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Eliminating Paper Records
- 1. Managing Paper Records Karin Ondricek Group Manager, Product Marketing Information Intelligence Group
- 2. CONCERNS ABOUT YOUR PAPER RECORDS?
- 3. Three Steps to Records Management 1 2 3 Electronic capture Automated workflow processes Physical and electronic retention
- 4. DISTRIBUTEDCAPTURE • branch or regional offices • field offices, customers • web-based scanning • scanners and mfp CENTRALIZEDCAPTURE • mailroom • dedicated scanning AD HOCCAPTURE • knowledge workers • desktop scanners Capture Anything, from Anywhere
- 6. 95% reduction in the ordering of paper and printing supplies
- 7. Hard copy responses reduced by 75%6,000 EMPLOYEES WORKING IN FIVE REGIONAL AND MULTIPLE DISTRICT OFFICES AVERAGE FOIA REQUEST IS 575 PAGES NEW YORK STATE DEPT OF HEALTH
- 15. Intelligent Data Extraction Extracts data from all document types using zonal or freeform data extraction SSN 555-44-3333 SSN 555-44-3333 Patient # 369-6123 CASE # 369-6123 Date 04/08/08 Date 04/08/11 Identifies regular patterns and data formats to increase accuracy
- 16. Automated Data Validation Agency Database SSN 555-44-3333 CASE # 369-6123 Date 04/08/11 Compares extracted data against data sources or business rules. Routes discrepancies for manual inspection
- 18. Reduce costs associated with using paper and transporting files between locations
- 19. Reduce costs associated with staff travelling to specific locations to review casesPRISON POPULATION OF 166,569, 8,000 TRANSFERS PER DAY (2009) $10.3B BUDGET AND 66,000 EMPLOYEES STATE DEPARTMENT OF CORRECTIONS
- 20. Business Process Management Orchestrate activities across people and systems EXTERNAL SYSTEMS Capture ECM Collaboration Customer Communication Record Retention
- 21. Process Automation does the work Eliminates mundane and error prone tasks, freeing people for higher-level work Provides Forms Validates Data Queues Tasks Applies Rules Performs Calculations Generates Documents Sends Reminders
- 23. Sample Process: Benefits Eligibility Applicant Provide Supporting Documents Fills out Application Automated Process Create Case File Receive Application Request Supporting Documents Notify Applicant State-wide Eligibility Database Determine Eligibility Case Worker Approve for Eligible Programs Deny Application Review/Verify Applicant Info EBT/Imaging Clerk Certify Case
- 25. Able to meet 30-day mandate for responding to applicants
- 26. Fewer welfare fraud cases abdicated due to delays
- 27. Improved information securityCOUNTY WITH THE LARGEST SOCIAL SERVICES CASE LOAD IN THE COUNTRY 63 LOCAL OFFICES THROUGHOUT THE COUNTY LOS ANGELES COUNTY DEPT. OF SOCIAL SERVICES
- 28. Security Access Control Report and Auditing File Plan Notification Storage Management Documentum Platform WEB-BASED CLIENT CONTENT SECURITY UNIFIED ARCHITECTURE Modular Records and Retention Core Records Manager Components Federated Records Services Physical Records Manager Web Services for Records Documentum Retention Policy Services
- 30. Barcode
- 31. Charge-in/out
- 32. Pass along
- 34. Security
- 35. User declare
- 36. Shredding
- 38. Holds
- 39. Audit trails
- 40. Notifications
- 42. Physical Records Services Manage storage and retrieval of any type of physical record
- 43. Descriptive file or folder labels Create and print labels directly – using NiceLabel
- 44. Embed Records within your Process and UI
- 45. Pass-Along Workflows Transfer physical records to next person in the process
- 46. Administer the entire record life-cycle Charge-in, charge-out, update location, qualify for disposition
- 48. Strengthened compliance with policy, research, and privacy regulations
- 49. More efficient patient care delivery through centralized access to information62,587 SURGICAL HOURS PER YEAR OVER 10 MILLION MEDICAL TESTS AND TRIALS MD ANDERSON CANCER CENTER
- 51. Automated processes improved productivity and reduced errors
- 52. Greater transparency and citizen satisfactionPROCURED $17B WORTH OF SUPPLIES, SERVICES, AND CONSTRUCTION LAST YEAR MORE THAN 57,000 VENDORS CURRENTLY ENROLLED ON CITY BIDDERS’ LIST LARGE CITY MAYOR’S OFFICE
