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EHR Money Could Lie Within Paper Records
By Ed Santangelo

U.S. hospitals spend billions of dollars annually to store and manage both paper and electronic medical records, placing a major strain on the national healthcare infrastructure. The American Recovery and Reinvestment Act (ARRA) hopes to rectify this by allocating more than $30 billion for the implementation and use of healthcare technology, including $17 billion aimed at EHR adoption.

While this promise of financial assistance and incentives will help healthcare providers begin the transition to electronic records, it likely will not be enough to support the massive investment required to complete this migration. What’s more, healthcare providers must implement an EHR system and demonstrate its effectiveness before they’re eligible for federal funding. This limited access to federal aid, combined with overextended hospital budgets and resources, requires hospitals to manage paper and film records more efficiently so they can find savings to apply to EHR transition.

Most of the dollars necessary to support the transition to an EHR already exist in the budget of large multifacility health systems. By focusing on their paper and film records —the way they are stored, accessed, and managed—healthcare systems can reduce their records management workflow to a single coherent strategy for building an EHR-ready infrastructure. This, in turn, frees existing capital for funding the EHR transition or other initiatives.

Currently, many healthcare organizations retain records in perpetuity due to overlapping and often-contradictory state laws that dictate the length of time providers must retain patient records. In fact, an AHIMA study found that more than one half of U.S. hospitals retain medical records permanently. This keep-everything practice, coupled with exploding volumes of patient information, results in the need to maintain giant file centers and, in turn, increased expenses such as labor and rent. Addressing this issue early in the transition process can help healthcare providers reduce the costs associated with the conversion process and the subsequent EHR expense, as there will ultimately be fewer records to convert and manage electronically.

Inefficient hard-copy records storage also creates a significant financial drain on current health information and records management systems. Assessing records management processes on a systemwide basis can help uncover issues that impact costs, care, and an organization’s goals. The following two steps are critical to this strategy:

• Consolidating and centralizing the records inventory reduces compliance risks and costs found in fragmented systems while ensuring cost-effective paper-to-digital conversion and continued efficiencies in the post-EHR environment.
• Establishing a unique patient identifier eliminates duplicate records, which make up an estimated 8% to 12% of a hospital’s records inventory. (Larger organizations that have been through mergers and acquisitions can be as high as 20%.)

As with storing hard-copy patient records, hospitals can pay more than is necessary for digital records storage during the transition planning process if they don’t account for streamlining digital archiving, reliable backup and recovery, and record retention. To cost-effectively manage this explosive growth of digital data, healthcare providers will need to evaluate nontraditional methods for archiving and disaster recovery, such as cloud storage. Industry analyst Brian Babineau confirms this idea in a recent report on the topic, stating, “The age of cloud storage is here; it is now secure, accessible and cost effective.”

A sound EHR transition plan can produce real savings, since an optimized records system costs less than an inefficient one and can take just six weeks to implement. In addition to the savings, the hospital will have an EHR-ready workflow for its records, ready to support the hybrid environment—part paper, part digital—of the next several years, as well as the eventual move to a full EHR system.

Properly executed, the transition process provides hospitals with both hard and soft savings. Hard savings are significant operational dollars spent on labor, storage vendors, purging costs, etc and produce direct savings sufficient to undertake records optimization. Soft savings are realized in the form of space savings, opportunity savings, and cost avoidance, among others. Together, these savings strengthen the case for self-funding.

The challenges of moving to an EHR are great but so are the opportunities. Addressing those core issues related to workflow and processes, as well as technology, offers providers a self-funded pathway to an EHR. Healthcare providers can look forward to a fully digital solution that combines all forms of medical records in a practical clinical solution that controls costs, allowing them to focus more on delivering high-quality patient care.

— Ed Santangelo is vice president of healthcare for Iron Mountain.