Creating and managing a paperless health information management department

• HIT Description: Hospital electronic health record More info...
  
• Purpose of Study: Describe one hospitalÕs journey from a cumbersome paper environment to an electronic environment and its impact and lessons
  
• Years of study: 1994-2000
  
• Study Design: Quantitative descriptive
  
• Outcomes: Impact on efficiency and costs
  

• Settings: Lehigh Valley Hospital and Health Network, a community-based health care organization in Pennsylvania, offering services at three clinical locations with over 800 combined inpatient beds.
• Evaluation Method: Observational and external benchmarking
• Description: An electronic document management system (EDMS) that includes technology to process all paper-based medical record documentation, archive images, and transfer data. Also included is a software component that allowed for parallel processing, i.e., allowing users to simultaneously complete processes without having to wait.
• Strategy: Step-by-step approach that included 1) business requirement identification, 2) cost-benefit analysis, 3) research, seminars, and tours to evaluate products, 4) system purchase, 5) system installation, and 6) system implementation. Full system implementation lasted approximately two years to get people used to the EDMS, stabilize the EDMS, streamline processes, gain benefits from the system, and for paper system to fade out gradually.
• Facilitators: The authors proposed many suggestions.
• Extrinsic Factors in valuing cost and benefits: From paper environment to an electronic environment since 1994. The vision was to improve medical record accessibility to providers from multiple locations, enhance medical record documentation, and meet consumer expectations.
• Changes in efficiency and productivity: With the electronic health record implementation and its related departmental reorganizations and work process reengineering, the organization's health information management (HIM) department decreased total staffing allocation by 27% (from 90.6 FTEs in 1995 to 67.5 FTEs in 2000) and space allocation by more than 75%. Additionally, the author listed 9 opportunities for cost reductions through improved efficiency and document management. When compared with best practice facilities, the organization realized an almost 50% reduction in labor costs per patient record.