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Document Management

On a mission to eradicate paper

Implementing a document management system paves the way for electronic medical records.


im Bowden is on a mission to round up and digitize every paper document related to patient care at Palisades Medical Center in North Bergen, N.J., as the hospital embarks on an electronic medical records (EMR) installation in the next 18 months. Before Palisades goes live with its Siemens Soarian EMR system, Bowden, Palisades’ director of patient fi nancial services, is having his team transfer all patient billing information into a document management system. He knows that, for many organizations, such a system can be a transitional bridge to EMR implementation. Palisades runs a 202-bed hospital and a 245-bed nurs- ing home and rehabilitation center. The state’s annual healthcare report card ranks Palisades Medical Center as one of the top hospitals in New Jersey and number one in Hudson County. Its nursing home, The Harborage at Palisades, has “zero defi ciencies” – a result that is earned by only 3 percent of nursing homes in the U.S. When Bowden took his post at Palisades in 2008, he was determined to earn the same stellar ranking for the Palisades business offi ce and patient admissions. Ac- countable for Palisades’ business offi ce operations and a 38-year healthcare management veteran, Bowden set out to automate all patient records. Patient information comprised of pre-admission docu- ments brought in by the patient plus hospital-generated forms were copied, maintained in paper folders and then stored in fi ling cabinets throughout the hospital campus. Storage rooms on-site and rented facilities off-site housed thousands more historical records at a costly fee.

Paper and fi nancial woes Treating approximately 160,000 patients annually,

Palisades billing clerks were copying an average of 20 paper documents per patient. This did not include the patient’s 40-plus electronic forms and images stored on servers and the continuous need to retrieve patient fi les for billing discrepancies. As a result, Palisades Medical Center was accumulat- ing millions of paper documents each year and spending a

16 March 2011

great deal of time trying to fi nd the documents that were stored either on-site or in the off-site warehouse. In addition, the business offi ce was handling patients who would deny their identity after receiving their hospital bill.

Palisades Medical Center was accumulating millions of paper documents each year and spending a great deal of time trying to fi nd the documents that were stored either on-site or in the off-site warehouse.

When it rains, it pours Shortly before Bowden arrived at Palisades Medical

Center, the hospital experienced a fl ood. Most patient billing records, which were only in paper form, were wiped out. Less than three years later (March 2009), the hospital experienced a second fl ood, just three months after going live with the RAS imaging and document management system from DB Technology. While the process of electronically scanning patient records had already begun, nearly 200 boxes of paper records had to be freeze-dried to recover patient data, costing the hospital approximately $20,000.

“This experience could have been a lot worse if it weren’t for the scanning project,” recalls Bowden.

The “paper automation” strategy The fi rst step toward overhauling patient billing opera- tions was to identify all the issues Bowden’s staff expe- rienced during patient registration, then developing the electronic workfl ows using the document management system to guide billers and clerks through the patient registration process.

A document management system would show the staff what paperwork (prescriptions, orders, referrals, authorizations, etc.) and insurance information was to


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