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- http://www.arma.org/policy/policy/newswire/10-08-24/Freezing_Saves_Tennessee_County_s_Water-Damaged_Records.aspxFreezing Saves Tennessee County’s Water-Damaged Records August 24, 2010 Recent events in Johnson County, Tennessee, show that quick action and use of advanced recovery techniques can save paper records for future use. In this case, the water damage was caused by a broken water line that flooded the basement in which the records were stored. Quick action resulted in 230 hours of staff time devoted to removing the documents and 50 docket and ledger books from the water-soaked boxes and putting them in dry boxes. Those boxes were then transferred to Nashville, where they were placed inside a commercial cold storage facility. In a recent article in the Johnson City Press, Steve Richards, co-owner of a records storage and recovery facility in Nashville, said, “Once a document is wet you only have hours – less than 100 – to stabilize it. The only way to stabilize it is to blast freeze it. ... That’s taking it to minus-20 degrees.”The records recovery is not yet complete, however. The records will have to go through a freeze-drying process, in which the records will be placed in a specialized chamber where they will be vacuum-sealed and the moisture extracted into a gas form. This will return the records to a usable state.It is important to note that extraordinary measures needed to recover damaged records do not come inexpensively. Costs for the recovery of these records could total as much as $50,000. Staff time has been needed to rebox the records and prepare them for freezing, and transportation expenses will be incurred for shipping the records to Texas for the freeze-drying process. While it is valuable to know that water-damaged records can be recovered when needed, it is also important to note that proper storage of these records initially could have prevented the disaster. Basements do not provide the optimal temperature and humidity conditions that protect records from damage. And, as this story shows, basement locations are easily flooded. ARMA International’s publication Records Center Operations, 2nd Ed. provides guidance for storing inactive records in ways that will protect the records from unintended damage. Diane Carlisle, CRM
- Effective intelligent enterprise capture solutions support the ability to capture documents wherever they are received. First, intelligent enterprise capture solutions supports high-volume centralized capture environments. Even in distributed organizations, organizations must be able to capture very high volumes of incoming documents in a mailroom environmentSecond, to accelerate document capture, an intelligent enterprise capture solution allows front-office workers to capture documents using scanners on their desktops or shared capture devices, such as network scanners or multi-function peripherals (MFPs)Lastly, a true enterprise capture solution must support the ability to capture documents throughout the organization, from branch offices, distributed offices, and even support the ability to allow partners or customers to capture documents.
- By applying intelligent automation, enterprise capture solutions can dramatically improve capture processes. automated document classification leverages several technologies to automate document sortingBy using both graphic identification and intelligent text-based identification, documents are automatically identified, dramatically reducing or in some cases eliminating document preparation tasks.
- Even more significant is the value that intelligent data extraction provides, transforming paper documents into electronic business information. With intelligent enterprise capture solutions, zonal and freeform technologies enable data extraction from all document types. The data is automatically validated using set business rules, and performing business validations against business systems and databases, ensuring the data is extracted correctly. The result is a significant cost reduction in terms of labor, and a faster, more reliable business process.
- With EMC Captiva solutions are able to eliminate most, if not all, manual document sorting. EMC Captiva applies several intelligent document recognition technologies to accurately identify documents of all types, including structured forms, semi-structured documents (e.g., invoices or purchase orders), or completely unstructured documents (e.g. correspondence).The EMC Captiva technologies include:Full-page image techniques, where the entire structure of the page is analyzed and compared against incoming documents.High-precision anchor techniques, where unique, identifying areas of a documents, such a logo, set of lines, bar code, or other consistent elements may be matched.Text-based analysis, where combinations of keywords or paragraphs can be compared to find commonality and match document types, orHandwriting analysis, where hand written documents may be identified for further sorting.
