FREE Health Data Management Site Registration

Sign up today and access the leading source of Health Care I.T. information on the Web.
Your FREE site registration entitles you to:

Free Health Data Management e-newsletter
 
Search more than 12,000 articles
 
Access Web Seminars on a host of I.T. topics
 
White Papers and Industry Research that provide valuable insights on a variety of technologies and implementation issues
 
Podcasts, updates on industry events, and much more!

 
   

The Best of Both I.T. Worlds


By Zack Martin, Managing Editor October 2007
CMH Regional Health System wanted to deploy an electronic health record, but didn't feel the time was right to force a switch to computerized care on its medical staff.

So the delivery system decided to meet them half-way via a forms management system from Alpharetta, Ga.-based Optio Healthcare that enables clinicians to continue to use paper on a day-to-day basis, but converts that paper documentation into electronic data that feeds an EHR application from McKesson Corp., San Francisco.

The applications are part of the Wilmington, Ohio-based delivery system's broader $18 million patient safety initiative, which has entailed the deployment of 22 new applications since last October, including the EHR and forms management applications as well as an admissions/discharge/transfer system and a laboratory information system, says Linda Keifer, senior electronic forms and imaging analyst at CMH. The delivery system comprises 93-bed Clinton Memorial Hospital, a cancer care center and a number of clinics.

First Step

Many providers are using forms management applications as stepping stones toward computerized care environments, says Gary Wood, president at Symsonia, Ky.-based DTE Consulting.

"Hospitals are not giving up on paper for a long time no matter what anybody says," he says, because the vast majority of physicians and nurses are accustomed to charting on paper.

Forms automation provided a good "middle ground" for the clinicians at CMH, Keifer says. Clinicians could still chart on paper and use standardized forms while getting accustomed to using the computer to look up and review information. Eventually paper will play less of a role in patient care but there are no plans to get rid of it completely, she adds.

The forms automation system at CMH is used in documenting virtually every aspect of patient care, Keifer says. The cornerstone of the system is bar codes. Patients are identified with two bar codes, one that is printed on documents relating to their care and treatment, and another that is printed on a wristband they are given at admission.

Bar codes also are used to identify each paper form that is used during care delivery, such as forms for nurse assessments and radiology, lab or pathology reports.

After a form is filled out, it is sent to the medical records office and scanned into the EHR, Keifer says. Based on the bar codes, the scanner indexes the form to the specific patient file and to the designated section of the electronic record.

The information initially resides in both the forms automation system and the EHR for 30 days. During that time, clinicians can use the forms automation system to locate and print individual patient forms instead of accessing the entire patient record. The forms appear as images on-screen. Depending on the rules around that form, the text may be edited within the forms automation system or be read-only. After 30 days, however, the data resides only in the EHR, Keifer explains.

A Smoother Flow

The forms automation system has helped significantly improve daily workflow for CMH Regional's clinicians, Keifer says. After a patient is admitted to the hospital, the system sends the admission forms to a printer at the patient's next stop, such as the floor where they're being sent to or the pathology department where they'll have a test performed.

The automatic printing function also has made life easier for nurses, Keifer says. The system has eliminated the back and forth between printer and computer to get all the necessary documents. The system also is set up to print patient progress reports when doctors are scheduled to make rounds.

Clearer lines of communication also have paid off for patients. Patients scheduled for specific tests and outpatient procedures are given a pager when they sign in. The pager number appears on their forms, so if a patient is waiting to have an MRI done, for example, the radiology department can page the patient to tell them to come to an exam room.

Having the proper forms automatically routed to different departments and having a way to immediately contact patients has reduced the average wait time to 10 minutes from 35 minutes, Keifer says.

The forms automation system also is being used to print bar codes on wristbands for medication administration and reconciliation programs as part of the patient safety initiative, she adds.

The forms automation system also has trimmed costs associated with managing information. It has enabled the delivery system to eliminate half the costs of a full-time equivalent position in the medical records department.

It's also eliminated the costs of "blue plates" that previously were affixed to paper forms. The blue plates, embossed plastic cards the size of credit cards, listed a patients' name, medical record number and other information, were expensive to create and required the hospital to maintain the machines used to generate them.

The hospital estimates it has saved more than $50,000 to date by getting rid of the cards. Other savings are coming from not having to buy carbonless discharge forms and labels for patient files, Keifer adds.

More Hospitals Articles

Hospitals Archive

I.T. Spotlights