How ECM implementation reduces medical record storage footprint

Thanks to enterprise content management software, one South Florida health system has digitized numerous paper records while expanding clinical and business use of e-forms.

A previous installment of this series on enterprise content management systems for health care providers examined

how an ECM implementation addresses meaningful use requirements. There is another way that ECM software can fulfill a promise of electronic health record (EHR) systems -- reducing the footprint of medical records storage.

When Baptist Health South Florida implemented CGI Group Inc.'s Sovera ECM software in 1997, the paper situation was out of control, said Lisa Morris, corporate director of clinical business systems and revenue cycle.

At the time, Baptist operated a single facility. By the end of April, the organization will have expanded to seven hospitals, in addition to a number of urgent care centers and outpatient clinics in three counties.

"We were literally running out of space -- floor space, shelf space, etc. -- both in the emergency department as well as across the hospital," Morris said. "We were outsourcing our storage to offsite campuses and paying the fees of retrieving that information frequently, as well as the high cost of storage in Miami-Dade County, where property is at a premium. It became a very expensive venture for us."

The ECM implementation was tough, Morris said, in part because it forced Baptist to automate processes that had been completely manual in the past. That meant giving PCs to physicians -- some of whom had never previously used them -- in order to digitize document flow for inpatient care.

"We were literally running out of space -- both in the emergency department as well as across the hospital."

Lisa Morris, corporate director of clinical business systems and revenue cycle, Baptist Health South Florida

While it took energy and arm-twisting to get the first instance of the ECM software up and running, Morris said it prepared staff to deal with implementations at the other hospitals Baptist has acquired in the last decade and a half.

In that time, Baptist has been able to expand its ECM implementation "beyond just our traditional patient record" to include patient pre-registration documentation as well as the obstetrics/gynecology and employee health departments, Morris said. The ECM software also manages crucial e-forms on the business side, such as Baptist's physician contracts, she said.

Five ECM implementation tips

From Morris and Cathy Fuhrman, manager of information systems at San Diego-based Sharp Healthcare, come these five ECM implementation tips.

  • Get the legal department involved in ECM vendor evaluation, since the software your facility implements could become the de facto legal EHR aggregator. Ask legal up front what it needs from the ECM implementation to make e-discovery more efficient and complete.
  • Remember that the document database will also become a crucial disaster recovery and business continuity tool, since backups can be built offsite -- unlike paper medical records, which are grounded in place. This can be a business selling point to administrators who can't necessarily see the need for ECM software.
  • Make the ECM implementation as seamless as possible with, for example, a quick pop-up window from the EHR system that asks a user to integrate a scanned paper document into a patient's record. If the practitioner doesn't even know it's the ECM software and just thinks it's part of the medical record app, that's an indicator that the integration is pretty seamless.
  • Get references from a software vendor's clients -- and listen to them closely.
  • Begin the ECM implementation in one department at first. Once you iron out all the kinks, measure, and prove, the return on investment. "Once we did that, we [deployed in] a few more departments. After that, it caught on like wildfire," Furhman said.

Let us know what you think about the story; email Don Fluckinger, Features Writer.

This was first published in April 2011

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