- Helps organizations manage physical and electronic records togetherAllows administrators to have one file plan and one set of retention rules to manage all contentEnables fast and accurate search and retrieval of physical recordsProvides the ability to create a virtual warehouse structure that links physical records into users’ content management cabinet and folder structureBuilt on the EMC Documentum platformIntegrates with EMC Documentum content management applicationsApplies to legacy EMC Documentum contentDesigned to support external content managementNote to Presenter: View in Slide Show mode for animation.What is EMC Documentum Physical Records Services?Physical Records Services, or PRS provides the ability to manage physical and electronic records through a common interface with common policies.Physical Records Services makes it easy to work with physical objects within RM or RPS. Administrators can create and manage objects that represent physical items such as documents, folders and boxes. Space management features allows the creation of a warehouse which supports locations, bays, bins, and shelves. RM and RPS policies and functionality, such as promotion, disposition and holds capabilities, can be applied to physical records as well as electronic records. Bar coding enables records to be uniquely indexed and controlled by various administrators and in different locations. Bulk processing allows for executing batch processes. Physical Records Services supports the ability to handle bar coding and bulk-processing requests, including location updates, charge-ins, and charge-outs, along with running reconciliation reports.
- Pass-Alongs leverage work flow which allows for the user to notify the person who they are transferring the items to. This can be configured so that an administrator can be part of the process (i.e. declining the pass-along). Finally the recipient can approve or reject the pass-along.
- We support the ability to bulk process or update for charge-in, charge-out, update of location (move) and reconciliation reports. This can be done by selecting a file and using the Upload Batch Processing or by using a monitored folder
- In 2010, U.S. News & World Report’s “America’s Best Hospitals” survey ranked MD Anderson as the top hospital in the nation for cancer care.BUSINESS OVERVIEWFor almost 70 years, the University of Texas MD Anderson Cancer Center has given hope tothousands of patients. The hospital’s mission is to eliminate cancer in Texas, the nation, andthe world through outstanding programs that integrate patient care, research, and prevention,and through education for undergraduate and graduate students, trainees, professionals,employees, and the public. Located in central Houston on the campus of the Texas MedicalCenter, MD Anderson pioneered a multidisciplinary approach to treating cancer that includessurgery, chemotherapy, radiation therapy, immunotherapy, or combinations of these and othertreatments. In 2010, U.S. News & World Report’s “America’s Best Hospitals” survey rankedMD Anderson as the top hospital in the nation for cancer care.CHALLENGESLike other large healthcare institutions, MD Anderson has a sophisticated and complexorganizational structure with many different departments, each with its own budget andcontent management requirements. Previously, application development had been decentralized,with each department independently choosing software and deploying solutions. As a result,a wide range of document management, document imaging, and workflow technologieswere in use across the institution, with little consideration for consistency or cost savings.And the IT department was still responsible for supporting the applications once theywere deployed.“We had begun to notice that many of the projects coming through our project management officefor approval had similar business cases and functional requirements, and yet each was settlingon a different configuration of technologies,” said Patti Layne, Director of Project Support andCoordination Services for MD Anderson’s Office of Information Technology. “Systemimplementations were generally uncontrolled and at the discretion of the funding source.”TO WARD TECHNOLOGY CONSOLIDATIONFaced with the ongoing challenge of supporting a wide variety of products meeting similarneeds and an increase in project requests for document and process management solutions,the MD Anderson IT department sought a comprehensive solution. Under the guidance ofMD Anderson CIO Dr. Lynn Vogel, IT partnered with technology consultant Gimmal Group toform a “center of excellence” to bring focus to the hospital’s information requirements anddefine a new technical infrastructure. The overriding objective was to establish an enterprise-ready, highly available, and scalable foundation that could support multiple solutionsand serve multiple departments, consolidating technologies for greater efficiencies and costsavings while still offering point solutions that would meet the specialized requirementsof.individual departments.One key part of this strategy involved bringing back in house an outsourced, hosted solutionfor document image management and storage of scanned documents that supported thehospital’s health information management system (HIM)—a measure that would save MDAnderson