By Cindy Atoji

April 1, 2008 | In the paper-intensive health care industry, having an efficient document management strategy can cut costs, help ensure regulatory compliance, and increase productivity, says Valerie Mason Cunningham, vice president of Xerox Global Services. Cunningham says the key to smart document management is implementation — changing paper to digital workflows where possible, and consolidating business processes. Cunningham, who is part of Xerox’s health care division, spoke with Digital HealthCare & Productivity about winning the paperwork battle.

DHP: Let’s start with the bottom line. What kind of ROI can be achieved from document management?

Cunningham: ROI varies depending on situation, but one example is the VHA-member organization, Texas-based Baptist St. Anthony’s Health System, which was able to reduce print-related costs by 90 percent. We evaluated its multi-vendor printing and copying operations, tracking how and when copiers, printers, and fax machines were used throughout the organization. Appropriate print jobs were re-directed to the multi-function systems, saving the Baptist St. Anthony nearly $200,000. Baptist St. Anthony’s is also achieving brand consistency throughout its 16 health care locations, standardizing documents and forms, and printing them on-demand. Xerox and business partner Siemens also developed a HIPAA-compliant bar code system allowing Baptist to track, index, and file clinical documents and forms.

[Few institutions] understand the full cost of document management accounts — they can give you their printing costs, but can’t tell you their warehousing costs, updating costs, and how many people have to touch or find the information. This can get into real dollars saved that can be reinvested into other projects. ROI can be immediate for some and in other cases [over a] period of time. There’s no cookie cutter approach.

DHP: How does one get to this kind of ROI and why aren’t more organizations doing it?

Cunningham: Having an effective document management strategy is the starting point. It can help streamline business processes, like form management, or maximize efficiencies in areas like imaging and archiving. You can minimize document costs, as well as waste and storage expenses. Many organizations don’t think about what happens when you have all these forms and documents in your facilities. And you have to make sure you are HIPAA compliant and that there is no risk as to where the documents are stored.

Health care organizations should evaluate their processes and look for areas of improvement. This can help identify solutions that make sense. Then you can put tracking and scorecard tools in place so you can monitor your progress going forward.

DHP: What are examples of document processes that can be evaluated?

Cunningham: You can observe how the information and documents flow in a particular department or environment. For example, if you’re looking at the nurses unit, you can watch what documents the nurses are trying to retrieve; how often they need to retrieve them; whether these documents are readily accessible, and who else has to touch it once they’ve done something with it. You can look for ways to take added steps out of process to give them more time to take care of patients and respond to doctor requirements. This can also be done with clinical or back-office operations such as human resources, procurement, and storage and production centers.

DHP: How can document management help organizations stay environmentally friendly?

Cunningham: Energy Star offerings and office device optimization can help reduce energy use, such as equipment and software designed with features that allow institutions to make efficient use of paper. An example of this is two-sided or duplex printing to save on the number of pieces of paper that are used for printing.

There are also software applications, digital workflow products that facilitate the electronic data management. So you can scan hard-copy documents to email addresses or repositories, FTP folders, web URLs, or remote printers. Or you can print on demand, and distribute the print workflow, cutting down on paper consumption.

DHP: Security and compliance are top of mind in health care. How can companies address these issues in a paper or digital workflow?

Cunningham: Services and technologies should be fused with security at every level. For example, secure access unified ID systems can help health care companies keep sensitive documents and records safe. These can combine a card reader and software for users to access products securely — swiping or waving an ID card can secure people from using it. For additional security, the software can also have embedded in it a pin or pass code so you can track users. And all this can sit on the network in a secure-access equipped multi-function device.

Multi-function technology can also allow for secure scanning that meets HIPAA needs, requiring controlled access to protected or patient data. Through features like image overwrite, confidential data can be kept safe by electronically “shredding” information stored on a device’s hard disk, on demand or automatically upon the project's completion.

DHP: When will health care will be able to move from a paper society to a digital workflow?

Cunningham: I don’t think it’s going to happen anytime soon. Twenty years ago, there were predictions that we would move to a paperless office by the end of the 20^th century, and today we’re generating more paper today than ever.

I believe we’re getting there but what we need to do is understand how to bring the paper and electronic worlds closer together, because right now we’re doing things separately to address those two worlds. But when we start pulling them together, there is opportunity for interoperability to take place between the two worlds.