The concept of a stand-alone surgical center is a relatively new one. The SurgiCenter of Baltimore—the first freestanding multi-specialty surgical center in the country owned exclusively by physicians—was conceived in 1989 by a group of physicians intent on providing a better surgical experience for their patients. The SurgiCenter of Baltimore later took on Lifebridge Health and HealthMark Partners, Inc., as partners.

The SurgiCenter performed its first procedure on May 22, 1989, and hasn’t stopped since. “We have 100 doctors and 35 staff members working together to provide superior patient care, with over 20 procedures performed on an average day,” says Jeffery Johnson, systems information specialist. “That creates a lot of information to manage.”

Relying on paper patient charts, however, was limiting staff’s ability to efficiently share that information. “Too many people needed records simultaneously, including clinical staff, the billing department, auditors and the medical records technician, who needed to file reports that came in days later,” Johnson says. “Staff didn’t take the process seriously, and there were constant filing errors.

“Around 30 charts per month were checked out just for auditing by anesthesia and nursing staff,” he continues. “If the charts were unavailable or incomplete, the billing department couldn’t do their work. And to make matters worse, we were more successful than expected—over a five year period, our case load grew from 5,300 to 8,600.”

Too much success is a nice problem to have, but the SurgiCenter faced its biggest challenge in managing paper patient records. The cost of storing records was rapidly increasing, and keeping up with records retention requirements was a burden. “Offsite storage was 5 miles away, so we were paying to store the records and wasting man-hours to retrieve them,” Johnson remembers. “Even before HIPAA passed, we knew we couldn’t maintain records integrity and patient confidentiality with paper records. We knew something had to be done.”

Staff initially considered implementing an electronic medical record (EMR) system, but rejected the idea because commercial systems didn’t meet the SurgiCenter’s needs. “As a surgery center, we typically only see a patient two or three times, so we didn’t need the functionality of a traditional EMR—not to mention the expense,” Johnson says. “We knew we needed to move to electronic record keeping, however, so digital document management seemed to be an ideal solution. We could eliminate paper, secure our records and easily locate information, which was just what we needed.”

When Johnson took over the medical records department in 1996, he agreed to manage HIPAA compliance only if he could deploy a digital document management system. “We experimented with another product that didn’t scan efficiently, wasn’t user-friendly and had poor retrieval capability,” he explains. “The clincher came when the manufacturer phased out the application, and they wanted us to purchase their replacement product. That’s when I began researching other document management applications and found Laserfiche®.

“We selected Laserfiche because we needed a solution employees would learn quickly,” Johnson continues. “We liked the quality of the scanned images, and the processing speed was superior. We also liked that we could run audit reports for accountability. Laserfiche had everything we needed.”

Implementation went quickly, with the repository going live after only one month of testing. “We initially scanned in three years’ worth of records,” Johnson says. “In phase two, we scanned another four years’ worth of records—about 31,000 medical records in all.”

Currently, the SurgiCenter uses Laserfiche to streamline workflow throughout the life cycle of patient records. When a patient pre-registers, staff create a paper chart that includes a bar-coded face sheet. After the patient’s procedure, they scan the chart into Laserfiche, using Quick Fields™ and Bar-Code Recognition™ to automatically create the digital patient record and populate each document’s template fields, simplifying indexing and chart retrieval.

The SurgiCenter’s billing department also uses Laserfiche to manage explanation of benefits (EOB) forms. Quick Fields automatically fills in the payor and date for each EOB in the associated template, which aids in tracking and retrieval. “Laserfiche has brought greater efficiencies in all departments, but especially in Billing,” Johnson says. “We’ve seen much faster claims processing and collections.”

Perhaps most importantly, Laserfiche helps the Center remain compliant with HIPAA regulations. “With Laserfiche, we can log in requests for records, track due dates and redact sensitive information, fulfilling release of information requirements. We also use the Audit Trail™ module to safeguard patient privacy,” Johnson explains. “Our administrator serves on a national HIPAA compliance panel, and she frequently invites confused hospital administrators to see how Laserfiche helps us meet these challenges.”

The Center also must remain compliant with Association for Ambulatory Health Care (AAHC) regulations. The AAHC conducts on-site evaluations every three years, and audited the SurgiCenter just a few months ago. “We passed with flying colors,” Johnson reports. “In a typical audit, they request random charts, but on this last audit, they got very specific, requesting two charts of patients who were also Wards of the State. This isn’t information we track, so it would normally be very difficult to find.

“Thanks to Laserfiche’s full-text search capabilities, we located these charts very quickly,” he continues. “The auditors also requested charts of cancer patients, which we found just as quickly. Needless to say, they were duly impressed.”

Laserfiche also helps the SurgiCenter easily complete state-mandated quarterly pathology reports of cancer quantities, broken out by type. “As you can imagine, this data was quite difficult to flag and track with paper, but with Laserfiche, the staff person simply searches on the specific cancer—like melanoma or carcinoma—for the relevant time period, and the results are right there almost instantly,” Johnson says.

The best thing about Laserfiche, according to Johnson, is that the Center can manage patient records with fewer staff members. “Before Laserfiche, we had separate departments for surgical scheduling, patient registration and medical records. We’ve merged the three departments and eliminated the medical records clerk position,” he says. “We originally had three scanning clerks, and when one left, not only did we not have to replace her, but the remaining two were able to take on scheduling and records management duties. We’re now down to a single full-time scanner.”

But Laserfiche has delivered more than easier compliance, faster reporting and staffing efficiencies. “We’ve had a lot of benefits that we didn’t expect,” Johnson says. “We used to have constant friction among departments who needed the same records or who were looking for missing records, but with Laserfiche, everyone who needs a chart can always find it. It’s dramatically improved the working relationship between departments.”

Johnson doesn’t hesitate in recommending Laserfiche to other ambulatory surgery centers. “In practical terms, we’ve reduced costs, improved collections and established peace of mind when it comes to record keeping,” Johnson says. “You can’t go wrong with Laserfiche.”

Tags: Healthcare, medical billing, surgery centers

Posted on Tuesday, May 20th, 2008 at 3:44 pm under Customer Stories, Healthcare. You can comment on this article. trackback from your own site.