Document Management Provides Six-Figure Savings

By Ken Congdon, Editor In Chief, Health IT Outcomes

An electronic document archive solution helps Morton Plant Mease Primary Care eliminate more than $140,000 per year in paper record storage expenses and streamline the flow of patient records to physicians.

Make no mistake about it. Just because most healthcare providers in the U.S. are now making the transition to EMRs (electronic medical records) doesn’t mean that paper has become obsolete. Paper documents (e.g. lab reports, referral letters, EOBs, patient transfers, etc.) still inundate medical facilities — particularly physicians practices. And what about all those old paper patient charts? Physicians have been recording patient histories on paper for years (many still do). All of these historical charts don’t just magically convert to EMR data with the snap of a finger. They either have to be converted into electronic data and migrated into an EMR or be managed by a separate system. A data migration initiative can be too expensive for a physicians practice, yet continuing to manage patient charts in paper form can be an expensive, time-consuming, and error-prone administrative burden. Morton Plant Mease Primary Care (MPMPC), a non-profit group of more than 100 primary care physicians, found the cure to its paper chart management woes with an electronic document management repository.

WAREHOUSES PROVE COSTLY, INEFFICIENT
MPMPC is affiliated with BayCare Health System in Tampa, Florida. Over the years, the health system has added a number of physician practices to its network. This activity created an increased demand for the paper record storage and retrieval services MPMPC provided.

“Each individual doctor’s office only has a limited amount of storage room for paper patient records,” says Nancy Cothern, director of physician management services at MPMPC. “In fact, our biggest office can probably store only a couple of years’ worth of patient records on site, and we’re required by law to keep these documents for at least seven years. We worked with third-party storage and retrieval warehouses throughout the Tampa area (but one as far south as Sarasota) to help us archive and manage the vast majority of these paper records.”

The process to retrieve records from these storage warehouses proved to be inefficient and inconvenient, particularly for physicians. Any time a physician needed to access a record stored at one of these warehouses, his or her office would either have to call the warehouse or submit a requisition form. Warehouse employees would then retrieve the record and hand deliver the chart to the office that requested it. The problem was this process usually took about 48 hours to complete, and sometimes as long as a week. Many times physicians were forced to see patients without actually having their medical records on hand for reference. Furthermore, the process of retrieving archived records from storage warehouses was costly.

“These storage warehouses charge you for everything,” says Cothern. “They charged us to retrieve the box. They charged us to retrieve the actual record. They charged us to deliver the record, and they charged us to return the record. Essentially, every time they touched one of our records there was a fee associated with it. These fees added up. We were paying more than $100,000 per year to these warehouses for storage and retrieval of medical records for all of our physician offices.”

SCANNING 10 MILLION PAGES IN 12 MONTHS IS NO EASY TASK
The rising costs and inefficiencies associated with storage and retrieval, coupled with the fact that some of the warehouses began closing their doors, prompted MPMPC to seek an alternate solution. Document imaging and management solutions immediately came to mind, but the scope of the project was a concern for MPMPC.

“We calculated how many boxes and how many charts we currently had stored in these warehouses and quickly determined that there were between 8 to 10 million pieces of paper that we needed to scan in order to move from a paper to an electronic environment,” says Cothern. “We had a small scanning team in place at the time but knew that we would have to double and triple our resources in this area to capture these documents in a timely manner. Our goal was to complete this mass conversion within a 12-month window.”

MPMPC purchased four additional Panasonic highspeed scanners (giving them a grand total of eight) and doubled their scanning workforce from two FTEs to four. Boxes of charts were shipped from the warehouses to the MPMPC billing office in batches, where each imaging employee would operate two scanners simultaneously. Documents were processed in two shifts on weekdays and one small shift on weekends. On average, MPMPC scanned approximately 1,000 record boxes per week, with each box containing 20 to 50 paper charts.

The imaging hardware was only part of the document conversion activity. Once scanned, document images needed to be archived and managed via an electronic repository. MPMPC chose iSynergy from iDatix to provide this functionality. Unfortunately, dropping scanned images into the electronic document repository wasn't a cut-and-dried activity.

"Every office and department in MPMPC had different search requirements for their specific documents," says Louis Mariscal, manager of physician management services for MPMPC. "Our team had to sit down with every office and decipher the documents they were likely to access and how they would search for this information. Based on these conversations, we had to customize search rules for specific documents into the iSynergy platform."

ELECTRONIC DOCUMENT ARCHIVE DELIVERS $140,000+ IN COST SAVINGS
MPMPC completed its mass paper record conversion in August 2011. With its new electronic document archive, a physician's office now submits an electronic form via the MPMPC intranet to request a medical record. This request is received by an employee in the billing office who accesses the iSynergy repository, searches for the record in question, and sends the requestor a secure PDF of the record via email.

"It used to take 48 hours to a week for a physician to receive a paper record from the warehouse," says Cothern. "With our new electronic document archive, physicians now receive the records they request within the hour. In addition, the solution enabled us to terminate our relationships with the storage warehouses — saving us approximately $140,000 last year in warehousing costs alone. We expect our savings to be even more substantial this year because we no longer have to endure the costs associated with the extra FTEs we had to hire to complete the mass conversion project. These additional FTEs offset some of the savings we would have enjoyed in 2011."

MPMPC physicians have expressed their satisfaction with the new document archive solution as well. "Our physicians love the timeliness of the information," says Cothern. "They now literally have the patient information they need at their fingertips. No more phone calls. No more waiting. It's all pretty instantaneous. Plus, each office used to have to pay for some of the warehouse space its office incurred. They are no longer burdened with these expenses, which makes them very happy."