Healthcare is stethoscopes and surgeries, pediatrics and prescriptions, tongue depressors and tests, right? Yes, but it’s also lots of documents and images that were traditionally stored on paper. Katherine Shaw Bethea Hospital (KSB Hospital) now uses electronic document management to eliminate the costly administrative burden of managing all of those documents and images.
KSB Hospital opened its doors in Dixon, Illinois on New Year’s Day, 1897. Today, in addition to its 80-bed acute care facility and other clinics in Dixon, KSB also operates health centers and clinics in Ashton, Polo, Amboy and Oregon, Illinois.
Diagnosed with an Unhealthy Document Management Software
In October 2003, the board of directors and president of KSB Hospital gave the hospital a mandate to move toward the future by implementing electronic management of medical records and images. This was seen as a way to streamline information flows and reduce costs.
To this end, KSB purchased a document management product that had been designed specifically for the healthcare industry. However, that product did not meet the hospital’s needs.
The product stored document images using a proprietary format. Not only was this format difficult to work with, but it also required that the images be kept on expensive iSeries Integrated File System storage devices. In addition, the software’s front-end consumed considerable CPU resources, which made it more costly to run.
Within a year of implementing the original software, the hospital began searching for another document management solution that would be more cost-effective and would better meet its needs. KSB found the solution it was looking for in Webdocs from Fortra.
Webdocs, which is available in versions that run on Microsoft Windows-based servers as well as IBM i servers, allows organizations to electronically store and manage document images and other files, such as PC files, emails and computer-generated reports. The documents can then be accessed using up to 10 keys or through a full-text search. When the documents are stored, the keys can be entered manually or Webdocs can automatically extract them from barcodes or textual data appearing within the images. Once loaded into the system, authorized personnel can use a standard Web browser to access the images.
The hospital considered a few document management alternatives. It chose Webdocs for a variety of reasons. For one, it was the only product that could handle all of the different document source formats and platforms that the hospital required. A user-friendly interface added to Webdocs’ advantage. In addition, the hospital appreciated the flexibility that Webdocs offers when it comes to where document images are stored.
Another factor in Webdocs favor was its vendor. KSB had considerable confidence in the ability of Fortra to deliver quality solutions because of the hospital’s experience with other products.
KSB Hospital uses the IBM i version of Webdocs, but it connects to its document management solution through a Windows interface.
Webdocs manages a wide variety of documents for KSB. For example, transcription services create documents from doctors’ dictation; documents enter the system through an HL7 data stream (a framework for exchanging medical information); medical imaging and patient identification documents are scanned in; and wound documents created in the ER are input directly into Webdocs.
The document management product that KSB used before Webdocs forced the hospital to store documents on expensive IBM i-attached storage units. In contrast, Webdocs allows the hospital to store documents on lower-cost disk units on a Storage Area Network (SAN).
When documents enter Webdocs, an account number is obtained from a variety of sources. In the case of transcription documents, the number is part of the file name. Account numbers in PDF documents are extracted from the document itself. And account numbers are manually keyed in for scanned documents.
Once Webdocs has an account number, it can automatically populate a host of other key fields by accessing the hospital’s other databases to gather that information. These index fields make documents easy to find when needed.
In addition to medical records, the hospital’s human resources department now uses Webdocs to manage its documents. Historical employee records were scanned in Webdocs and they are now kept up to date on an ongoing basis.
The hospital continues to expand its use of Webdocs. It currently adds about 70,000 documents per week.
Electronic Document Management that Works
KSB hospital has not done a quantitative analysis of the value it receives from Webdocs, but the benefits are tangible nonetheless.
Compared to the hospital’s previous document management software, Webdocs has significantly reduced costs. The savings have come in a few areas, but the biggest cost-reduction resulted from the ability to store documents on low-cost, SAN-based disks.
Electronic document management also freed up considerable space. After scanning in medical records, the hospital was able to eliminate a full room of filing cabinets. And after moving the human resources department onto Webdocs, KSB was able to eliminate filing cabinets that had lined a hallway.
Webdocs has also helped to improve document privacy, which is a critical issue in the healthcare industry. Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), any organization that handles healthcare documents is required to ensure the utmost privacy for those documents.
Webdocs helps KSB Hospital to fulfill these HIPAA requirements. In the days of paper-based documents, “medical records moved around the hospital,” explained Larry Stevens, senior systems analyst at KSB Hospital. “With Webdocs there is no general user accessibility to documents. Only authorized users can see them.”
The only way to access Webdocs at KSB Hospital is through the hospital’s Windows-based interface to it. As required by HIPAA, that interface creates log records whenever anyone searches for and accesses health documents. The logs can then be used to audit that activity if required.
Electronic document management also helps to improve document flow efficiency. When medical images, reports and charts were on paper, doctors often had to go to where the documents were stored to see them. Either that or the documents were faxed in black-and-white, which reduced the quality of the transmitted information.
In addition, when a chart or image was removed from the storage area and someone else needed it, the document had to be hunted down to find out whose desk it was on.
Today, medical documents and images are online and easily accessible by authorized personnel through Webdocs. What’s more, whereas in the past doctors might have had to wait to see a manually transmitted paper-based report or image, now they can see it the instant it is available on Webdocs.
According to Dr. Greg Reckamp, “This system is the best I’ve seen for organization and speed of getting to the documents.”
KSB also thinks that Webdocs puts the hospital in a good position to deal with future demands. Electronic medical records are a hot topic in the medical community and in government. As a result, they may be mandatory in the future.
In addition, “As healthcare changes and progresses, so do our needs,” said Stevens. “KSB foresees regional, if not national, health information cooperatives that will allow hospitals to share information on patients to improve the quality of the care provided. The flexibility Fortra has given us with Webdocs allows us to realize these goals.”