Hospitals use third-party
providers for active file tracking

Records management costs cut with hand-held computer

Market forces are causing healthcare providers to cut services, consolidate businesses and find more cost-effective ways to deliver care. One area where healthcare is finding cost savings is in outsourced records management of active patient files.

Records management is critical because, without proper documentation, providers don't get reimbursed for services. And without timely access to patient information, providers can't make the right decisions about care.

Vernon Martell, co-owner of Southeast Records Services of Greensboro, NC, says, "We deliver to one medical facility about five times a day. A file we pick up at 9 a.m., they may need back at 2 p.m., so it has to go in and out of our system quickly. We rely on technology to do it."

Southeast Records Services is a full service records management company focusing on storage and management of hard copy and computer records for more than 150 customers. Records are stored on open shelving and also in a temperature-and humidity-controlled vault. They currently manage more than two million documents in a 49,000-square-foot facility. They also offer secure shredding and records management consulting.

To meet customer needs, the company uses portable data terminals to scan bar-coded files and a 32-bit Windows application for tracking purposes.

Bar code tracking

When files come in initially, they are assigned a unique number. The software has a built-in bar coding feature that pre-assigns bar code labels to customers. The number is printed in a Code 39 bar code (because it is easily received and read by the scanner) and in human readable form on a label. Files then are stored on open shelving or in the vault and the location is scanned, marrying the location to the file. Items are retrieved by entering the file description, for instance, Jane Smith's medical record from 1994.

The system responds with an item number and the most recent file location or file status. Any time a file is retrieved or leaves the facility, the software shows who requested the file, when it left, and the work order number. As files are returned and re-filed, they are again scanned in. Protective defaults in the software prevent mis-scans that could result in files being permanently lost, and validity checks in the software ensure that all information associated with any specific bar code is uploaded. Records for several different accounts can be handled at one time, so an employee can work efficiently in one area of the storage center. As each filing project is completed, information captured in the hand held is uploaded to the PC clone. A remote user software module permits customers to view their inventory, print customized reports, and make requests for service electronically.

"The medical industry is like any large industry," says Martell. "It is consolidating. This causes complications because, before they consolidate, they have their own individual ways of managing records, and it's possible one patient may have been seen by each doctor. They need a way to consolidate those separate records for one patient into one record."

The company has been working with one hospital to purge its medical records department of approximately 60,000 of its 400,000 files, moving them to Southeast Records' shelves. "As we remove the records from the shelf, we will scan the bar-coded medical record number on the file, using the ... scanners," Martell says. The company is using Apex II portable data terminals from Compsee and Total Recall Records Management software developed by software integrator DHS Associates, Green Cove Springs, FL.

No boundaries on customers

One measurable benefit of the system has been the ease of adding and relocating items into inventory. Previously, new files would not be available to customers until Southeast Records Services' employees performed laborious handwritten documentation and then keyed the information into the tracking system. With bar coding, information on the status of new records and re-filed records is available less than 24 hours from receipt.

Using this solution has broadened Southeast Records Services' market base "from our backyard to worldwide," says co-owner Don Keller, a certified records manager (CRM), and member of the Association of Records Managers and Administrators who serves on the board of directors for PRISM (Professional Records and Information Services Management).

By publication time, integrator DHS expected to offer customers a scan-on-demand option using a variety of image scanners. (Specific contracts with image scanner manufacturers had not been signed by press time.) This new software program will incorporate document scanning, as well as handle the document tracking tasks, etc., that the software already does. Southeast Records Services already is in the process of adding Records this function to its system.

"(Customers) will be able to call in their requests, we'll pull the documents, scan them in, customers can come in electronically through a security wall and retrieve the scanned image by a T-1 line. Someone 1,000 miles away can store their documents here. We offer retrieval in a matter of minutes," says Martell. "With Internet and intranet communications, customers can choose to use any records services company, regardless of where either is located."

Keller says business success extends beyond efficient record storage and retrieval. "You can't do all microfilm or all optical imaging, or all bar code scanning. You have to offer all types of document handling and management. This tool allows us to manage at the lowest price level and offer customers a level of technology that is unsurpassed in paper-based document handling. We can house records here, give them 24-hour access and manage the files. Using bar codes, we're saving one hospital $400,000 over five years' " To provide customers extra security, Southeast Records Services performs a complete back-up each day and ships the computer tapes out of state to a secure location.

When Keller and Martell bought Southeast in January 1997, the previous owners were using an earlier DOS version of Total Recall Records Management. Compared to other software, "The DHS software has a higher level of customer service and flexibility. Other closed-structure software would not lend itself to the Internet," Martell says. The company is working now with DHS Associates to develop future applications for the scanners, and is in the process of developing document imaging for Internet communication.

"They will have three options: we will pull the file and deliver it, pull it and fax it, or pull it and scan it and they can bring it up online," says Keller.

Bottom-line results

Changes in healthcare cost reimbursement and record-keeping requirements are placing a premium on accessing information at the same time that managed care is reducing payments to providers, forcing them to manage records carefully to get proper payment for their services.

"You've got more records managed by fewer groups of people. The way we manage those records affects the patients and the medical services companies. In today's society, where government regulations increasingly require you to keep documents, and a misplaced document can cost tens of thousands of dollars, the ability to track documents completely is very important," says Keller.

Reprinted from:

Healthcare Automation Magazine
Advanstar Publishing
September/October 1998

Vital Statistics

USER:	Southeast Records Greensboro, SC
APPLICATION:	Records Management
TECHNOLOGY:	Bar code scanning
OUTCOME:	* Files can be located easily * Movement of files tracked easily, accurately. * Easy to view files in inventory. * New or replaced files inventoried quickly, making them available for review in 24 hours. * Market base expanded. * Retrieval in minutes.

Total Recalltm; for Windows� Records Managment Software

Total RecalItm; for Windows� is the most comprehensive and simple to use records management software available. It features an intuitive Windows� interface and works with the Apex IItm; hand held bar code scanner. Using the Apex IItm; bar code terminal you can add items to inventory, temporarily retrieve items, put away items and permanently withdraw items. The program maintains a complete log of all activities. You can even send pick lists to the bar code scanner. Other Total RecalItm; features include: Over 130 standard reports for management, accounting, operations and clients; Custom report/label module; Multiple indexes for all items; Efficient work order processing; Complete retention series/retention code functions. Tracks and reports destruction dates; Extensive search capabilities, including Boolean search; On-line help and color users manual; and Billing module available for commercial centers; Client web server interface and remote access module; Tape rotation module; Customizable data entry fields and screens, and Extensive import and export capabilities.

DHS Associates, Inc. 1409 Kingsley Avenue, Bldg 3 Orange Park, FL 32073 (904) 269-5330 (V) (904) 269-8133 (F) www.dhsassociates.com