NEA Baptist, a 100 bed hospital in Jonesboro, Arkansas, was growing and running out of space to store medical records. Their FTEs were stretched to the limit. No electronic health record system was envisioned when they opted to outsource scanning. This action turned out to be the first step on a journey of transition.
Tackling the Most Immediate Problem
NEA Baptist annually purged old records, and sent them to EDCO® Group Inc. for conversion. In doing this process, they realized two things:
- The file room was relieved of enough paper charts to create shelving space for expansion.
- Patient records were easier to locate with a computer after being converted into electronic images and stored on the network.
These realizations led to the decision to pursue an electronic medical record system.
Recognizing Deeper Issues
“Converting older records only helped us keep up with growth, but didn’t solve the real issues,” said Cindy Teague, Health Information Management Director at NEA Baptist. “We still had to deal with paper charts remaining in the file room and new visits. Having only 13 FTEs required us to constantly make time to get files on the shelves. I couldn’t dedicate people to just this task.”
While NEA Baptist benefitted from having their older records in electronic form, their incoming charts still required folders, labels, filing, and interfiling. When a paper chart was requested, it still had to be pulled and copied. Invariably, when a chart was sent to be scanned, a request was made, and it had to be returned.
To give NEA Baptist access to recent charts, EDCO began collecting records to scan once a month. The benefits of this process included no need to file new visits into an existing chart or create a new one. This reduced folders and tabs and eliminated the potential for misfiled charts.
Faster Turnaround
Eventually, Teague wanted faster access to newly completed charts. Her new goal was to have patient records in electronic form within a few days of discharge. She visited a hospital where EDCO was offering onsite scanning and saw their success.
“When you don’t have an EMR, and one is not on the horizon, scanning in-house is the next best thing,” remarked Teague. NEA Baptist decided to do just that.
“We didn’t have the manpower or expertise to scan ourselves, so we asked EDCO to move their process into our facility. We found that more cost effective,” Teague said. “They provide two full time operators and scanning equipment.”
An added benefit of bringing EDCO’s scanning team onsite is that they do not get distracted with other department projects like hospital staff. Instead, one EDCO team member can index and scan 9,000 images a day. Each EDCO team member works 40 hours per week without struggling to keep up with the paper.
Their process began when a physician completed the record. The record then went straight to prepping, indexing, and scanning. Prepping involves removing staples, unfolding pages, and anything else needed to obtain a good image. A face sheet is inserted between each account number, and the record is scanned. Using the hospital’s MPI on the scanning server automatically populated all the index information. With electronic records, loose sheets can be scanned at any time and become attached to the rest of the chart regardless of when it was scanned.
Since the files never leave the hospital, access is much easier. Now, there is no hunting for the record.
Factoring in Costs
The driving factor for scanning onsite was faster retrieval, but, of course, cost had to be considered. Initially, onsite scanning appeared more expensive than sending records offsite for scanning. However, Teague soon realized that the cost was off set by eliminating consumables such as folders and labels and, most importantly, freeing up employee time previously spent on filing. There was also an enormous time difference in pulling and sifting through paper for copying versus selecting electronic images and sending them to a printer.
After eliminating the file room, Teague converted that space into offices.
The hospital only pays for scanned images. There is no per-hour cost, no employee benefits required, and no equipment and maintenance investment.
Doing It Over Again
Teague is very satisfied with her decisions. As a safety measure, images go through a quality control process, and Teague has paper records shipped to EDCO’s underground storage facility for a designated holding period.
Future Moves
NEA Baptist was purchased by Baptist Memorial Health Care Corporation in Memphis; they will integrate with the corporation’s Horizon Patient Folder (HPF) electronic document management system from McKesson. EDCO’s scanned images will populate the data repository when it is implemented. Electronic input will further reduce the need for paper.
