TORONTO – To improve care delivery and workflow, The Scarborough Hospital (TSH) has been integrating its OnBase enterprise content management (ECM) solution with its Meditech EHR.
Patients’ paper records – such as clinician transcribed reports – are scanned directly into OnBase by Hyland and the information is directly accessible in Meditech, reducing duplicate processes.
While other hospitals and health systems across Canada are also scanning patient information to create digital records, most of them do not have advanced workflow processes in place, says Devee Perna, Manager of Health Records at TSH. Nor do they make the information easily available to other providers in the continuum of care.
“We were early adopters in completely automating the process,” said Perna. “We share information twenty-four-seven within our own organization, as well as with our circle of care providers, including long-term care facilities and Community Care Access Centres.”
In July 2015, the Health Records department further integrated OnBase records into the ConnectingGTA portal, Ontario’s regional electronic health record at the point-of-care.
Customizing document management: Each year, The Scarborough Hospital receives more than 100,000 visits to its Emergency Departments at the hospital’s two campuses (Birchmount and General), has nearly 30,000 inpatient admissions, and performs over 40,000 surgeries.
As a result, the organization generates an average of 25,000 pages of scanned images per day. Prior to the ECM solution, this massive volume of paperwork strained the ability of the Health Records department to make the documentation available in patients’ paper charts.
“Before implementing the ECM solution, TSH took time to understand how clinicians accessed and used patient information,” explains Dion Maxwell, Manager, IT Applications and Clinical Health Informatics. Once the processes and workflows were evaluated, Hyland and TSH customized OnBase to meet user needs.
“OnBase has allowed us to make changes to the way we utilize health records,” Perna says. “Now with an automated workflow, every scanned document is identified and bar coded by form and then put into a universal chart order.”
“We’ve done significant work,” Maxwell adds. “We’re not just scanning; we’re really using the software as a content management system.”
As a result, the organization has greatly reduced the amount of time required to pull files to provide clinicians with access to patient records.
“You have to measure the cost of labour,” Perna says. “Tracking down specific information is labour-intensive and document identification and a management system like OnBase saves significant time for our staff.
Immediate and long-term benefits for TSH: In Ontario, all hospitals are required to submit patient visit and clinical information to reconcile the funding they receive from the province’s Ministry of Health and Long-Term Care. Coding departments at each hospital must complete charts and submit information on a timely basis, or face penalties and fines.
Through OnBase, documents are scanned directly into the system and are available within seven days of a patient’s discharge, allowing coders to easily search online for patient information, thereby greatly reducing reconciliation delays, penalties, and fines.
For Perna, another important impact of this ECM solution is the reduction of time that physicians spend addressing deficiencies in patient charts.
Physicians must complete charts in a timely fashion, as per provincial health regulations. Patient records can be inches thick and it can be tedious and time-consuming when looking for a document, such as a surgeon’s operative note, Perna explains.
OnBase enables TSH to organize charts in such a way that physicians can click on a tab and go directly to the content they are looking for.
Signatures are also captured electronically, so that physicians are able to complete their documentation even when they are not at the hospital. As a result, TSH physician and Health Records staff satisfaction has risen significantly.
Looking to the future: TSH continues to innovate with its EHR strategy. OnBase is now being used in the Human Resources department to scan and easily retrieve employee files, and it is being implemented in other areas of the hospital as well.
In addition, TSH is exploring OnBase to allow clinicians to view patient information, complete patient charts, and capture clinical images at the point-of-care from their mobile devices.
“Our goal is to provide world-class care to the global community of Scarborough, while continuing to build on our history of leadership and innovation in health information technology,” says Perna.