By Greg Park

Seventy Five percent of you reading this post will experience a major system downtime within twelve months.  More than half will be down more than an hour, and a smaller percentage will experience a downtime in excess of twelve hours.

Patient perceptions, staff satisfaction, decreased revenues and adversely affected quality measures are byproducts of a major system downtime, and must be addressed by every provider.

Data and platform redundancy are obvious responses to this situation, but for many hospitals maintaining hot-sites with real-time redundancy is too much expense while managing the resources required implementing Meaningful Use of certified EHR’s under ARRA.

Hospitals without deep pockets must be creative to survive this new environment of ever-expanding technical demands and limited personnel to maintain required platforms.

Hospitals should consider that Document Management can excel as a downtime clinical and financial data repository.  Document Management platforms, like RAS from DB Technology, provides customers a platform to aggregate patient information from all platforms for all recipients without the expense typically associated with sophisticated disaster recovery models.

Hospitals that have implemented RAS have access to face-sheets, insurance data, waivers, orders and results, medication lists, allergies and advanced directives even when their main hospital information system is inaccessible.  The extent of which they aggregate data within RAS is limited only by their need, as expansion of your environment to new platforms and documents is self directed and without further professional service fees.

DB Technology has recently expanded our ability to serve customers by partnering with Bridgehead Software, a leader in healthcare storage virtualization.

If you are confident that you will be one of the twenty-five percent that doesn’t experience downtime this year, then do nothing.  If you want to perform your due diligence then consider Document Management as a platform that can replicate clinical, administrative and financial data in an easy to support environment.

Statistics compiled through the Forrester document titled “Server Availability Trends In The Time Of Electronic Health Records”

Health Data Management published an article this week about a paper data breach that hit four hospitals recently.

Four community hospitals in Massachusetts and their associated pathology practices are investigating major breaches after tens of thousands of paper pathology records were found at a recycling station by a Boston Globe photographer who was dropping off his trash.

Unfortunately paper data breaches like this are far too common.  Although they should be easy to avoid, that isn’t always the case.  How secure is your paper?  What audit procedures do you have in place to track compliance?

With RAS this process is simple.  Everything that can be captured electronically is sent to RAS and stored in a secure and encrypted system.  Any data requests are granted based on role based permissions.  All requests are tracked so you can easily determine who viewed, printed or emailed a report.  These permissions can be granted or restricted based on your organizational policies.  Your information is made available instantly throughout your organization through a secure web browser.

The dumped records appear to be pathology reports from 2007 to early 2010, which include names, addresses, dates of birth, diagnoses, insurance policy numbers and Social Security numbers.

Contact Us today so we can show you how to protect your data.  You can be live with RAS in under 30 days.

By Charlie Wilson

The dictionary describes automation as the technique, method, or system of operating or controlling a process by highly automatic means, as by electronic devices, reducing human intervention to a minimum. If you ask people to describe what automation is, you will get many varied responses.

Henry Ford’s version of automation was revolutionary in history.  By driving the manufacturing process via the assembly line, productivity was skyrocketed, employee wages were much higher than average, and Ford became a leader in the industry.  Many advances in automation have been made since the early 1900’s.

Automation in its simplest form is all about efficiency.  By taking repetitive tasks and minimizing or eliminating those tasks, people will become more efficient increasing productivity.

At DB Technology, we specialize in Workflow Automation.  Managing a business process through a series of automated steps is Workflow Automation.  I am not speaking about Business Process re-engineering.  DB Technology will enable you to improve your existing business process by minimizing or eliminating a series of tasks that your people perform today.

Make your people more efficient.  Employ Workflow Automation and give DB Technology a visit.

On Tuesday July 13 the Department of Health and Human Services released its much anticipated definition of “Meaningful Use” and set standards for electronic health record incentives.

The Medicare and Medicaid EHR incentive programs will provide incentive payments to eligible professionals and eligible hospitals as they  adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology.  The programs begin in 2011. These incentive programs are designed to support providers in this period of Health IT transition and instill the use of EHRs in meaningful ways to help our nation to improve the quality, safety and efficiency of patient health care.

The 864 page definition document will take us a few days to interpret, but at first glance it appears the government has softened expectations from the original draft. Providers who have not adopted CPOE will breathe a collective sigh of relief, as physicians can rely on transcribers to enter orders and still comply with CPOE requirements.

