Summer's over. 

My daughter's trying to decide on a college.

I'm trying to decide whether to bag or mulch.

My daughter wants to go out of town, and I just want the leaves to go away. The decisions of life are all important, depending on your perspective. And healthcare facilities are no different.

More hospitals are implementing document management and document automation. Why? While forms seem as numerous as the fall leaves, it is increasingly important to sweep them into piles, mulch or bag them and make most of them go away so that your yard grows in the coming seasons. Ultimately your goal is about more than the bottom line: it's about patient safety, minimizing risk, and meeting the regulators' demands.

I'm pleased to report that business is booming here at FormFast. And our Fall, 2003 newsletter is filled with topics that address these issues with information you can use-at your facilities-today. I also want to give you a heads up about a new product we've developed, called Web FormFill. It does what the name promises: companies can post forms on the web, so that staff can retrieve them, fill them out, and send them to the appropriate next stop along the way. Not only does Web FormFill insure fast, reliable information processing, but also like all our automated products, it saves valuable resources-and that saves money.

Watch for an e-message about Web FormFill in the coming weeks. And if any of you have any ideas how to keep my daughter in town and export my leaves, let me know.

Rob Harding, President
FormFast, Inc.

Today individuals and companies have access to more information than at any time in history. Managed well, this information can help a business to prosper; however, managed poorly, information can drain a company's productivity, increase its exposure to risk and waste expensive resources.

Getting a handle on the vast and ever-growing world of information is no small task. Managing document repositories, process workflows and controlling retention are just a few of the tasks facing modern companies. Undertaking this complex challenge requires a comprehensive approach for managing your information and the ability to let go of outdated assumptions and procedures.

Let's consider the documents themselves. According to Al Morris, document management consultant, when we talk about “documents” we're including email, internal forms, external forms, letters, contracts, computer reports and other media sources such as voice mail, teleconferences and even video conferencing. Managing how these documents/information are proliferated and utilized presents unique challenges. “One common problem centers on making sure all company employees are using up-to-date processes for a given task,” says Morris. “This is where web-based technology can prove very helpful,” he adds. For example, he recommends companies consider establishing their policy and procedure documentation and related forms and reports in a common company intranet strategy (web site). “That way, employees are always assured of using only the most current (and therefore, accurate) version of a company document. “There's only one copy to worry about with this approach,” he explains. “And when it's expired, it can be replaced, deleted or archived as the policy dictates.

Document management also incorporates “process issues.” According to Morris, a business must not only concern itself with the creation of its documents, but also with how they are used and their demise. “Let's use the example of email,” he explains. “An email is created by an employee who is on a company PC attached to a system server which performs a nightly back-up. The email is sent to a recipient, perhaps on a different system server and at a different company via an email service provider. The second system server and the email service provider also create nightly backups which are held on tape for thirty days. The email recipient receives, reads, forwards a copy to a friend and then saves his email. Is it printed and filed? How many times? Is it copied onto a hard drive? How many times? Now add an attachments to the email in the above scenario” In short, a “private” document may not be as private (or as secure) as you'd like to think. While a document is “out in the world” it can undergo a major metamorphosis: Comments written by an interviewer in the margin of a job applicant's application, copies of contracts, even preprinted slogans on a company letterhead or verbiage on a forms can make statements that protect a company or expand its vulnerability.

Equally important is the matter of document retention. Observes Morris,” The time people and companies are the most interested in document management is when the possibility of litigation exists. Every company should be interested in document management up front.” It's not just a matter of “electronic filing” of forms, “You need to have the information linked to document management systems and your database(s) systems in a meaningful way. You must have a methodology for retrieving this information for reporting as and when needed,” he adds.

