Getting Healthy with Electronic Document Management
In 2004, Proposition 63 – The Mental Health Services Act prompted the Alameda County Behavioral Health Care Ser-vices Group (BHCS) to strive towards creating an “integrated, culturally competent, consumer and family-empowered system of care”. The primary focus was to enunciate a community-wide participatory and prevention system that would promote wellness, resiliency, and recovery.
The Behavioral Health Care Services Group (BHCS) serves as a facilitator of behavioral health care needs for the County of Alameda. The beneficiaries of these services include individuals of varying ages, from adolescence to adulthood, suffering from chronic or acute behavioral needs. Currently, the County of Alameda operates 15 clinics and document storage facilities from Oakland to Fremont and Eastward over to Pleasanton. Clinical files are created by the clinicians as documentation for rendered services by the department, and to be used as support for billing purposes. Continuity of client care, regulatory compliance, state accreditation, effectiveness of treatment, and timely reimbursement rely on the use of these clinical files.
Each month, the Behavioral Health Care Services group takes in approximately 300 new clients county-wide, generating over 180,000 files annually, and occupying approximately 4,200 linear feet of file cabinets.
The Agencies governing mission is to enhance the recovery and wellness of eligible County residents suffering from in-tense mental health, alcohol, or drug-related issues. The vision for Alameda County is to create an environment in which individuals, and their families, can realize the possibilities for accomplishing their dreams. Their goal is to break-down barriers and socially-constructed stereotypes against those with mental health and/or alcohol and drug-related impediments of their past.
Clinical content is currently stored in two major fashions: Electronic files and Paper files.
Electronic Files (Non paper):
Client information and Clinical services rendered content is stored in a number of software applications known as IN-SYST, Clinicians Gateway, E-mail accounts as well as some ad-hoc systems (i.e. MS Access Databases). Each of these electronic repositories augments the paper based filing system.
The majority of the BHCS clinical content, some of which dates back thirty-six years to 1975, still remains in a paper for-mat. This content is stored in a decentralized manner with each clinic or program area tasked to maintain their own clinical content. Each active clinical file within the department is accessed, on average, weekly by each program. Files are accessed when notes are added, information is needed, clients are seen and billing issues are investigated. The issues and drawbacks to storing files in a decentralized paper-based system are numerous. It is estimated that there are approximately 60,000 active clinical files being managed by the Department. The average clinical file in AC BHCS is 50 pages in size, so a total of approximately 3,000,000 pages are being managed by the Department.
The Behavioral Health Care Services group of Alameda County has a major need to evolve its content management systems in order to provide an enterprise solution that will allow staff and clinicians to easily search and retrieve digital copies of the clinical records. Currently the majority of these client records are in a paper only format.
The scope of the Records Management and Retrieval Project will be to incorporate a document imaging solution for the Behavioral Health Care Services group that can be implemented at each of the Health Care Clinics in Alameda County. In addition, a web based Content Manager solution will be available throughout the enterprise network to allow for the sharing of the digital client records in a secure and encrypted manner that supports the HIPAA requirements. Additional enhancements to the system will also allow for the integration of the application into the existing Clinician’s Gateway to allow for viewing of records and potential integration with future BHCS systems.
An RFP was released to find an Electronic Document Imaging Solution that could centralize; retrieval, retention / compliance, records management, business process automation, and storage of these vital records.
ECS Imaging’s Martinez office was selected as the vendor of choice with over 50 points ahead of the pack to provide the Alameda County BHCS group with the required software solution necessary to meet the needs of an Enterprise Content Manager (ECM). ECS Imaging will be responsible for installing and implementing the solution, and scanning some of the back-file. Our local SLEB Contractor Digiscan of Pleasanton will also be scanning all current clinical and other selected documentation into a secure HIPAA compliant digital records management system known as the Laserfiche Avante sys-tem. The following are the software components of the Laserfiche Avante ECM System:
Laserfiche Avante – Enterprise Content Manager (MS SQL DB backend) – DoD 5015.2–certified, complies with Sarbanes-Oxley, HIPAA, USA PATRIOT Act, SEC, FINRA and others.
Laserfiche Server – Centralizes management of multiple types of information, including digitized paper documents, electronic documents, e-mail and digital audio and video files.
Laserfiche Desktop Client – Users with full access rights can connect via a PC based client application.
Laserfiche Workflow – Automated rules-based document routing, e-mail notification and activity monitoring.
Laserfiche Scanning – An interface to add paper documents and an array of tools to enhance images.
Laserfiche Snapshot – Creates archival TIFF images from existing electronic documents.
Laserfiche E-mail Plug In – Uses a MAPI-compliant e-mail application to distribute documents.
Laserfiche Web Access – Full user access into Laserfiche via a web browser, also supports Blackberries and iPhone.
Laserfiche Weblink Unlimited Public Portal – Unlimited read only access via web browser for internal and external users.
Laserfiche Audit Trail – Tracks Users actions to ensure information security and compliance.
Laserfiche Quick Fields – Including Zone OCR, Bar Code Recognition, Validation & Real Time Look Up.
Laserfiche Plus – Archival publishing to CDs, DVDs, USB drives or external hard drives.
Laserfiche Records Management Edition – A DoD 5015.2-certified solution, fully integrates records management with your Avante system.
Laserfiche Import Agent – Monitors your network folders for new content, and then automatically imports that content to the Laserfiche repository.
The Alameda County BHCS assembled an implementation team including;
Sandy Stier – Director of Information Systems, Steve Kline- Project Lead and Camille Peterson –Application Specialist.
ECS Imaging Inc’s James Green will be our Project Manager and has begun regular coordination meetings with the County BHCS team. The kickoff date is slated to be early March 2011 and target organizations within the County BHCS are now being selected for rollout dates.
Scanning of physical documents at the numerous locations will be scanned in tandem with the installation of the software & scanning hardware. Project completion is targeted for 8 months.