As we review this document in detail we will keep you updated on any information we believe is important, and please share your thoughts and ideas with me at gpark@dbtech.com.

John Wooden and UCLA basketball will always be associated with one another.  Under Coach Wooden, UCLA had the greatest success in the history of college basketball and possibly all of sports.  His teams won the NCAA championship 10 times in 12 years, 88 games in a row, and 4 undefeated seasons.  He is inducted into the College Hall of Fame both as a player and a coach.

For all of his success in the world of basketball, he has had more impact outside of basketball.  He taught life lessons to young men that translates well into lessons for all.  His lessons on being prepared are simple yet unparalleled in their effectiveness.  Start with the fundamentals, be true to yourself, and do the right thing are some of his credo’s.

Some of my favorite quotes from Coach Wooden:

• Be quick, but don’t hurry
• Failing to prepare is preparing to fail.

Below is the famed John Wooden Pyramid of Success.  It should be a model for all to follow.

John Wooden is a true American hero.  Thank you Coach.

Charlie Wilson is the CEO of DB Technology located in Clark, NJ. DB Technology is a provider of document management solutions, including document imaging, workflow and electronic forms.

The FTC has delayed enforcement of their Red-Flag regulations.  Each deadline has been delayed and providers are inconvenienced with a new false-start.  This latest delay maybe the final one as the AMA seeks permanent exclusion for physicians, dentists, veterinarians and accounting offices within the regulation’s scope.

The Federal Trade Commission said Friday it will push back the Red Flags Rule deadline to December 31, 2010, as Congress considers legislation that would affect the scope of entities covered by it.

Officials said today’s announcement and the release of an Enforcement Policy Statement do not affect other federal agencies’ enforcement of the original November 1, 2008, deadline for institutions subject to their oversight to be in compliance.

Medical identity theft is the fastest growing sub-section of all identity theft in the United States.  Adhering to the FTC Red Flag Regulations is good for patients, and provider’s bottom line.

The first area is data integrity.  Many providers utilize credit-reports to manage the likelihood of patient remittance.  The Red Flag Rules mandated providers to report discrepancies between data provided by the patients and data provided through the credit bureau.  This step protects your patient and assures accurate data is applied to your business rules.

The second area is the mitigation of insurance fraud.  When staff recognizes behaviors leading them to believe the patients presenting information are not the owner of that information, you must identify the account as a potential “red-flag” and subsequently prove or disprove the allegation.  This is good business which secures your account liability while assuring against insurance fraud. .
These practices protect the provider’s bottom line while it prevents the spread of insurance fraud.

So why is the AMA seeking to exclude healthcare? Perhaps it is fear of fees and penalties.  Or perhaps it’s a belief that healthcare is currently overrun with regulation deadlines, i.e. ICD10 and ARRA.

All hospitals should have these safeguards built into internal policies now, with or without a Federal mandate.

A comprehensive review of the FTC Red Flag Regulations can be found at the DB Technology Events Page.  Please fill in the form and ask to access the FTC Red Flags webinar within the description box.

By Phil Sullivan

Last year, John Mancini published Ten Excuses Not To Consider Document Management.  It is an excellent read and still holds true today.  The entire article can be found here but the list also appears below.

John’s Handy-Dandy, Top-10 Excuses to Avoid a Document Management Resolution#1: If we need to, we can usually find it. We usually can find the information we need when a customer calls. Sometimes it takes a while, but once we send out an email to all staff asking for the information, it usually shows up after a bit.

#2: No one will ever sue us. Who would ever want to sue us? I’m sure if push comes to shove we could find whatever we need to defend ourselves. Let’s not go looking for problems.

#3: We’ve got to pick our battles. Even if it’s true that organizations typically spend $20 in labor to file a document, $120 in labor to find a misfiled document, and $220 in labor to reproduce a lost document, it’s chump change to us.

#4: Green/schmeen. Who cares if the average document is photocopied 19 times? Not my problem. I’ve got more important things to worry about.

#5: It’s good for staff to be busy. We understand that professionals can spend up to 50 percent of their time looking for the right information. That’s what we pay them for.

#6: It’s easier to just get everyone together in person. If my staff needs to work together on a project, we find it more productive to send everybody a draft in advance and then have everyone fly in for a few days and sit together with all of the different versions and just hammer out the details. Plus everyone likes staying in hotels and having nice dinners.

