Many HIM professionals are already scanning medical records to an electronic archive. According to the January 2004 Healthcare Information and Management Systems Society (HIMSS) Analytics database, 61 percent of hospitals report having some form of scanned or imaged records. A subset of these, perhaps 20 percent of hospitals, have installed a complete electronic document management system (EDMS).

However many organizations, particularly in smaller health care facilities, are just getting started. North Valley Hospital in Whitefish, MT, is a small, rural hospital that waited - until now!

Perhaps, like me, your HIM department is just getting started with the migration from paper to electronic records using electronic document management. If so, this monthly column is for you! Throughout 2007, I will be sharing my experiences, insights and tips through this online diary. Visit this column every month to hear about the good, bad and the ugly of our implementation process.

My goal is to help other HIM professionals successfully move to electronic environments. Even if you are a small hospital, today's document management systems are manageable. As my counterparts at larger health care provider settings have learned, the advantages you gain when records are scanned, archived and available electronically are tremendous. Now is the time for all organizations to experience the advantages - regardless of size!

Where is North Valley and Why EMDS?
With only 25 beds, North Valley is a critical access hospital (CAH) located in northwest Montana. Close to the Canadian border and Glacier National Park, North Valley is in the process of building a completely new facility. We will relocate to the new location in 2007 and, in preparation for the move, we need to completely eliminate paper medical records. Why? Because the new HIM department has very little storage space!

North Valley is also a Planetree® Hospital. The Planetree Model is patient-centered rather than provider-focused, and is committed to improving medical care from the patient's perspective. It empowers patients and families through information and education, and encourages "healing partnerships" with caregivers. All patient-facing areas such as patient rooms, waiting areas, etc. are open and provide expansive views of Glacier National Park. In the business and operational departments, however, the focus is on efficiency.

Business office, HIM, materials management and other operational areas have limited space, especially for storage. While the promise of a new, high tech, facility is exciting news for the residents of our community and our patients, it is creating a great deal of stress for me and my staff. It means that electronic records aren't an option-they are a necessity! Beyond the upcoming space limitations, I identified several other business problems that would be solved by a complete EDMS:

-          Need to move clinical data into long-term archive. Clinical documentation is electronic through hospital information system (Meditech®).
-          Need for electronic storage in business departments such as human resources, business office, etc.
-          Streamline claims submission process.
-          Improve customer service and reduce paperwork at point of registration.
-          Better manage and access ancillary documents (e.g. EKGs).
-          Support younger medical staffs that are already electronic.

With a list of business problems in hand, our chief executive officer blessed the project, and we have the approval to proceed. The first step in my journey is to establish a core team and find a system to accommodate everyone's needs.  

Dear diary, originally I thought our upcoming move to a new, paperless HIM department would be justification enough for our EDMS investment. But once other departments realized that they too would have limited space for document storage, our needs grew.

This month, we created our evaluation team, which consists of business office manager, acute care manager, information services (IS) manager and me. We decided that other stakeholders in the process could be included on an "as needed" basis. These adjunct members include representatives from materials management, human resources, fiscal services and administration.  With the team in place, we created a high-level list of EDMS criteria to meet our organization's specific needs.

High-Level Vendor Criteria:

-          Meet everyone's needs (not just HIM or business office).

-          Implement quickly (so we could move into the new facility).

-          Complement and interface with our Meditech hospital information system.

-          Provide flexibility for customization (primarily for interfaces).

-          Have a proven track record with positive, successful client relationships.

Once we had all agreed on the high-level list of requirements, it was up to each team member to work with IS in creating a more detailed list of system features for his or her department. By the end of the month, the team consolidated our wish list into a two-page review sheet that we'll use for upcoming demonstrations, presentations and reference calls. We made a lot of progress in a short amount of time.

The greatest lesson I learned this month was to always look at the bigger picture. EDMS is not just about HIM's needs, it's really a solution for everyone.

Teaser for next month:
In February, join Traci as her evaluation team begins meeting with vendors, watching system demonstrations and making the tough decisions.

Traci Waugh is director of health information and compliance at North Valley Hospital, Whitefish, MT, and a client of SDS.