The Huntington Internal Medical Group (HIMG) in Huntington, W.V., is a major regional medical provider with more than 60 licensed internists specializing in disciplines ranging from cardiology to endocrinology, gastroenterology, oncology, and pulmonary diseases. It also has dozens of support personnel, lab technicians, and a caseload of some 1,000 patients per day.

Until recently it was like most doctors’ offices – reliant on myriad paper documents to conduct business with patients, other physicians, administrators, insurance companies, governments, and other entities. Medical charts, patient data sheets and history, authorization forms, lab reports, prescription and hospitalization logs, and other documents related to patient care were created, maintained, sorted, filed, retrieved, and hand delivered to doctors, labs, and billing clerks. Then they were collected and refiled by a full-time document-management staff of 17 people. That’s a yeoman’s task by anyone’s standards and a lot of money down the drain.

It’s not hard to imagine the paper documents generated by such an operation – nor the need to reduce the paper load. HIMG began planning for the transition from an analog to a digital system about a year in advance. The impetus for the strategy was the fact that the group would be moving into a new, state-of-theart 150,000 square foot facility. Scanning and digitizing of existing paper records commenced about four months before the new facility opened.

HIMG was determined not to transfer any of the organization's tons of paper files. Indeed, the interior design of the new building provided no space whatsoever for paper-document handling and storage. So the digital system needed to be – and was – fully operational when the practice moved in.

A State-of-the-Art System
By then it had implemented a collection of specialized medical document management systems. Jonna Hughes, director of clinic operations, explains that the solution is comprised of two components. Along with Panasonic KV-S3065 and KV-S2026 scanners, HIMG deployed Sage Software's Intergy practicemanagement system as well as the Intergy EHR health record management system.

The first component, she says, “is where financial information is – billing, appointment scheduling – anything to run your practice that requires computer assistance.” The second, she explains, pertains to patients and “provides the equivalent of a chart” with a tabbed folder offering different sections for documents, scanned images sent from outside the practice, lab records, and other data and reports.

The software applications provide scalability and are thus compatible with HIMG’s large, multispecialty practice. “We are a lot larger than most physician offices, and not all systems will work for multispecialties,” says Hughes. “For instance, we have a radiology lab, and our new solution is large enough to accept the interfaces for radiology, our transcriptionists, and all the different things our specialists use. A lot of the smaller electronic health records (EHR) products will not allow you to do that.”

The scanners yield durability, speed, versatility, extended service intervals, maximum uptime, and vendor support as well as service that exceeds the industry average. The high-speed 65ppm/120ipm KV-S3065 color scanners are installed in the back office for medical billing and general business office use, while the compact KV-S2026 workgroup scanners are used in patient intake and treatment areas to capture medical records, charts, patient data sheets, authorization forms, lab reports and other carerelated documents.

To expedite automatic insurance claim submissions, optimize patient scheduling, and help manage electronic billing and payment protocols, data collected by the KV-S3065 scanners is primarily processed by the Sage medical practice-management system. Working with data input from the KV S2026 scanners, the Intergy HR (human resources) application has exceeded expectations of how much it would reduce group operating costs and streamline clinical workflow that so dramatically improves patient care.

Rapid acceptance
The solution yielded improvements in a number of areas. There were cost reductions and the improved productivity of medical and back-office staff. But going digital has also enabled significant customer/patient benefits, including the elimination of lengthy examination room wait times for paper records to be found and sent over from other parts of the facility, more accurate appointment scheduling, and improved communication between healthcare providers and patients’ insurance carriers.

Upon implementation, the Panasonic/ Sage solution proved so flexible and customizable that the vast majority of the first doctors exposed to it found it exceptionally user-friendly, time-efficient, and failsafe. So much so, in fact, that many immediately volunteered to assist in the training of other doctors in order to bring the whole of HIMG up to speed on an accelerated schedule.

Document management staff reduced from 17 to four
But the quantifiable benefits of the system are many more. According to Hughes, the Electronic Health Records system also “eliminated paper chart pulls for about for about 1,000 patients a day.” The document management staff has been reduced from 17 full-time employees to four; four storage rooms on site have been eliminated and converted to more productive use; and several thousand square feet of offsite storage space has been completely eliminated. Access to medical and billing records is much faster, and the HIMG has achieved real-time filing of many types of patient records (files go directly from examination room or lab into the medical records server), making doctors, nurses, and lab technicians far more productive.

HIMG’s reduction in document handling staff has resulted in a net, bottom-line gain of approximately $500,000 annually. In addition to lower personnel and real estate costs for storage, other very significant contributions to an outstanding returnon- investment were derived from the streamlining of such previously unwieldy tasks as patient, doctor, and lab scheduling; billing and collection services; and secure distribution of appropriate records to thirdparty stakeholders.

For instance, says Hughes, “We send all of our prescriptions electronically except for scheduled meds like narcotics. Prescriptions also go directly into the record, making it easy for our doctors to see it. We’re multispecialty so it’s not unusual for a patient to be seen in primary care, then go down the hall and see their cardiologist. The cardiologist can see what we prescribed for that patient, what tests were ordered, and everything instantaneously.”

Meeting a Raft of Regulations
Finally, the system helped the practice meet regulations that were challenging for the paperbased solution. Scanning and then shredding charts received from referring physicians and hospitals, reports from outside labs, requests for prescription refills, and examination summaries enabled HIMG to fully comply with insurance company record handling and storage requirements, federal HIPAA retention rules, and West Virginia law mandating medical records be kept in perpetuity.

This was in addition to eliminating the financial expense and administrative overhead of maintaining off-site storage for generations’ worth of paper documents. Furthermore, security protocols and backups built into the electronic process arguably provide a higher level of both patient privacy and physical security than was available with the previous paper-based document system.

HIMG is now a state-of-the-art digital operation that aids doctors in their various “paperwork” requirements, renders support staff more productive, and speeds the entire document management process so that patients get accurate, prompt care. This is how a modern medical practice should function, and HIMG serves as a commendable model for other healthcare facilities facing similar problems.

John Harney is president of ASP Watch, a consultancy for application service providers and software-as-a-service vendors.