Los Angeles County Children’s Medical Services Streamlines Costly Paper Handling with EMC

Thousands of active patient cases, 65 remote locations, thousands of  documents each day, and hundreds of nurses, physical and occupational therapists. At Los Angeles County Children’s Medical Services (CMS) they receive on average 5,000 pages of documents from several providers via fax and mail each day – patient records, lab reports, claim forms and so on. Previously these documents were manually sorted and put into physical folders. That presented several challenges including the manual effort involved in filing paper, misfiled and lost documents.

To address these challenges, Los Angeles County Children’s Medical Services (CMS) worked with EMC consulting partner Burntsand to tackle the challenges in managing all the paper associated medical records. Using Captiva, the documents received by fax and mail are captured, identified and indexed. Once transformed into digital content, documents and data are delivered to the Documentum repository and securely stored as part of an electronic patient case folder. Practitioners and case managers are notified when new documents are online. The integrated Captiva and Documentum solution has truly created  a modern-age digital office for medical records.

In a recent AIIM Survey that polled 882 information and records management professionals, IT staff and line of business executives; improved searchability of business documents was the highest driver for scanning, closely followed by compliance and business process improvement. Another interesting data point was forty-six percent of users reported ROI within 12 months with two-thirds seeing returns within 18 months.

You can read more about the CMS story by visiting EMC.com and viewing the full press release and case study.

Automating the Capture Medical Claims Process – Not a New Concept, but Delivers Benefits

So what do you get when you take intelligent capture and medical claims mix them together? Simple…tangible benefits in the form of cost reduction and process efficiency.

For those who are not familiar with what a medical claim is and how it gets processed, think of  the last time you visited your physician or hospital. Following that visit a paper document (claim) gets generated which contains the medical billing information (e.g. procedure performed and amount being billed). The claim then gets submitted to an insurance company so that the physician or hospital can get paid.

CMS 1500 Medical Claim Form

CMS 1500 Medical Claim Form

Why Not transmit electronically?

In many cases, the information does get transmitted electronically but not all medical billing is done that way today and it will be some time before 100% of all medical billing is electronic.  So that still leaves insurance carries like a BCBS or third party payors with the problem on how to best capture and process the thousands of claims they receive each day.

Intelligent Capture is King with Medical Claims

There are many line of business processes you can automate with a document capture solution, but medical claims is one where the benefits standout.  The amount of data that needs to be extracted encompasses over a hundred fields (name, address, SSN, doctor ID, line item procedure and diagnosis codes, and so on).  By using OCR (optical character recognition) and applying business rules, a key part of the claims process can be automated, thereby eliminating most of the data entry that would occur otherwise.

Partners are Key

I like to think of this solution as a speciality that requires a software vendor and partner that know the medical claims process.  This is not your simple run-of-the-mill capture deployment, rather it takes a solution that has been proven over the years and a partner who has the skill set to deliver.

EMC partners like PaperFree, Paragon Solutions, and other EMC partners demonstrate that skill set. You can read about a recent win PaperFree just announced:

New West Health Services Chooses PaperFree Corporation to Implement Claims Processing Solution

Intelligent Data Capture Delivers

Intelligent capture for medical claims is key to solving what is often the bottleneck in the process where lots of data needs to be transformed into electronic informaiton.

The benefits can be significant, in fact cost and efficiency savings like 60% increase in overall productivity, 75% reduction in error rates, and 30% reduction in average claims processing cost are benefits that can be achieved.

So give it some thought.  Starting with the obvious challenges around automating the capture of medical claims data may be the way to go.

-Bill-

New Administration Pushes for Digital Health Records

With a new administration in place, a lot has been said and written about computerizing our medical records over the next several years , and to help make this a reality the administration is considering delivering some funding.  Most experts agree that digitizing much of the medical information that is currently maintained on paper will reduce costs and improve patient care.  But simply dropping a computer and a scanner on every physician and administrative staff desk just won’t cut it.

Doctors need to reap the benefits of technology without imposing an undue burden and taking time away from their main responsibilities of providing medical care. Administrative personnel need to be as efficient as possible, and require a solution that can be operated with a few button clicks, allowing them to get their job done quickly.

With that said, a key piece to digitizing information and more effectively managing paper based processes is to use document capture.  Capture solutions not only convert paper into electronic format but can automate most if not all aspects of the capture process including classifying what type of document it is, reading the data off a form, validating the information, and finally delivering it into a content repository and other medical systems. Those elements are important because it saves time and money during the capture step and makes people more effective at their job.  Without an “intelligent” capture solution, users are often left to manually classifying documents, keying data, and hoping they did not accidentally make a mistake along the way.

Another key element to capture in our hospitals and physician offices is the concept of distributed capture. Hospitals and medical groups are often distributed among many buildings and locations. Therefore the need to provide capture at the point of entry is critical so that the information can be processed and delivered into the appropriate systems in near real time making it instantly available to others who can then utilize that information to make informed decisions.

So where can you use this technology? Many medical departments can use capture, including physician practices, inpatient, observation, emergency, ambulatory services, urgent care services, and more.  Forms and processes could include automating the capture of patient registration forms, medical history, encounter forms, insurance cards, release forms, and more.

It all sounds good, so is there anything we need to be concerned about?  Well patient privacy certainly is a concern for consumer groups. There is fear that without adequate safeguards medical information could be misused or inadvertently released. The fears are valid but with proper planning, the right software solutions to manage and secure the content, well documented procedures and processes, we can overcome those fears. 

There will always be those privacy concerns, but there can be an appropriate balance between protecting privacy and being able to deliver high quality care in the most efficient manner. Change is good especially when it reduces costs and makes things more efficient.