The centralized health information management department at the University of Pittsburgh Medical Center is a very busy place--as in 24/7/365 busy. There, some 75 staff members are devoted to one primary function--keeping the patient records from UPMC's 20-hospital empire up to date.

And while many of UPMC's hospitals are highly automated (seven are at HIMSS Analytics Stage 6; one is at Stage 7, the highest rank), UPMC must contend with an array of information residing on paper. Those documents must be scanned by the HIM staff and then linked to the core EHR. "We scan about 2 million pages a month," says Nancy Soso, executive director of HIM. "It's an enormous orchestration task."

Compared with most hospitals, UPMC is highly sophisticated in its use of information technology. But its complex document management operation reflects a greater industry challenge-coping with a staggering amount of information needed to inform patient care and facilitate the billing thereof. Many of these documents--EOBs, advance directives and referral requests, among others--originate outside the walls of a hospital. But even within those confines reside numerous forms and records beyond the reach of advanced EHRs.

To manage all this information, hospitals and group practices rely on document imaging and management systems. In their most rudimentary form, the systems have provided electronic snapshots of the documents that once lived in a paper folder. Beyond that, current-generation document management systems have more advanced features that can automate routing of scanned documents and work in conjunction with medical devices to capture patient data directly.

Here's the rub: Preoccupied with EHR deployments, many health care organizations however have not moved beyond the technology's scan-and-store capability. Enhanced efficiency rewards those that do. Tech-savvy health systems have devised ways to adjoin their document management systems with other technologies, such as bar coding and optical character recognition, to make their systems more valuable.

Gary Baldwin’s feature story in the July issue of Health Data Management examines the latest and greatest in the document management arena.

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