of the paperwork burden would not be eliminated through such a system. Numerous paper forms never become part of the medical chart, such as corporate contracts, purchase orders, requests for goods and services, human resources forms, risk management documents, capital purchase requisitions, chargemas- ter, and form changes and check approvals. Many hospitals have more than 1,000 forms in use, only a percentage of which are clinical. This reliance on paper comes with a high price tag. According to a study by PriceWaterhouseCoopers, the average cost
was siphoning time and money, and even contributing to policy failures.
IT staff took the proposal for an automated work-
fl ow system to the hospital’s chief fi nancial offi cer and demonstrated a return on investment that could be realized shortly after product implementation. Timing was good, because administration had just begun the process of evaluating EHR products that would require several million dollars (a conservative investment) to implement. While an administrative work-fl ow system required an upfront investment, staff was able to dem- onstrate a near-immediate fi nancial benefi t.
Evaluation: any and all
Doctors Hospital began evaluating vendors able to handle the administrative work fl ow of an organiza- tion of its size. The selected product would need to create and manage forms and processes to accommo- date several departments across numerous buildings: clinician groups, human resources, accounting and the business offi ce.
to process an invoice manually is $1.26, compared to an electronic invoice at 36 cents – a cost differential of 90 cents per invoice. Additionally, as discussed in a study by CAP Ventures, a world-wide document technology strategy and consulting fi rm, 15 percent to 25 percent of pre-printed material becomes obsolete, meaning hospitals must spend additional time collect- ing and disposing of aged materials.
In one instance, Doctors Hospital IT staff estimated that pre-printed forms were costing the hospital ap- proximately $700,000 annually, and this fi gure could be reduced by nearly 70 percent through forms and work- fl ow automation. Staff determined that they needed an enterprise-wide solution to handle unmanageable manual processes and presented a proposed plan of action to select and implement a new system. Gaining the support of the hospital’s administration and clinical staff was crucial for making the case for a solution. Initially, there was some pushback – like most healthcare organizations, the hospital had been paper based since its inception – and transitioning to an automated work fl ow required an up-front training allowance in addition to the cost of the system. But it was clear that the manual system had critical fl aws,
A team consisting of IT, administration and clini- cal staff was created to assess work-fl ow automation products and lent an ear to any and all vendors offer- ing a work-fl ow application. Unfortunately, it found many solutions to be clunky add-ons that needed to be coupled with other IT platforms. Many systems were convoluted, and implementation and follow-up support was limited. Doctors Hospital wanted a tool that could stand alone or easily mesh with the planned EHR roll out. After evaluating numerous vendors, IT staff se- lected an enterprise work-fl ow product developed by FormFast of St Louis, Mo., capable of customizing individual work fl ows and compatible with a future EHR system. Following installation of necessary hard- ware, Doctor’s Hospital staff received both on-site and remote training and support.
The chosen solution also included a form design feature. In addition to creating new, compliant forms within the system, existing forms could be scanned and automatically converted to editable forms with optical character recognition (OCR) technology. The OCR technology recognizes not only text, but also the fi elds of a form and converts them to fi elds in the electronic form that can be mapped to data and dynamically fi lled.
From implementation to automation After on-site training by product implementation experts with boots-on-the-ground knowledge, Doctors Hospital began to sync work fl ows to the automated system. Each administrative work fl ow required ap- proximately 30 days, and implementation of most
HEALTH MANAGEMENT TECHNOLOGY October 2010 31