All documents have a retention period. “It's necessary to keep documents long enough, but not over what's legally necessary,” advises Morris. That's easier said than done, with regulatory agencies that can demand the retention of documents for up to 40 years. That's where electronic document management systems offer some real pluses. Not only do they eliminate the vast amount of warehouse space that years of physical documents can require, but they also offer some real safeguards for companies. “Once a document is stored in its repository as final, it doesn't change. And with search engines, the problem of misfiled or lost documents can be greatly reduced if not eliminated. “If you're wanting to review a completed and finalized contract from a year ago, you don't have to hope someone kept a hard copy or filed it in the right place. It's there,” explains Morris.

So how does a company address such a far-reaching and complex issue? This is where the “management” aspect comes into play. “A company needs a standard process for forms and document management,” says Morris. “It also needs designated staff to manage the process and its related document repository(s).” He adds that companies often utilize the services of a Registered Health Information Technician, certified by the American Health Information Management Association. This person, professionally credentialed by the state, keeps up with the legal regulations affecting document creation and retention. “By being able to define the legally required retention period for a document, this person will be critical to allowing for the deletion of documents thus managing the repository(s),” says Morris.

Document management is not just a good idea; it's a significant cost saver as well, according to Morris. “It's not uncommon for a company to use 500 of more unique forms with a larger number of documents defining procedures. When you consider the cost of printing, storing, and managing physical documents, it can be extremely significant,” he says. What's more, if the documents represent duplicated effort or outdated information, the drain on staff productivity can also place a major burden and/or risk on a company's resources.

But just as the challenges surrounding document management are complex, so are the solutions. “Determining the best approach to document management must take into account its affect as part of the overall infrastructure of a company,” explains Morris. Even beyond deciding whether a system will employ client server and/or mainframe technology, a comprehensive approach must be incorporated into plans for disaster recovery and protecting the company documents as an infrastructure asset.

All right, document management is a good idea. Businesses have known it for years. And healthcare is beginning to seriously embrace this philosophy. How do you get started? Morris advises companies to start the process with high-access forms and documented procedures in order to realize the greatest impact and return for their efforts. “You have to talk with the people using the forms and processes.” It sounds obvious, but you'd be surprised how many companies forgo this step. “Sit down with that person who uses a form and its related documentation everyday. Let them explain the steps they follow.” Morris stresses it not good enough to verify the information on a form is correct, but that the processes are really working. “You have to ask: ‘What do you do with this data? Why are you doing this step? Where does this information come from? The result of your effort will be you will often find steps that have “always been there” but you don't need in today's environment. You will be surprised with the number of forms and documents that are filled out, only to be filed and later thrown away,” he says.

The importance of document management, according to Morris, is only likely to intensify. “There's an astounding amount of information available to us today and the future will bring even more need to integrate, use and manage this information. Conference calls, video calls, phone messages, all mechanical devices with back-ups will eventually be filed. Whether we're using CDs, memory sticks, chips, or however the technology evolves, companies will have more information to manage.”

The task is formidable, but essential. Concludes Morris: “Document management is a concept that must move forward for companies to survive. Companies cannot continue to use systems that served them in the fifties and sixties. You must begin to utilize today's technology. You cannot keep proliferating paper and survive. You must understand and improve your process flows and adopt sound practices for document management, retention and its related controls. In today's document management environment, if you're standing still you are really moving backwards and you will be left behind.”

Everyone agrees that ensuring patient safety is a top priority for healthcare providers. The first step lies in accurately identifying the patient. Technology is providing some outstanding advances in this area, but more needs to be done.

Balancing the need for patient privacy and security presents some special challenges, but the two really do work in concert—when a provider uses a system that will accommodate and grow with its growing needs.
Stated simply: the key to patient safety is first of all, communication. From the first electronic signature (with hard copies to the patient) to discharge orders, technology makes quick, efficient care possible…but only if the systems in place really accommodate the needs of the institution and its patients.

The most basic need of any provider is knowing, first of all, the patient you’re dealing with. It seems simple enough, but it’s a step with lots of gaps in application. The FormFast approach provides solutions: Identify the patient early, offer checks and balances that help eliminate errors, and make systems cost effective and easy to use.