#7: Our business isn’t located on a flood plain or anything. Sure, when we see all those paper documents floating around after a flood on the news, we feel bad for those people. But we’re not located in a place where disasters happen.

#8: Information security just isn’t at the top of our list. Yes, we lock the doors at night. And yes, we keep the HR files locked. And yes, we use passwords on our computers. But we need to be flexible. If people want to take information home and work on it on their home computers, that’s a good thing. We trust our employees.

#9: Change is expensive. When I need to get an invoice approved, I just put it in the right department’s mailbox at the front desk. They usually pick it up in a few days and sign it. We file it and then every few years pack up the old files and send them to off-site storage. Why spend money to automate something this simple?

#10: This information management stuff is just too squishy. Managing our financial assets is important to us, so we invested in a top-notch financial system. Managing our people is important, too, so we invested in HR systems. But information is just not as critical. And managing it seems so complicated.

If information security isn’t at the top of your list, you should call us so we can explain why it should be.  If you think change has to be expensive, let us show you how simple and cost-effective it can be to implement a document management system.

RAS has been enabling people to work more efficiently for years.  It is time for you to see the benefits first-hand.

By Phil Sullivan

ARMA International reported a very troubling healthcare statistic.  Fraud Resulting From Electronic Medical Record Theft Doubled in 2009.

Fraud resulting from exposure of health data has risen from 3% in 2008 to 7% in 2009, a 112% increase, a recent Javelin Strategy & Research report found. There were more than 275,000 cases of medical information theft in the United States last year, which means there were an estimated 19,250 cases of fraud resulting from stolen health records in 2009.

“Information such as social security numbers, addresses, medical insurance numbers, past illnesses, and sometimes credit card numbers, can help criminals commit several types of fraud. These may include: making payments from stolen credit card numbers and ordering and reselling medical equipment by using stolen medical insurance numbers,” InformationWeek reported.

As the use of electronic medical records increase, so will incidents of related fraud. Further, James Van Dyke, president of Javelin Strategy & Research, said, “We think medical providers aren’t up to the task. They won’t have security best practices in place to match the incidents of fraud, and we think theft of personal health information is going to get worse.”

An increase of 112% in one year is very unsettling.  What is you doing at your facility to protect yourself from Electronic Medical Record Theft?  DB Technology offers a Red Flag solution that allows you to verify patient photos and report suspected breaches at the point of registration.

On May 19, 2010 you can attend a complimentary webinar that highlights the Red Flag solution.  On June 1, 2010, the Federal Trade Commission will require all healthcare providers develop programs to protect against identity theft.  At the point of registration the patient’s image can be captured, stored and compared for use in identity verification.

There is still time to put your solution in place.

Phil Sullivan is the Director of Technology and Marketing for DB Technology.  He originally joined DB Technology in 1999 and is responsible for the development and execution of DB Technology’s marketing, technology and social media initiatives.

By Charlie Wilson

The best part of my job is visiting our fantastic customers.  Customers are the ultimate report card and the feedback is always welcome and needed.  Listening to the creative ways that people are benefiting from RAS always warms my heart.  Document Management has evolved and people continue to amaze me with their ideas.

This week I spent my time on the West Coast speaking with customers, future customers, and software partners.  Having lived in the San Francisco Bay Area for 1/3 of my life, it was good to be back on the West Coast.  Thank you to all that provided feedback during the customer forum.

Listening to your customers is an important part of any good company.  How does your market offering benefit your customers?  Where are the shortfalls?  Where is the market direction?  Without an understanding of how your customers are using your solutions, without soliciting your customers’ opinion of future requirements, and without an understanding of the overall market, you cannot build a roadmap for your company.

Go speak with your customers.  They are great.

Charlie Wilson is the CEO of DB Technology located in Clark, NJ.  DB Technology is a provider of document management solutions, including document imaging, workflow and electronic forms.

By Phil Sullivan

Doug Miles wrote an excellent article on document scanning and capture.  The original article can be found on aiim.org and also appears below. Some highlights that are worth noting:

• Only 38 percent of paper-originated records are scanned and archived electronically
• 51 percent of scanned documents are 100 percent “born digital,” i.e., come direct from a printer
• 46 percent of users report return on investment within 12 months, with two-thirds seeing returns within 18 months. These are consistent across many types of content and processes, with invoices, contracts and application forms being the most popular

March/April 2010

— Doug Miles

The term “capture” covers the combined processes of document scanning, image correction, recognition of text, barcodes, form fields, etc. and finally, output to an appropriate format for subsequent processing or archive storage. For 20 years or more, capture has been the entry point for document store-and-retrieve systems and increasingly for forms processing, workflow and Business Process Management (BPM). Capture may also be applied to faxes, emails, electronic documents, images and messages, but we will restrict our attention in this report to document scanning.

