BY GREG PARK
Much like the blind men and elephant, you will only understand a person, place or thing when you see the big picture.
How true this is for patient care.
Your EMR is great, and better be considering its price-tag! Would it surprise you to learn it is missing 25% of the data required for a complete record? So where does this data exist? It exists on paper, locked in tertiary applications and desktops, or has been lost and never captured. This data represents the missing link in many EMR’s, and is often the root-cause for staff frustration and failure.
Lets call this data unstructured, as it is not connected with your EMR.
Providers successful at integrating their EMR with unstructured content benefit from cost savings, greater workflow efficiency and a measurable increase in patient satisfaction and quality care.
Others will spend excessive time tracking down unstructured data AFTER it becomes necessary, and by then it could be anywhere…locked in a desk…misplaced…even lost. While staff searches the EMR and other silos for this missing data, practitioners are stuck in a holding pattern because they can’t make an informed decision based on complete data.
What do you think happens when it takes too long to locate this data? Bingo, it is not considered in the decision, creating a risk for you and your patients.
Do I have your attention now?
This isn’t just a clinical issue. The inability to corral unstructured data will impede your revenue cycle. Coding and billing will be delayed because unstructured data exists outside your primary applications.
Implementing an enterprise content management (ECM) solution for the scanning and aggregation of unstructured data is the first step towards singularity, but the solution must include an ability to connect the ECM data with your EMR. Only through this integration will you achieve your desired results. Data Singularity.
When you are considering an ECM, please consider Dbtech (That was my unapologetic sales pitch – and its over!).
After selecting your ECM, catalog all data not connected to your EMR, be that on paper, diagnostic and digital images, and all the forms that are used.
Consider this step as a data gap-analysis project for your EMR. The results of the analysis will yield a road-map towards a complete patient view. It will illustrate the data entry points and location of its arrival. This analysis will help streamline patient registration, and will eliminate situations where the patient is asked multiple times for the same information. This is a good way to improve your patient’s experience.
ECM’s are to paper as CPR is to a dying man. It brings life. Documents captured into an ECM can travel and speak, and the data re-used to serve a multitude of purposes. The ECM you select should accept input from paper, data feeds from inside and outside your organization, and should provide some mechanism for electronic forms, but most importantly it MUST provide integration with your EMR.
Integration can either be push or pull. Your method will depend on your ECM vendor and organizational preferences. In the push method selected content on the ECM is given to the EMR, typically in an HL7 format. In the pull method the EMR references the ECM via indexed fields like the patient encounter number, MRN and document id. Don’t force yourself into just one method. Some documents are best housed on the EMR while others are best stored on the ECM. The discussion on which is best is one for another blog.
Your mantra must be “paper-free”. Capture unstructured content immediately, and don’t wait until it is needed. Accept that unstructured content will continue to exist, but do not accept its existence unattached to your EMR.