First, FormFast’s automated forms software allows for quick, accurate identification of all chart forms in the admissions process. By avoiding expensive preprinted forms and printing forms on plain paper, hospitals not only cut costs and save staff time previously used in assembling records, but they also prevent errors inherent in stockpiling (and using) forms that have become outdated. These records can provide traditional information (name, record number, doctor, etc.,). It can also imprint records with a bar code.

Patients traditionally receive the all-important wristband during the admissions process. Again, FormFast provides the answer —in a cost-effective software solution that also accommodates bar coded wristbands and medical records. Increasingly, providers are seeing the bar-coded wrist band as an important patient safety check: scanning the band will help ensure correct patient identification for medication administration, lab work, transfusions, testing and other procedures.

But hospitalization isn’t static. Orders change, additional forms are required, and wristbands get lost. Again, FormFast provides a quick, efficient, and safe remedy: Forms on Demand. Nurses (or other staff) on a division can print replacement wristbands, additional chart forms, or other materials quickly and in the exact quantities needed. These forms arrive preprinted with the patient ID information…eliminating the extra step (and possibility for errors) that accompanied the old blue card system.

FormFast Site offers another benefit/security check for patients and staff. Storing the most current version of standing orders and other forms ensures that mechanical errors (which cause the greatest percent of patient care errors) can be avoided.

Patient security is further enhanced when technology is also put into play to identify staff that are administering medications, tests, or procedures. These not only offer an important (and time saving) record of the provider/patient interaction, but they also provide an extra check to help avoid errors.

Much of the important technology to achieve these results already exists. Even more is in development—especially as hospitals move toward the electronic medical record and its special considerations. But the reality remains: hospitals must balance these opportunities with bottom line financial considerations. Finding the solution will require careful selection of a software provider who can meet current and future needs of the provider—who will partner with the provider for today and tomorrow. The choices surrounding this opportunity will vary widely…but the stakes have never been higher…or the rewards for patient safety, more compelling.

Nearly one in four Americans say they or a family member have received the wrong medication at some point from a healthcare professional.* Patient safety has become a top priority. And most see barcodes—that staple of the grocery store—as offering the safety check—and privacy—which patients deserve. But hurdles remain.

Current HIS systems do not print a usable barcode on a laser or thermal wristband from their ADT application software. And, the curved nature of a wristband calls for a compressed barcode. What’s more, studies show that as many as 30% of patients may lack a wristband at a given point in time. Rather than turning to admissions for a replacement band—and losing valuable time in the process—nursing must have the ability to create a replacement band on the floor. Once again, the HIS company or third party vendor must provide software to enable this function.

The bar code may also be used to verify patient identity using automated Glucometers, bedside Phlebotomy systems, point of care Blood Bank and transfusion systems and supply chain management systems. This is doable, but requires agreement on a standard type of bar code (most likely code 128) and on what data to be represented by the bar code.

And all of these processes provide the best quality control only if a bar code is read from the employee’s badge to record who drew the sample, administered the meds, etc. The technology exists, but the need remains for faster employee ID systems with more flexibility interfaced to employee databases for validity checking.

*Source: AmerisourceBergen Index, February 25, 2003

Listed below, you’ll find a schedule of some conferences and professional meetings upcoming in 2003.

If you’re planning to attend any of these events, please be sure to stop by our FormFast Exhibit to learn more about our expanding product line.

In the world of music awards, there’s no category for "hot news" but if there was, we’re sure that the new FormFast CD would be at the top of the charts.

It’s not just a great resource, it’s an interactive learning tool with frogs!! So call 800-218-3512 or log on to www.FormFast.com and request YOUR very own copy now! We’re sure you’ll be glad you did.

We Want to Hear From You:

We hope you’ve enjoyed this issue of InFormFast.

As always, FormFast remains focused on YOU. We welcome your feedback regarding this issue of our newsletter…as well as information you’d like to see included in future issues.

Please take a minute to share your views by logging onto
feedback@formfast.com.