Traditionally, scanning and capture has been considered technically challenging. Achieving high throughput at minimum cost has required specialized machinery and skilled staff, hence the prevalence of service bureaus and outsourcers. There has in the past been some reluctance to invest in capture technology, particularly where manual keying costs have been reduced by low offshore labor rates and cheaper communications, enabling a combination of onshore scanning, with offshore remote keying into corporate legacy systems.

However, more reliable and capable scanners, more automated capture processes, and in particular, the availability of a multifunction scanner/printer (MFP) in almost every office, has led over the last five or six years to a new model of distributed scanning, local to the office staff processing the documents. In some scan-to-archive applications, particularly in professional services or healthcare, a scanner-per-desk policy can be viable.

In this report, we look at the issues and potential benefits of these different approaches, and consider the potential Return on Investment (ROI) across the more popular application areas. We measure the adoption levels of different approaches to scanning and capture, as well as the levels of success in automated indexing and metadata capture.

Key Findings

• Centralized in-house scanning and mailroom scanning are set for considerable growth, compared to outsourced scanning and capture.
• Distributed scanning on MFPs is set for some growth compared to desktop scanning.
• Also set for a considerable increase is automated recognition via OCR, ICR, etc., and automated classification.
• Despite the long term preferred strategies, sales next year of dedicated scanning hardware is set to drop, with MFPs just holding their own. Capture software and modules are the only areas of spending set to rise.
• Knowledge management in the form of improved searchability of business documents is the highest driver for scanning, closely followed by compliance and business process improvement.
• 46 percent of users report return on investment within 12 months, with two-thirds seeing returns within 18 months. These are consistent across many types of content and processes, with invoices, contracts and application forms being the most popular.
• Legal admissibility of scanned documents is still seen as an issue in over a quarter of businesses.
• 30 percent of the sample use outsourced services, citing “No staff management overhead” as the main benefit, along with cost-per-scan.
• Integrating the scanned files back into the internal system is a bigger outsourcing issue than security breaches or lost documents. Quality of indexing is an issue for 30 percent.
• 48 percent of respondents have a centralized, in-house scanning service, citing better indexing and closer integration with the process as the main benefits.
• Meeting demands for fast turnaround is the biggest issue with central scanning operations, followed by logistics and space problems.
• 78 percent of those surveyed have some form of distributed scanning via MFPs, desktop scanners or branch-office scanners. Ownership of the process by line-of-business owners is given as the main advantage, as well as improved utilization of MFPs.
• The biggest drawback of distributed scanning is training staff to index properly and maintain quality of indexing over time.
• While 32 percent of organizations report that the consumption of paper and/or number of photocopies is still increasing, this is equally balanced by those who feel it is decreasing.
• 25 percent of scanned documents are photocopied prior to scanning. Only 31 percent of scanned documents are destroyed after scanning, with a further 32 percent being archived off-site.
• Only 38 percent of paper-originated records are scanned and archived electronically.
• 51 percent of scanned documents are 100 percent “born digital,” i.e., come direct from a printer.
• 37 percent of organizations are scanning over half of their incoming documents. 12 percent scan more than 80 percent. • As regards accurate recognition and capture, on average 6.5 percent of scanned documents are rejected at quality assurance or require intervention.
• Based on the broad definition of distributed scanning to include MFPs, desk-top scanners, branch office scanning and field scanning, 72 percent of the survey sample make some use of it, compared to 48 percent who have some form of centralized scanning operation, and 30 percent who use outsourced services.

Doug Miles is head of the AIIM Market Intelligence Division. He has over 25 years of experience with users and vendors across a broad spectrum of IT applications. He was an early pioneer of document management systems for business and engineering applications, and has also worked closely with other enterprise-level IT systems such as ERP, BI and CRM. He holds an MSc in communications engineering and is an MIET.

Phil Sullivan is the Director of Technology and Marketing for DB Technology. He originally joined DB Technology in 1999 and is responsible for the development and execution of DB Technology’s marketing, technology and social media initiatives.