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Electronic document management is improving Denmark’s largest hospital
Odense University Hospital (OUH), one of the largest hospitals in Denmark, with 7,500 staff and more than 1,000 beds, is located on Funen in the Southern Denmark Region. Each year, the hospital handles 350,000 admissions, 60,000 A&E visitors and 488,000 outpatients, providing care 24 hours a day, seven days a week.
With medical records storage occupying seven kilometres of physical space, OUH needed an electronic document management solution capable of reducing the cost-intensive storage of paper and supporting electronic medical records (EPJ, in Danish). OUH’s requirements included the following points:
- Electronic medical records and associated documents had to be accessible on demand and securely via the Internet at all times of the day and night
- The solution had to comply with national legislation on the storage of medical records and patients’ personal information
- OUH wanted an electronic document management solution that would allow easy integration with any medical records system at all, including systems that might become necessary in the future.
OUH approached OnBase, asking about an Enterprise Document Management solution. OnBase, developed by Hyland Software Inc., is an integrated information platform comprising ECM software solutions, including core functions for scanning documents, electronic document management, workflow, COLD/ERM and document management.
The web-based OnBase system gives authorised, approved users access to view documents in all file formats securely and instantly from any location using the secure web client. Because OnBase documents are electronic, the hospital benefits from secure access to the desired documents any time and from any location, even in sterile environments.
INSTANT, WEB-BASED DOCUMENT ACCESS ADVANCES PATIENT CARE WHILE REQUIRING MINIMAL MAINTENANCE
OUH allocates the patient’s CPR number as the keyword for all documents associated with that patient’s medical record. This keyword can be used to immediately find the necessary documents.
Furthermore, multiple users can look at a document at the same time. Electronic documents contain a history for each user who has viewed or modified the document. “You couldn’t see fingerprints on paper medical records, but now all medical records have an audit trail,” says Jette Kotsis, section manager at OUH.
With instant access to the desired documents and a reduction in labour-intensive procedures in place for document management requirements, OUH is able to reduce patient waiting times and make room for private visiting areas at the hospital in the space previously occupied by paper storage. “OnBase makes document access 64 times faster than with paper,” Kotsis says. “Before OnBase, it took staff seven minutes to fetch the necessary documents; with OnBase, documents can be retrieved in seven seconds.”
By eliminating tasks that required a lot of paper and thus upped the amount of time and money spent on patient contact, such as filling in paperwork or manual fetching of paper documents, OUH has been able to move many secretaries from all departments to other secretarial openings where there is a need. Furthermore, storage space in hospitals is very costly, so the very act of eliminating seven kilometres of paper medical records was worth a great deal.
Paper documents are scanned into OnBase using two Eastman Kodak i640 colour scanners, so staff at all hospitals in the Southern Denmark Region have instant online access to documents as soon as they have been scanned or imported electronically. The documents scanned include all types of record documents, transfusion records and laboratory results from the Department of Clinical Immunology, the HR department’s staff records, and invoices. “We have guaranteed, secure access to patients’ medical records when we need them,” Kostis says. “The medical records are always accessible, because working with OnBase means we can grant multiple users access to the same medical records at the same time.”
Unlike OUH’s previous document management system, which had client software for use in document searches installed at all workstations, OnBase can be updated on the server rather than on more than 2,000 IT workstations.
ONBASE, WHICH IS GRADUALLY BEING ROLLED OUT TO MORE DEPARTMENTS, REAPS THE BENEFITS OF CENTRALISED MANAGEMENT OF METHODS
In Odense, OnBase was initially chosen for the system’s capacity for web-ready document management, but its implementation has now been expanded to include additional administrative needs and requirements for handling medical records at the hospital.
Furthermore, it is not necessary to scan documents in order to import them into OnBase and achieve instant online accessibility. In Odense, they import other objects directly from CDs onto OnBase, including applications, digital photos and course materials for the doctors’ continuing education centre, Center for Lægers Videreuddannelse.
