Ochsner's ECM Overhaul

By Amanda Griffith, Contributing Writer

In an effort to achieve content consistency and enhance efficiency, Ochsner Health System replaced three document management systems with a single ECM solution.

EMR and HIT (health information technology) adoption has fueled a huge increase in medical data. The need to manage and analyze this digital information has also caused the ECM (enterprise content management) solutions market to grow. In fact, according to research from Frost & Sullivan, the global ECM market for the healthcare industry will double in terms of earned revenue from $318.2 million in 2013 to $715.4 million by 2019.

One man who knows the rapid growth of the market all too well is Al Tugaoen, project manager at Ochsner Health System, one of the largest independent academic health systems in the United States (13 owned, managed, and affiliated hospitals, and more than 40 health centers). He’s long been at the forefront when it comes to ECM adoption, helping his organization build its own document management system, something that brought its fair share of challenges.

Manually processing paper is often errorprone and expensive. Ochsner Health System knew it would need to address these two issues in order to continue to provide effective and efficient care to its patients.

Hospital M&As, New EMR, Drive ECM Changes
As far back as 2009, Ochsner needed a more efficient way to handle paper documents to improve insight into the AP process. As Southeast Louisiana’s largest nonprofit, academic, multispecialty healthcare delivery system, the health system relied completely on paper to process the nearly 300,000 invoices that came into the AP department every year.

Back when Ochsner owned and operated just one hospital and associated clinics, the organization maintained a home-grown EMR. However, after Hurricane Katrina, the health system began to acquire more hospitals (five hospitals in six years) — all with their own EMRs and document management systems. Ochsner quickly realized that its home-grown EMR was no longer able to address the needs of its clinicians and hospital staff throughout all of its locations. As a result, the health system implemented an Epic EMR enterprisewide. As Ochsner embraced its new Epic EMR system, increasing volumes of patient information were captured digitally, and the company’s document management requirements grew. At the time, the health system was actively using three different document management systems to feed the EMR and other business applications, which created several problems.

“At that point we had a separate application to house hospital documents and another one from which to scan registration documents,” says Tugaoen. “With three different document management systems, it became increasingly difficult to find a one-stop shop for obtaining information. Because the applications did not fully interact, staff had to release documents from all three, which is time-consuming and inefficient, and had the potential to generate inconsistent and outdated content.”

ECM System Provides Single Source For Nonclinical Documents
After researching various options, Ochsner selected Hyland OnBase to replace the three document management systems previously in use. The health system chose OnBase to serve as the single document management system for all of its nonclinical documents because it fulfilled the AP department’s need for paperless document management, and it could scale up to meet future needs.

“The existing clinical document management systems needed to be replaced with an application that fully integrated with our new Epic EMR,” explained Tugaoen. “Given our successful implementation previously and the fact that it could integrate with our EMR, the choice became obvious to use OnBase as the enterprise solution as well.”

The new OnBase system enables Ochsner to:

• establish a complete, secure, electronic patient record compliant with Meaningful Use;
• heighten physician satisfaction by providing immediate access to all the data they need;
• empower more informed care for improved outcomes and patient satisfaction;
• reduce costs by eliminating paper and disparate systems with a centralized electronic repository; and
• streamline clinical and administrative processes with content-centric automation.

Tugaoen and his staff appreciated that the OnBase solution had an infrastructure capable of scaling and adapting to all of its facilities and clinics — without the need for custom coding and IT resources. The health system can now create a single patient record by connecting information from not only the Epic EMR, but also the ERP (enterprise resource planning), clinical, IT, financial, and other systems enterprisewide. Implementing this technology ensures that content is properly captured at registration, clinical content is available for treatment, and billing and reimbursements are expedited due to access to the complete patient record.

ECM Adds Value To HR, eSignature, And MPI Initiatives
According to Tugaoen, the ECM solution has continued to grow and adapt with the changing needs of the organization. For instance, Ochsner has now integrated it with Infor Lawson for its HR needs and is working to incorporate it into two additional initiatives. The first is to capture electronic signatures on consent forms using OnBase Mobile eCapture for iPad. With this application, a clinician can capture critical patient information electronically, on a single platform, at the point of care.

The second initiative is with OnBase Patient Viewer, which allows HIM departments, physicians, and clinical staff to view legacy medical documents associated with a patient’s medical record number (MRN) or master patient index (MPI). In addition, Patient Viewer will allow Ochsner to provide access to acquired physician practices’ previous medical records. Designed to integrate with third-party EMRs, it provides a way to retrieve and navigate patient records stored in the ECM solution.

ECM Enhances EHR Utilization
With the capabilities to now conduct real-time concurrent scanning, Ochsner Medical Center - North Shore in Slidell, LA, achieved a HIMSS Stage 7 designation in November 2014. To date, it is the only hospital to receive this designation across Louisiana, Mississippi, Alabama, Arkansas, and Tennessee. HIMSS Analytics developed the EMR Adoption Model in 2005 as a methodology for evaluating the progress and impact of EMR systems for hospitals in the HIMSS Analytics Database. There are eight stages (0-7) that measure a hospital’s implementation and utilization of information technology applications. The final stage, Stage 7, represents an advanced patient record environment. With an improved ability to efficiently scan multiple documents across disparate systems, Ochsner has its eye on an even bigger prize: HIMSS Level 7 for additional hospitals in its system in 2015.

“It’s more than just scanning a piece of paper,” stressed Tugaoen. “More and more of that content — lab results, tests, EKG strips — is generated electronically, so being able to use something like OnBase Patient Viewer to easily manage that content means our clinicians can provide better care to our patients, no matter at which facility they initially received care.”