Hyland Software's Document Management Blog

Enterprise Content Management and Meaningful Use

// December 6th, 2011 // No Comments » // Healthcare // Jared Blankenship

As of last week, OnBase officially earned meaningful use certification as an “EHR Module” from the Drummond Group in both acute and ambulatory settings. I have mixed feelings about the meaningful use initiative and its ultimate impact on the quality of patient care. That said, I think that our certification says a lot about the state of ECM in healthcare and what it means to your organization.

The reality for many of you is that you probably have already deployed (or plan to deploy) a certified EHR (or EMR, but don’t get me started on the frequently disregarded distinction). On top of this, you’re more than likely using it in a manner that meets the stage one criteria. Do you really need to worry about yet another HIT application?

Technically, no, you probably don’t. But maybe that’s not the point.

Looking back on the process to establish meaningful use criteria, confusion reigned. As requirements and timelines were proposed, modified, rejected, reworked, debated, clarified, obscured and finally published, technology vendors and healthcare providers alike worried about the final outcome and its ultimate impact. What applications needed to be certified? What are the penalties? Do we have the budget? Among our current HIT application environment, what needs to be upgraded? Replaced? What if our physicians openly rebel? Ah, memories…

Here’s what our certification gets you: you have the assurance that OnBase can only enhance any of your plans with respect to meaningful use. If you’re currently compliant, implementing an OnBase ECM solution won’t change that. Not one tiny bit. That counts for something.

Also, when a vendor earns meaningful use certification, you have fairly concrete evidence of that vendor’s commitment to healthcare. Otherwise, why go to the trouble? For companies exclusively dedicated to healthcare, pursuing meaningful certification is a no-brainer. But it’s easy to see why companies that offer technology used in various markets might skip it altogether.

Finally, you have validation that ECM is a legitimate part of the HIT landscape. No, I’m not delusional. I fully realize that the EMR trumps every other application in scope, expense and impact. ECM, however, deserves a place at its side. Taking content normally outside your EMR and making it accessible within it – that’s a core value of ECM. Ultimately, that helps your EMR, your HIT crown jewel, become more complete, more effective and more useful.

And on a technical and financial level, that’s where true meaning lies.

Mobile ECM: Well Within Your Grasp

// December 5th, 2011 // No Comments » // Back Office, Document Management, Enterprise content management, Healthcare, Higher Education, Insurance, IT, Mobile // Lindsay McCune

Put mobile ECM into your employees' pockets

The concerns people have about ‘The Future of Work,’ with regard to mobile technologies, was top of mind for Vice President and Principal Analyst Ted Schadler. Schadler was speaking to Fortune 2000 organizations at Forrester’s Content and Collaboration Forum. Questions came pouring in:

• How are professionals using mobile devices?
• What about bring your own (BYO) versus corporate provisioning?
• What kinds of applications are available? Are they task-specific? Role-specific?
• How do I know which vendors are spending time on security and efficiency around development?
• How do I manage licensing?
• What about security?

To my surprise, some organizations anticipate it will take five years to get comfortable with mobile devices and all that goes into managing them. And while mobile will mature over the next few years, you shouldn’t stand still and try to catch up later.

It’s time for organizations to take small steps, and move out from under the blanket of consumer mobile enablement. It’s time to empower the worker. They have valuable needs that can be addressed today.

Enable your workforce

It is all about enablement – not just about devices or applications, but rather overall empowerment. Sure there are lots to things to consider – security and licensing, for example – but you don’t have to eat the whole apple. Just bite off what you can chew.

Start with roles or departments, like human resources or managers, rather than the diverse enterprise. Baby steps! Consider your goals and which employees would benefit most.

Maybe you are thinking you have much bigger fish to fry and that mobile business solutions are low on your priority list. I would argue that bringing your mobile devices into play with even your most basic business processes will reap immediate rewards and have a dramatic impact on your business.

How about an example

So, let’s imagine you are a human resources manager hiring new employees. Let’s also imagine you are on vacation in Hawaii. Your company is competitive and needs to act quickly to get offer letters and other documentation to your soon-to-be colleagues. But you are hanging out by the ocean and won’t be back for a week. Those irreplaceable new hires now take the offer of your competitor. Think of the now wasted time spent interviewing, completing reference checks and all.

Now, imagine you are in Hawaii and getting ready for the day, checking the weather on your smartphone and you notice that you also have notifications from your mobile enterprise content management (ECM) application to approve. Through your mobile device, you can push these offer letters through workflow. With a few taps, you’re done.

It’s time to look beyond mobile’s soft consumer side and empower the devices to make your organization more efficient and more competitive. Are you ready?

Let the race begin: Final ACO rules announced

// November 2nd, 2011 // No Comments » // Document Management, Healthcare, IT // Jared Blankenship

Well, there you have it. The CMS recently released the final rules for Medicare’s accountable care organizations (ACOs). HIStalk did a fine job of summing up the differences between the final and preliminary versions:

• Quality measures reduced from 65 to 33
• Use of an EHR is not a requirement to participate
• Introduction of a savings-only track without financial risk during the initial contract period
• CHCs and rural health clinics now have an option to lead ACOs
• A longer phase-in for reporting and performance measures
• Multiple start dates established
• CMS will provide approved marketing guidelines and language (so ACOs don’t have to wait for CMS approval, as was stated in preliminary rules)

According to the CMS, the preliminary elicited more than 1,200 comments, which helped shape the final iteration we now see. Great to see the healthcare community so vocal and active. Even better that the CMS listened.

