In August 2014 the Health Service Executive (HSE) in Ireland appointed a selection of vendor’s to their framework agreement for Electronic Document & Records Management Systems. Since then and as expected, many hospitals within the HSE are conducting their due diligence on the companies listed on that framework, and their own internal analysis to decide how as a hospital they wish to leverage the offers under this framework.

Many hospitals have immediately started thinking about their medical records. Not necessarily those charts that are in use and are live for their current inpatients, day-cases and outpatients, but rather those vast quantities of charts in both in-house and offsite archiving. This archiving is a major pain point for a large acute hospital, high costs are incurred with offsite storage units, a lack of detailed inventory of how far back the charts date and time lags for retrieval of chart for re-admissions. The high costs being an ongoing driving factor forcing hospitals to look for other solutions.

So that brings us to the ECM (Electronic Content Management) solution. This involves scanning all of the medical records in storage and also as they are created on patient discharge, so they are electronically stored/viewed and the paper version can be destroyed. There are certainly many benefits to this solution compared to the current paper storing option.

Namely, 

• Removal of the requirement for offsite or onsite storage.
• One way – once scanned the paper is destroyed.
• Easy retrieval of patient chart information on re-admission.

However this solution presents many questions to be considered, which begs the question, what problems does an ECM solution NOT solve?

• Integration – how is the scanned record linked to the MRN of the patient?
• Integration – how is it made available and viewed?
• Time difference between creation and being made available digitally – what benefit does the scanned chart bring when there is a time lag for the clinician?
• How can we leverage the content and change/add to the online content, with only a scanned image?
• How can we access the data within the record, through only a scanned image.

In conclusion, an ECM solution, while solving the problem of high cost offsite archiving of paper charts, does not ultimately solve the ongoing problems in hospitals in relation to a live paper chart. However, hospitals are slow to commence a full EMR project given the consideration of the change management required.

It is at this point that one should consider, an ECM to EMR journey.

The journey might start with a viewer/ECM solution, followed by an integrated solution, then areas of the hospital become paperless section by section, next stepping up to a Hybrid approach and ending with full electronic medical record.

This journey and the identification by a hospital that they wish to start this journey is critical when considering an ECM project. The biggest mistake the healthcare industry can make is being too short sighted, solving the high priority items but finding themselves “boxed in” with that solution and requiring a “back to square one” approach when they are ready to take the next steps.

Under this new HSE framework, hospitals should be considering, where are we now? Where do we want to be in the next year, then next three years and ultimately the next five years?

Once that question is answered, then when the hospital comes to choosing a vendor they can ensure they are choosing a solution that future proofs their five year plan and enables them to undertake that ECM to EMR journey….