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be provided at the time of registration and it would take a picture of patients while they were sitting in front of admission clerks. This would eliminate the patient re- turning months later and denying that they had received the services that they were billed for.

Bowden had used a document management system at a previous hospital and was able to convince admin- istrators that this technology was the best way to cut paper overload, streamline patient information, protect against disasters, shore up workfl ow processes and cap- ture lost revenues. His initial goal was to convert every paper document to digital form, starting with patient accounting records. Palisades Medical Center chose RAS because the software was proven effective at other well-respected hospitals in the region, including Hackensack Hospital and St. Barnabas. RAS also had more fl exibility and was far less expensive than competing products. “The RAS imaging system took us less than three months to install without requiring any custom program- ming or IT involvement, which was a big selling point,” says Bowden. According to Bowden, RAS gave him a true enterprise resource with multiple functions and workfl ow capabili- ties. RAS captures, compresses and archives all scanned paper and electronic patient documents into a searchable database, which allows users access to real-time, ad-hoc and archived information in report form. At Palisades Medical Center, RAS consolidates patient data into a centralized database for processing, workfl ow and archiving. Authorized users can access reports or submit individual patient queries to the system. RAS also stores hundreds of admissions/discharge/transfer reports generated by Siemens’ Invision, Palisades hospital infor- mation system (HIS), and makes them accessible with a user ID and password, or pushes reports to recipients through e-mail.

Mission to eradicate paper a success so far Now RAS manages all patient admission and regis- tration forms for a variety of departments, including emergency, outpatient, inpatient, wound care, mental health and the sleep center. This includes any paper documents the patient brings to the hospital upon reg- istering, such as a driver’s license, insurance card, drug prescriptions, physician referral forms, consent and release forms, etc. “We now collect and scan all patient information, and it’s managed in one central place,” says Bowden. “If one of our clerks copies down the wrong insurance card number, they can go back to RAS and get the correct ID number. Using RAS, it now takes less than 30 seconds to fi nd the information needed.”

As the patient goes through clinical treatment, services

are coded and bills are dropped by Invision and circu- lated through the billing offi ce for insurance eligibility review.

“If we need to look up eligibility, we can go back to

RAS to check the electronic patient folder for insur- ance coverage and make the necessary changes,” says Bowden.

A separate process is required for the 15,000-plus patients who apply for fi nancial assistance each year. The paper charity-care forms plus all non-clinical patient information are now stored in RAS.

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Also with an average of 35 out of 100 bills being ini- tially denied by HMO and commercial payers or delayed in the payment process by the insurance carriers each month, RAS-based patient registration information pro- vides easy proof that a specifi c treatment is covered. Due to the fact that all paperwork for the patient’s episode is indexed in Palisades’s computer system, it is very easy to determine what the situation was when the patient walked in the door. Did the patient provide the correct insurance information? Did the clerks obtain a pre-cert? What were they told by the person on the other end of the phone? Also, photos of each patient are now taken at the point of registration and stored within electronic patient documents using RAS. “If we have a picture of the patient we serviced, that patient cannot deny his or her identity,” says Bowden. “Sometimes, the patient even admits to us that they know the person in the picture. That leads to a very interesting conversation!”

Document management’s future at Palisades Medical Center

By early 2011, all 64 patient registration and clinical forms will have bar codes to identify patients’ medical records, patient account numbers and form numbers (for indexing purposes). This will allow billers to scan a stack of documents in no particular order, and RAS will direct documents to the proper electronic patient fold- ers. Also by year’s end, all managed care contracts will be accessible through RAS. This year, Bowden and his team plan to scale RAS to manage non-patient information, including administra- tive management contracts, purchasing, shipping and receiving, vendor accounts payable and possibly payroll and human resource department functions. Most importantly, Bowden foresees RAS being an integral part of Palisades’ overall goal to have complete electronic medical records. “No matter how technologi- cally advanced our EMR system is, there will always be paper copies of documents that will need to be combined with the system,” he says.


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