Find Real Meaning and Accountability with an Enterprise-Wide Solution

For physicians, medical groups and other caregivers, 2011 begins the real test of the federal government’s Health Information Technology for Economic and Clinical Health (HITECH) Act. That’s when eligible professionals who demonstrate “meaningful use” of a “certified” electronic health record (EHR) can receive incentive payments of up to $44,000 from Medicare and $65,000 from Medicaid per individual physician to help cover the cost of EHR adoption.

When the act was signed into law in 2009, there was an immediate rush to understand what constituted a true EHR solution. Unmet needs can cost money, create hassle – and obscure the real benefits of a “one patient, one record” solution. Forget meaningful use when your physicians can’t find any use in your solution.

Those that took a more thoughtful approach are entering into a new phase in 2011, what John Moore, an IT analyst for Chilmark Research, calls “the tactical implementation stage.” This stage is underscored by organizations making sure “systems are in place, clinicians trained and meaningful use requirements met.”

But many EHRs remain incomplete, omitting at least 25 percent of patient information in most instances, leaving the goal of “one patient, one record” more of an aspiration. The reason why? Loose items like financial forms, administrative faxes, clinical images, charts and more are left out. Items not easily handled by even best-in-class EHR solutions, but better suited for an enterprise-wide document management solution, like OnBase.

An enterprise-wide solution like OnBase lowers total cost of ownership, the calculation used to assess both direct and indirect IT costs and benefits, increase return on investment and brings value organization-wide.

One Patient, One Record

One patient, one record is the goal for Allina Hospital & Clinics in Minneapolis, Minn. The challenge was its struggle with managing paper and disconnected systems across the enterprise, from accounts payable to home healthcare. It need to figure out how to incorporate the paper it would inevitably receive – both paper it generated as an organization, as well as paper arriving from outside the system – and make it truly meaningful and usable for its staff.

It decided to find an enterprise-wide electronic content management (ECM) system that would automate manual processes, integrate with software application like GE Centricity and Lawson, and inevitably become a core IT system. It chose OnBase.

Allina, an 11-hospital, 60-clinic health system, knew that its Epic electronic medical record (EMR) would still require health information management (HIM) to pull charts and wouldn’t provide clinicians with a complete view of a patient’s history. With its easy integration with OnBase, that missing information is captured and delivered with a single click from OnBase into Epic. Physicians don’t know they’re working in OnBase.

From there, Allina deployed OnBase in its revenue cycle, from start to finish, allowing for a more streamlined registration process and speeding up the revenue cycle after patient discharge.

It accomplishes this by centralizing revenue cycle documentation and allowing authorized users from across the health system to access billing information. The result? Increased patient satisfaction and faster processing.

Now OnBase has grown truly enterprise-wide at Allina, eliminating paper it is accounts payable department, reducing human resource response time to employees by 50 percent and reducing time, labor, costs and risks associated with records management and audits. Allina has integrated OnBase with Lawson Financials, BMC Software Remedy CRM, and Oracle PeopleSoft.

The kicker? In the first year, Allina realized a complete return on investment and continues to save year after year.

A Final Note on Accountability

Analyst Moore predicts the buzz at HIMSS 2011 will be about Accountable Care Organizations (ACOs), physicians, medical groups and hospitals sharing responsibility for providing care to patients. The concept is still relatively new – and Moore rightfully advocates caution before making an IT investment – but let’s talk about how it could work from a document management perspective.

If the goal of an ACO is to bring together caregiving points of contact for patients – primary care physicians, specialists, medical groups, at-home or visiting nurse care, and so forth – and have those points of contact interact glowingly, the “one patient, one record” concept becomes vitally important.

Fast, fingertip access to a patient’s full EHR must occur for the ACO to be successful. An audiologist who can get instant access to a patient’s complete medical record – each chart, prescription, note, scribble and thought – reduces time to treatment, saves thousands of dollars, and inevitably eliminates patient stress by getting rid of repeated medical tests, X-rays and physical exams.

Test results automatically populate the EHR, electronic alerts can signal prescription drug interactions, and patients who receive care far from home benefit from caregivers who can access their full records easily and securely.

It could also centralize administrative areas like accounts payable and human resources and speed time to payment in the revenue cycle.

“It’s easier to see patterns, such as missed courier stops or mislabeling at a particular site,” says Bonny Paetznick, reference lab director at Allina Hospital and Clinics. “Before OnBase, there was no opportunity to step back, look at these trends and address them.”

And as one sees with Allina, it can centralize administrative areas like accounts payable and human resources and speed time to payment in the revenue cycle.

With a smart, enterprise-wide document management solution in place, ACOs could be closer to reality – and closer to fulfilling their promise.