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 Hospital Information Systems

Change unmanageable work-flow procedures

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   By Health Management technology, April 2010

System provides physician practice with streamlined work flow, easy user interface, filing templates, reduced costs, and organization and multitasking of documents.

Work-flow ManagementChoiceCare Physicians, an eight-doctor private-practice physicians' group specializing in physical medicine and rehabilitation, was using a dated electronic medical record (EMR) program and found that it was not meeting expectations. The office had a filing room full of charts that nurses or other staff would spend hours in, looking for charts for their next-day appointments. Sometimes, they could not find a chart. Since diagnostic reports are in constant demand, staffers could not afford to have a chart go missing or spend hours tracking their progress through the current system. Also, if a patient called wanting results, finding their report took a long time.

With their work-flow problems getting worse every week, staff decided to look for a different type of electronic health record that would not be so time consuming. Staffers also did not like charts leaving the office, so looking for a way to keep all of their files in-house would prove most beneficial.

After putting a lot of time and effort into their previous system that could not lasso work-flow problems or integrate with accounting programs and other necessary business processes, ChoiceCare found a new document-management system.

ChoiceCare was using an EMR, but was getting frustrated since the system forced them to adapt to its business procedures rather than working to better suit the office's needs. "With our new document-management system from Cabinet NG (CNG-SAFE), we're now able to have the patient charts and explanation of benefits in one place, and we can use it for other practice functions as well — something that I couldn't do with an EMR," says Tara Stawiarski, practice administrator. "I have all of my employee files and vendor files in a separate cabinet. The EMR didn't have the ability to create cabinets for such things as administrative filings or employee files."

ChoiceCare is still maintaining the EMR system with one of its doctors and CNG created a new program that would allow staff to import those documents into CNG-SAFE. The practice, which started out with fewer than 10 users, now has 30 users on the current document-management system, which offers more functions. Features of the CNG-SAFE system include:

  • organization of documents that categorizes the filing system to make it mimic the paper world;
  • multitasking of documents so that multiple staff members can access them at the same time;
  • streamlined work flow; and
  • filing templates for reducing filing errors and increasing productivity.

"When someone calls, it's logged in the system. If the ball gets dropped, you know who's accountable," says Stawiarski. "Efficiency means the setup is designed to make the flow of the work seamless. With everything streamlined through work flow, there are no lost messages and everything can be tracked by the user. New patient information is immediately sent to a nurse or the front desk, where the (insurance) information is taken from the patient and then sent directly to the billing department.

Document management also helps reduce the risk of a possible malpractice suit. If a provider finds itself involved in a lawsuit, it will need precise notes and all of the necessary files for its case.

"Insurance companies require so much documentation, whether you are getting a major medical procedure or ordering a wheelchair," Stawiarski adds. "Having a paperless office helps reduce the chance of losing a document or having that document be misfiled into another patient's chart. If you can't find the chart in a paper-based system, chances are you'll end up going through each patient chart to find it."

Document management also helps reduce the risk of a possible malpractice suit, she says. If a provider finds itself involved in a lawsuit, it will need precise notes and all of the necessary files for its case.

An added benefit of finding the right document-management system is finding one that can support all current document types and be integrated with the organization's current practice-management system. ChoiceCare uses McKesson's Practice Point Manager. Stawiarski says that with CabinetNG's Synchronizer product, a new patient folder is automatically created in CNG-SAFE when a patient is entered into their practice-management system.

"This process is very valuable for making sure that any changes we make with our patient data, such as a phone number or home address, are automatically updated," she says. "CNG-SAFE gives the user direct access to the documents they need without ever leaving the main application."

Stawiarski adds she can also access patient information by doing keyword or full-text searches when she needs to run reports, or see if there is a recall on certain medications.

Another key feature is in-your-face notification for when there are similar files, such as having several patients with the same name. The system supports a reference index so an organization can cross reference with a second value, such as date of birth, Social Security number or another unique identifier. The system automatically displays this reference to determine if it is the correct patient.

ChoiceCare is planning to integrate CNG-Books, a QuickBooks interface from Cabinet NG that streamlines QuickBooks data entry and document filing into one consistent and efficient electronic process. Also, with the government having incentives for EHR and penalties for e-prescribing, ChoiceCare will be considering implementation of another medical-record program. Stawiarski says whichever EHR company they choose, it will have to be able to interface with CNG.

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Tags:  Hospital Information Systems