership

Factors that impact the document management system’s total cost of ownership include not only its entry cost, upgrades and technical support, but its ease of implementation, the amount of necessary user training, its compatibility with existing network equipment and its requirements for storage devices and scanners. The easier the system is to install, support and use, and the more highly integrated it is with popular platforms, the less expensive it will be to maintain over time.

Compatibility With Existing Systems

To speed the rate of adoption, the system should complement, not disrupt, systems already in place. Employees should be able to route and annotate documents and quickly identify who made which changes. Security features ensure the confidentiality of sensitive files. In addition, a hierarchical storage management system uses an intuitive file cabinet/drawer/folder approach, which is similar to traditional archiving systems.

System Portability

Physicians are among today’s growing mobile workforce that relies on cell phones and laptops. For physicians, a document management solution is useless if it cannot provide information when they need it, either remotely or through a dialup connection. During an emergency situation or while out on call, physicians may especially need instant access to key information.

“Walk-away” Considerations

If the system is problematic, or if the medical practice decides to replace its document management package as the result of growth or a merger, will existing mission-critical data be accessible to the new system? Systems built around proprietary standards can lock physicians into an unwanted application because users can’t access key data any other way. Systems built around open standards ensure that new packages or custom applications can continue to support older files after the system is replaced.

Imaging and document management technologies promise dramatic timesaving benefits for physicians, which can stimulate productivity and efficiency across the entire medical practice. However, physicians must carefully consider the requirements, benefits and usability of each system in order to calculate the total investment and speed of return. If the point of an imaging and document management solution is to create value, the total investment should produce a return quickly, while ensuring the accessibility of mission-critical information for years to come.

Rick Rollins is vice president of sales and marketing for Computhink, a Lombard, Ill-based company specializing in document management.