up to $2 million annually in hosting fees.EMC SOLUTIONAt the core of MD Anderson’s new infrastructure is the EMC® Documentum® xCeleratedComposition Platform (xCP), which provides graphical, rapid application developmenttools enabling new applications to be built quickly and easily. Documentum xCP alsoincludes a unified content repository and comprehensive business process managementfunctionality. For document image capture, the MD Anderson system also includes theEMC Captiva® solution, which is fully integrated with Documentum xCP. “As longtimeDocumentum users, we were well aware of the Documentum platform’s robust featureset and its ability to interoperate with other systems in the enterprise such as MicrosoftSharePoint—so we believed it would be an ideal fit for our requirements,” said Layne.GIMMAL SOLUTIONGimmal developed the strategy and managed the initial staffing and implementation for MDAnderson’s center of excellence, establishing a technical and functional infrastructure capableof supporting multiple solutions and serving multiple departments. The primary goalwas to drive consistency and provide governance.The strategy implemented at MD Anderson reflects how information management needs arechanging in an increasing number of organizations. Traditionally, an enterprise contentmanagement (ECM) system would be deployed to efficiently and securely manage all information.However, as demonstrated by MD Anderson, there are additional requirements around howthat information is used. This pattern of work that includes the creation, routing, collaborationon, and monitoring of materials for the purpose of making optimal business decisions isreferred to as case management. Documentum xCP handles both the case management andECM needs of the hospital.EFFICIENT AND COMPLIANT MANAGEMENT OF BUSINESS -CRITICALPOLICIES AND PROCEDURESThe first significant MD Anderson application to be migrated to Documentum xCP was a legacyLotus Notes application used by the hospital’s Compliance Office for the management andpublishing of institutional policies and procedures (IPPs). Subject to audit by the JointCommission on Accreditation of Healthcare Organizations (JCAHO), as well as other regulatorybodies and grant organizations, IPPs document and standardize every aspect of the institutionfrom financial policies down to minute procedures for patient care. The policies must bereviewed annually by all key stakeholders, and the review itself is subject to audit. Thus, theeffective management of policy and procedure documents is considered a business-criticalfunction that requires iron-clad processes for updating and approval, as well as easy accessto the certified and approved versions by all impacted personnel.Previously, the Lotus Notes database had served as a centralized repository for IPPs, but didnot offer lifecycle-based security or automatic routing for review and approval of documents.As a result, the Compliance Office was having difficulty managing and approving changes topolicies and ensuring that current versions were being published. Now, Documentum xCPprovides the repository for all IPP documents and manages the complete workflow for documentsauthoring, review, approval, and publication. Reviewers are able to access the documentsvia an easy-to-use web interface based on Documentum Webtop. Documentum Site CachingServices automatically publishes approved IPP documents to the MD Anderson intranet,where employees can access the information.The IPP application has far-reaching impact within the MD Anderson professional community,with up to 10,000 users relying on the system every day to access current policies andprocedures. “By providing a secure and auditable repository for IPPs, the system has easedthe administrative burden of policy and procedure maintenance for the Compliance Office,”said Layne. “Plus, we’ve received a great deal of feedback from the users in praise of themore intuitive organization of the documents and the improved searching capabilities.”MIGRATING A HOSTED SOLUTION FOR SIGNIFICANT COST SAVINGSAND STRENGTHENED COMPLIANCEThe next—and most ambitious—application to be addressed by the center of excellence wasmigration of the outsourced solution for the hospital’s health information management(HIM) system. For many years, MD Anderson had used a hosted service for document imagemanagement and storage that supports each patient’s electronic medical record. In additionto tremendous savings in yearly hosting fees, the hospital sought to improve systemperformance and reliability, thereby reducing or eliminating down-times for caregivers andothers who need to access the medical record images. Another goal for this mission-criticalsystem was to improve work processes and productivity for the HIM department, responsiblefor processing and handling up to 60,000 pages of patient information every day.Working with Gimmal, the MD Anderson IT team completed a large-scale effort to migratemore than 75 million pages of scanned medical records documents to DocumentumxCP.,Providing automated image capture for the 60,000-image daily workload, the EMC Captivasolution automatically separates pages into multi-page medical records and delivers thescanned pages as multiple-page documents to Documentum xCP. A large advantage of thenew system is its seamless integration with the hospital’s internally developed electronicmedical record (EMR), giving more than 10,000 patient care providers and researchers 24x7access to patient records.By capturing and storing the documents as multi-page TIFFs, as opposed to the single-pageTIFFs previously managed by the hosted solution, the HIM application has delivered significantperformance improvements and has strengthened the IT department’s ability to meet importantservice-level agreements (SLAs) regarding the information’s availability and access. With theproductivity increases resulting from the new system, the HIM department is able to handlea larger daily workload and is delivering much shorter turnaround times for processingdocument images.