Optical character recognition (OCR) is used in the Medical Records Research Department to quickly locate information in questionnaires, eliminating the need for doctors to maintain their own research databases.
Other business processes which are being handled via OnBase at present include a workflow intended to ease negotiations between trade unions and the hospital, and a plan to deal with matters of staffing and personnel. The need to train users who are involved in all these OnBase processes was minimal. “It’s a very user-friendly system,” Kotsis explains.
ECM SUPPORTS ENVIRONMENTAL INITIATIVES IN DOCUMENT-BASED DEPARTMENTS
Implementation of OnBase and Cosmic (OUH’s medical records system) supports eco-friendly, “green” initiatives, as electronic documents reduce the costly impact of paper in connection with documentation-based processes. Using electronic documents reduces resources and costs associated with printing, storing, sending and producing paper.
INTEGRATION OF MEDICAL RECORDS PREPARES US FOR COMPLIANCE WITH FUTURE NATIONAL REQUIREMENTS
OnBase integrates with Cosmic, so OnBase documents, including digital photos, X-ray images, correspondence and videos associated with patients’ medical records can be accessed directly from Cosmic. Integration with Cosmic provides a means of accessing necessary documents without a steep learning curve. Staff can log on to Cosmic and retrieve all the necessary documents directly from the Cosmic interface. Only one version of the document is stored, but this can be accessed simultaneously by multiple users at many different locations.
It is likely that a joint model will be deployed to enable integration that complies with all requirements across all medical records systems in Scandinavia, and this requires all hospitals to have their documents in electronic form. Using its Cosmic and OnBase solution, OUH is leading the way when it comes to being prepared for any future requirements for national electronic medical records (EPJ).
To comply with current national legislation on the storage of electronic documents, OUH uses OnBase CD Authoring to create a record for the purpose of data restoration in the event of an IT system breakdown directly from the OnBase system.
Healthcare professionals from all over Europe regularly visit Odense to observe OUH’s forward-thinking processes, and many apply the hospital’s successful methods as a model for ideas to implement in the future with a view to streamlining processes and improving patient care with the help of a real, future-oriented electronic medical records system. Kostis emphasises that “all hospitals should have a system like OnBase.”
“OnBase makes document access 64 times faster than with paper. Before OnBase, it took staff seven minutes to fetch the necessary documents; since implementing OnBase, documents can be retrieved in seven seconds. All hospitals should have a system like OnBase”
- Jette Kotsis, section manager
Using electronic document management, Denmark’s biggest hospital, Odense University Hospital (OUH) is able to improve patient care by reducing waiting times, increasing staff job satisfaction with instant access to necessary documents, and reducing labour-intensive procedures in relation to compliance with requirements for medical records.
- Treatment of more patients without requiring extra staff or resources
- Better utilisation of limited and costly hospital space; the space previously occupied by storage provides extra wards for undisturbed patient care
- Authorised healthcare professionals can search within the necessary documents in connection with the patient’s electronic medical records 64 times faster than when using paper processes
- Staff can access information directly from Cosmic in just seven seconds, compared to seven minutes prior to implementation of OnBase
- Elimination of paper-intensive searches and archiving, which increased the time spent and the costs associated with patient contacts, and reassigning of secretaries from all departments to other necessary secretarial openings
- Staff have access to documents immediately after scanning or import into OnBase; multiple authorised staff can view documents simultaneously from anywhere, even in sterile environments, using secure Internet access
- Reduces costs and supports environmental initiatives by minimising the paper production, printing, storage and sending associated with paper-intensive, document-based processes
- Complies with national requirements for the storage of documents, which require hospitals to retain medical records for 15 years
- The hospital is well equipped to comply with future national requirements relating to electronic medical records
- Medical records
SUPPLEMENTARY PRODUCT INTEGRATION
- OCR to AnyDoc™
- Eastman Kodak® i640 scanner