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September 29, 2008

How to Net a Document Capture System — Spectrum Health Used Five Steps to Prepare
By Michael Putkovich
For The Record
Vol. 20 No. 20 P. 10

According to the Medical Records Institute’s ninth annual Survey of Electronic Medical Records Trends and Usage for 2007, one of the most commonly cited barriers to implementing an electronic medical record (EMR) plan is the fear of a difficult migration strategy.

Implementing a document capture solution for a healthcare system can be just as daunting, especially considering it is the starting point for an EMR solution. With millions of pages to be digitized, how do organizations develop a strategy that fits their needs? What kind of preparation is necessary? How do they get everyone on board? What about costs? These are just some of the questions that HIM professionals ask when considering document capture.

The technology involves capturing paper and electronic documents and forms in a digital format, transforming content into accurate data, and delivering the results to an organization’s business applications and repositories. Document capture provides the opportunity to prepare for an EMR system or improve the current one. Incorrect preparation or a lack of employee support can lead to system failure down the road. However, if the strategy is defined and clearly conveyed to everyone involved and the proper groundwork is in place, document capture can result in significantly improved efficiency, patient satisfaction, and a robust EMR system.

So what is a good document capture strategy? Preparation is key. After deciding to move forward with a document capture solution, organizations must identify the reasons for making the transition and develop a clear, concise messaging platform to be communicated to all employees. In the case of Spectrum Health, a seven-hospital health system in western Michigan, a quality improvement process served as the impetus behind implementing the technology. The goal was to reduce the amount of manual paper processing and create a system to get the right data to the right person at the right time.

As a result of the implementation, several steps have been developed to help other organizations prepare for successful document capture.

Do Your Homework
Given that every organization has specific needs, the first step when preparing for document capture is to identify the most appropriate partner and vendor. If you have worked with a partner in the past, it is often easiest and most effective to continue working with one that knows your organization well. The technology, however, should have the capabilities to be customized to your requirements. For this, Spectrum Health turned to Kofax and its Kofax Capture technology. Having worked with the product previously, Spectrum Health knew it would be able to meet its specific needs.

For any project, be sure to clarify your organization’s needs and do your homework to find the most appropriate and customizable solution.

Assess the Situation
As early as a couple years prior to implementation, assess what paper documentation currently exists and determine why it is on paper. If there is an EMR system in place, determine why this material hasn’t been archived and whether it needs to be.

During the review process, a forms analysis will help the HIM team find ways to reduce the number of forms to be digitized. This will help make the capture process even more efficient, reducing time and saving on heavy manual assistance.

Since patient and physician forms are often repetitive, be sure to identify those that can be consolidated into one form type, complete with a bar code to simplify the capture process. Physicians sometimes create their own versions of the same form, and the HIM team should work with them to combine information fields and standardize these forms into one document type that everyone agrees on.

Certain documents, such as government-issued birth certificates, cannot be changed, and some older form types may be missing a bar code altogether. In this case, having the right technology in a capture solution that can classify forms without bar codes is extremely powerful. Spectrum Health was able to automate data capture, identify forms based on other specifications, and process them accordingly.

Find It a Home
Because you will need to get input and buy-in from users, the most crucial step in the planning process is determining where medical records will live in the EMR system. If physicians will be accessing the system, it’s important that they have a say in its arrangement.

Healthcare organizations often have medical advisory boards consisting of physicians in various specialties. These are the groups to work with when deciding where documents will be most accessible because, in the end, people want to go through the fewest number of “penalty clicks” as possible. In other words, they want to click on a minimal number of pages to reach the information they need.

However, be aware that there is a fine line to walk with this step before it becomes problematic. Do your best to determine what will meet the majority of needs but realize that you will not make everyone happy. Get proper input but find the tipping point in which there is too much information being provided.

Get Everyone on the Same Page
Reaching out to practitioners and employees regarding the forms provides a forum to talk about the strategy behind the solution. Present your messaging platform and make sure everyone involved understands the solution’s importance. To implement a successful capture solution, it is vital to clearly convey the intent of your organizational strategy.

Clinicians and other employees may perceive the strategy as an HIM solution that will change the way the medical center archives data but have little to no effect on their operations. In reality, you are providing employees with more power in the decision-making process because everything will be accessible to multiple users at all times. To secure support for the project and its future use, make sure this is communicated and the organization understands.

Provide the Tools
Training and education are the final step when preparing for document capture. Once the solution goes live, everyone should be ready to use its many features. Training courses need to be close to the launch date to keep the knowledge fresh in people’s minds. In a large organization, it can be difficult to train all the major players within a week of launch. However, the training and the ability to provide tools to keep employees fresh will secure support and full use of the new solution.

Spectrum Health recently completed the implementation of its document capture solution, which has enhanced the current EMR system and captured various forms for several departments, including inpatient, observation, emergency, and ambulatory services, with expectations to extend the technology to adult and pediatric physician practices, prenatal triage, urgent care services, and access management.