“Much of the scanned information is extremely time-sensitive and directly associated withpatient care, so this application is absolutely mission-critical and requires high availability,”said Layne. “For instance, a surgeon cannot begin surgery unless the patient’s consent formis available in the EMR. With Documentum, we’re able to easily meet our SLA to have theHIM department receive and quality-check the paper form, prep and scan it, and make itavailable for the doctor to see within two hours of the patient’s consent.”As a result of the HIM migration, the hospital expects to save approximately $1.8 a year inhosting fees, with a projected return on the application’s investment within three years.Also, by bringing such a critical function in house and under the management of an internalrepository, the application strengthens MD Anderson’s compliance with the federal HealthInsurance Portability and Accountability Act (HIPAA). “There is newfound security in knowingthat this data is now managed by our own data center and meeting our own stringent internalrequirements for protected health information,” said Layne.“This application has had a huge impact on our operation,” she added. “Not only is there a verylarge financial driver, but we really viewed this as a ‘make or break’ application that would provethe worth of the center of excellence and help convince departments to migrate their pointsolutions to the new infrastructure. In all of those regards, the HIM migration has succeeded.”MOVING FORWARDFollowing the IPP and HIM migrations, two more significant applications have gone live withDocumentum xCP:• A system for the MD Anderson Office of Multi-Center Clinical Research, which captures andstores medical records of patients enrolled in clinical trials for which the research center isthe lead protocol investigator. Combining Documentum xCP with a fax server, the applicationhelps ensure that the hospital is meeting FDA regulations for tracking and auditing theclinical data supporting a given protocol.• An integration with a McLaren application for access and change management of engineeringdrawings for the entire MD Anderson facility, which occupies almost eleven millionsquare feet. Previously, without a centralized repository for blueprints and drawings, thehospital was required to bring in outside consultants to re-draw blueprints any time abuilding was modified. Now, the Documentum/McLaren solution offers an automated processfor making changes and managing approvals of drawings, without the expense of having tore-create information. Plus, the risk is lowered for engineers when they begin new buildingprojects or modifications, through easy access to accurate and approved blueprints.With the success of the initial Documentum xCP applications and the growing acceptance ofthe platform as the standard for information infrastructure across the MD Anderson enterprise,the original center of excellence has evolved to a more permanent, formalized applicationpractice. The IT group is now focused on managing the tide of requests that has come infrom many different departments for new applications on the infrastructure, as the popularityof the first systems has spread. Among the next application areas the IT group is consideringare a repository for departmental policies and procedures and a digital asset managementapplication, in addition to an ongoing effort to continue consolidating and migrating legacycontent management system.SUMMARYBased on EMC Documentum xCP and Gimmal’s planning and implementation expertise, MDAnderson’s new infrastructure has enabled the hospital to standardize many diverse applicationswithin a single platform. Gimmal worked alongside MD Anderson to help plan the projects,perform requirements analysis, design, test, and implement the Documentum solution.While the most tangible benefits stem from the significant cost savings of consolidating andmanaging applications (such as the $1.8 million savings in HIM hosting fees), DocumentumxCP has strengthened the hospital’s compliance with key regulations regarding policies,procedures, and patient privacy. The streamlined approach to intelligently capturing andmanaging patient information has led to new efficiencies that directly benefit care; forinstance, the ability to scan all patient information including insurance information right atthe bedside, as opposed to the former batch scanning process. With instantaneous access toinformation that is more accurate and current, MD Anderson has seen a significant decreasein Medicare reimbursement rejections.