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Mercy Medical Center North Iowa in Mason City, IA, used to spend a lot of time and money putting reports and data on paper and microfilm for storage and future use. Indeed, until very recently, reports generated by the hospital’s Med Series IV information systems, Shared Medical Systems billing software, and Sunquest lab management computer systems generated paper reports for dissemination to those who needed copies. Many of the reports, such as patient bills and lab results then had to be archived on microfilm and microfiche. The hospital paid a fee of about $20,000 per year for copying, and more money still in storage pace, says Maggie Herman, a systems analyst at the hospital. "We were always looking for places to store all this information that we’re required to keep," she notes.
Now, a new computer output to laser disk (COLD) system has replaced the old ways, and the hospital expects to save not only the $20,000 in copying fees, but an additional $80,000 annually, as well. The system captures internal reports generated by the hospital information and laboratory management systems and downloads them to a hard drive. This information is accessed from PCs rather than being distributed on paper. The system is also replacing microfilm and microfiche as the permanent repository for documents that must be stored. A new imaging system that will be added to the system later this year will capture digital representations of paper documents such as patient charts and personnel records and store the images in the COLD database. By eliminating the microfilming costs for these documents, the imaging system will pay for itself in the first year of operation.
There are other benefits to the new system, developed by Metafile Inc., of Rochester, MN. Because the old reports were hand delivered, there was often a delay between when a report was generated and when it reached recipients. In addition, says Herman, it was difficult to find information in stored documents.
The storage facility wasn’t in the main part of the hospital and searching among paper documents for the specific report was difficult. "One of our lab clerks had to go through 900 pages of documents at the end of every month and look for two specific charge numbers," she says. Data security was compromised by fact that both microfiche and microfilm documents could be damaged and misfiled.
Finally, this archival method affected service. When a patient or an insurance company needed a copy of a bill that had been purged from the computer and stored on microfilm, it wasn’t possible to respond to the request immediately.
These issues led the hospital to search for technology that would "let us get away from paper as much as possible," according to Herman. A team of individuals from various departments led by Herman researched the technology and learned that a COLD system would address many of the limitations of the current approach by reading the report files generated on the AS/400 and RS/ 6000 computers and distributing them over a network. It could also serve as the archival mechanism, storing the information in digital format and eliminating the need for microfilm and microfiche. An imaging system would complement the COLD system by making it possible to scan and digitally archive documents such as patient charts and employment applications that must be created in hardcopy format.
Herman’s team evaluated four vendors’ systems before choosing Metafile. One of the main reasons for the choice was that Metafile’s COLD and imaging systems shared the same database. "Some of the other vendors’ programs weren’t so tightly linked, and if you wanted to search for something, you’d have to search the COLD database and the imaging database separately," Herman explains. Metafile’s programs also seemed to be the most user friendly. They also met other selection criteria including a full text search capability, ability to work with multiple systems (such as Sunquest Lab and Med Series IV), support for different levels of security, ability to use over a wide area network, and support for a variety of storage media including hard drive, CD-ROM, and DVD-RAM.
Since installing the COLD system, Mercy has stopped printing many of the day-end and month-end processing reports and distributing them manually. The COLD system reads the files created by the information and laboratory management systems and converts them to compact, searchable files. The software automatically scans a specified location for the files, and if they are found, automatically downloads them to a Windows NT server. The information is available to hospital employees at their desktop PCs. They no longer wait for reports to be printed and distributed but can access the information almost as soon as it is created.
Reports are currently stored on a hard drive, but the hospital is eventually going to install a DVD tower to serve as the permanent storage medium. By using the COLD system and a digital archival method, the hospital has eliminated $20,000 of its annual microfiche and microfilm costs. Now the continual search for storage space is no longer a concern. Perhaps more importantly, access to stored information is almost immediate. Rather than getting up from a desk and going to a distant storage site, a user simply performs a search with MetaViewer from his desk. The system’s full text search capability makes it possible to search for a specific number or name anywhere in a document. The clerk who used to spend hours searching through 900 pages now finds the charge numbers she needs in minutes. By providing this kind of convenience to hospital employees, the COLD system is also benefiting patients, doctors, and insurance companies. When one of them has a question about a past bill, for instance, Patient Accounts employees can find the information through their PCs and respond instantly. This eliminates the time they used to spend taking down the necessary details, going to the archives to find the relevant information, and calling the person back later with the answer.
The COLD system is also being used to backup the laboratory information management system (LIMS). It makes it possible to determine patient blood types and groups when the LIMS is down. The laboratory also uses the cold system to produce reports required to comply with regulatory agencies. The hospital is currently in the process of setting up access to Metafile in remote clinics via its wide area network. Currently Mercy Medical Center - North Iowa sends via courier or faxes copies of monthly reports to approximately 40 clinic sites all across North Iowa. These clinics will soon view their monthly reports with MetaViewer resulting in easier and timelier access to the reports.
Mercy will also soon install a Metafile imaging system to digitally capture hard copy documents created by the medical records, human resources, and education departments. This will add 100 more users to the 30 who currently access the Metafile database. When the imaging system is implemented, the hospital will no longer need to make microfilm or microfiche copies of patient charts, personnel records, and competency reviews. These and other HR and Education Department documents currently account for $80,000 in microfilming costs annually. By avoiding that expense, the hospital will recoup the costs of the imaging software, the scanner, and the DVD storage in one year.
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