At Hutchinson
Area Healthcare Center, located
in South Central Minnesota, the plan for information technology
includes a mandate for "less paper." Although hospitals
will always have to deal with paper in some manner, the goal here
is to seek new technologies that will reduce the vast amounts of
paper in routine work processes.
In the past, too much of the information
generated within the hospital could only be accessed in paper or
microfiche format. This was true for the clinical as well as the
financial areas of the hospital. For example, much of the
information for the patient billing office, including hospital
billing forms, patient summaries, zero balance statements, daily
posting journals and other transaction-related reporting, were
printed in data processing and sent to the business office in the
form of microfiche and paper. Billing clerks would then sort
stacks of paper reports and file them into patient billing
folders and manage the microfiche.
In order to access information from the
reports, billers would later return to the folders, search for
the correct piece of paper or go to the microfiche and try to
make a usable copy. Often, data was then re-keyed and used to
complete other routine tasks. The process was slow, inefficient
and wasteful of precious human resources.
Enhanced Capabilities
To reduce the amount of paper and fiche within
the hospital, Hutchinson Area Healthcare Center implemented the
DataStore for Windows system, developed by Hitec Laboratories. In
addition to the software's computer output to laser disk, or COLD Archiving, features, the system includes enhanced capabilities for the
electronic distribution of reports, on-line search and retrieval
of specific data elements, automated archive management and
electronic forms overlay. The system automatically downloads
reports from a Meditech System, compresses them at the rate of 30
to 1, indexes them and files them away in the correct electronic
file cabinets.
Report information is now available in an
electronic format on the local area network with standard PC
workstations.
The heaviest use of the system is evident in
the business office and billing departments. Both are areas that
have been inundated with paper in the past. Staff members now
find it much easier to search for specific information, extract
data and manipulate it as desired in spreadsheets or other
software applications.
The software captures
Meditech computer-generated
reports/documents in an electronic format and downloads them to electronic
media. Currently, electronic files are sent to both optical
platters and a magnetic hard drive. The optical platters, each
holding as much as 1.4 Gigabytes of information, are used
exclusively for archiving purposes; the optical storage media has
replaced microfiche and paper filing systems for archiving
purposes.
Both the magnetic drive and the optical
platters are used for report retrieval over the network. In this
respect, the DataStore application server acts as an electronic
repository of information from the medical records coding
software, the automated claims processing system, billing
information from the patient accounting office and general
accounting reports off the HIS system.
Primary Beneficiary
The patient accounting office has become a
primary beneficiary of the COLD technology, as it simplifies work
processes and allows the staff to become more productive. Prior
to implementing the new system, the processing of patient
accounts was labor-intensive.
More importantly, billers no longer have to
wait on microfiche production or filing before they can do their
jobs. Every night, the COLD system automatically searches for new
reports created on the mainframe and downloads them to the
magnetic disk drive, all without manual intervention. The system
also automatically archives, indexes and purges dated material.
When billers arrive at 8 o'clock in the morning, all report
information is on line and easily identified in electronic file
cabinets. Individuals with proper authorization can then access
reports and get to work.
Finding and using information had been one of
our more problematic issues. On open accounts, for example,
searching through paper and microfiche files to find information
could take anywhere from 10-to-30 minutes.
By comparison, finding documents on line is a
simple procedure that takes only seconds. Given the system's
search capabilities, information can be pulled up by any control
factor. With user-defined parameters, it is possible to search
through the index for bills in alphabetic grouping, by payers, or
by other controls such as inpatient, outpatient or ECC. Billers
regularly search for such items as re-bills, or accounts that
require special handling, such as new mothers and babies covered
by Medicaid whose claims are combined.
Staff workers in data processing have stopped
printing multiple copies of billing forms. Now, original claims
off the mainframe, as well as UB92s and HCFA 1500s that have gone
through editing software at the claims clearinghouse, are stored
electronically.
With the system’s forms overlay
capabilities, only the patient copy claim forms or claims
requiring special handling are printed. Therefore, the expense of
preprinted forms for the business office has been substantially
cut back.
With the DataStore system, the number of
reports distributed electronically over the network will continue
to grow. Department heads and support personnel will gain access
to the system, giving them on-line access to all
inter-departmental reports, accounts payable, expense reports and
other information traditionally generated in data processing.
While some of these new applications are still under
consideration, the implementation of the system has proven to be
a significant step to attaining "less paper."
Too often, discussion about the use of
information technology in Health care focuses on strategic
issues. Yet, attention to operational solutions can provide
tangible rewards. Hitec DataStore is an easy-to-implement system
that facilitates productivity gains and benefits the hospital
staff almost immediately.