But now that we have the final rules, it’s time to get to work. Sure, additional rules are likely to follow. Also, as real-world lessons bubble to the surface, there will be changes, adaptations and modifications. Nothing is likely to remain static for very long. More than a little reminiscent of how Meaningful Use unfolded – and continues to unfold. Nevertheless, with clear guidelines in place, those of you in technology-oriented roles will find even more complexity working its way into your daily lives. As if you needed any more…

InformationWeek recently highlighted an interesting report – “Preparing for Accountable Care: The Role of Health IT in Building Capability” (full version available here). There’s one message resonating with crystalline clarity throughout the report: Information technology has a critical role to play in the ACO model.

All right, that seems obvious. But technology doesn’t operate in a vacuum. It’s up to those of you who understand IT’s potential and limitations to share your insight and knowledge. Because the ACO model implies (and demands) such deep organizational changes, many people in your specific organization will find themselves involved. Amidst all the ensuing politics and confusion, the strategic planning and trial-and-error, it’s easy for the rational-minded soul to lose patience and succumb to frustration.

Don’t let that happen. Make sure everyone understands your position and that IT’s role is not misunderstood, overstated or ignored. Daunting, I know, but the stakes are high. Assumptions made in your absence today will only drop a mountain of pain on your desk tomorrow.

The Evolution of ECM and the Gartner Magic Quadrant for ECM, 2011

// October 20th, 2011 // No Comments » // Back Office, Document Management, Enterprise content management, Financial Services, Food and Beverage, Government, Healthcare, Higher Education, Insurance, IT // AJ Hyland

While the stand-out fact in this year’s Gartner Magic Quadrant for ECM, 2011, was the 7.6 percent growth in the ECM industry, even in a down economy and as organizations tighten their tech investment belts, what’s more remarkable is the rapid evolution of enterprise content management as a strategic business solution. 

Gone are the days when ECM was little more than a means by which companies transformed paper documentation into electronic information and then organized and disseminated that information to employees and staff. That still occurs, but it is really now only a foundational piece to a much larger solution.

Or, truly, solutions, because every organization is as different as the business content and process challenges they face. You see, it’s about more than knowing where your information is and how to quickly access it. It’s about leveraging that information in a meaningful way so that you can achieve your specific organizational goals, all the while taking care to achieve just the right balance of focus and flexibility in that endeavor.

What do I mean by this?

I’m saying think of your ECM solution holistically – beyond what you want to capture and how you want to capture it. Consider who will access this information. When will they do it and why? Is your audience an admissions staff? Or a business decision maker whose office is in the air or on the road? Is that information critical to keeping your business moving forward, to beating the competition or better serve a constituent?

In other words, are you leveraging your information in a meaningful way? Do you have a protocol in place should your admissions staff get snowed in during the busiest time of year? Can your managers and executives make decisions via their mobile phones whether they’re in Boston or Bermuda?

A strategic ECM solution must have the flexibility to help answer those questions. It must work in concert with other software solutions, to accurately capture, process and quickly distribute information to staff when and where they need it, and connect the content dots that allow organizations to gain the competitive advantage, better serve their constituents – or both.

Strategic ECM vendors will help organizations elevate their game by focusing on speed of deployment, getting organizations up and running faster, putting them ahead of the competition sooner or offering improved services to constituents faster.

After all, the strategic use of ECM is a differentiator for today’s organizations. And there is ample opportunity to become even more competitive using ECM technology.

AHA and OnBase: When Endorsements Matter

// October 7th, 2011 // No Comments » // Document Management, Enterprise content management, Healthcare // Jared Blankenship

We’ve all seen celebrity endorsements. I have foggy childhood memories of that famous line, “I’m not a doctor, but I play one on TV.”

I faintly recall the words coming from Bernie Kopell, the doctor from “The Love Boat,” as he offered advice on over-the-counter painkillers – or maybe it was a doctor from “General Hospital.” But if it was “The Love Boat” doc, well, that strikes me as especially funny. I mean, sure, the guy pretended to care for the fictitiously afflicted while coping with Gopher’s zany antics. Why not turn to him for medication advice? That can only end well.

Here we have a great example of an appeal to celebrity, a logical fallacy essentially meaning that just because someone famous says something, it must be true. Yet as an advertising and marketing tool, it remains chillingly effective.

On the other hand, have someone more credible deliver that message, perhaps your family physician, and that same message carries much more weight.  

There are distinct reasons for that credibility. First, your physician is making a recommendation predicated on knowledge gleaned from education and experience. But I wouldn’t even take this recommendation at face value. Ask for an explanation. Explore the reasoning behind the endorsement. Know the “why” inside and out before taking it to heart.

There’s also the nature of your relationship with the endorser. Does that person or entity know you, your needs and your goals? Or, rather, is the endorsement more of a blanket statement, architected more toward mass appeal than individual benefit? No harm in those endorsements meant to apply to a larger target audience, but I’d recommend taking those with a grain of salt and doing a bit of research to make sure your uniqueness falls under its umbrella.

And, of course, there’s the endorsement itself. Does it even make sense? Even the best and smartest among us are human, capable of making mistakes and errors in judgment. And, sadly, sometimes that endorsement can be purchased. After all, do we really think that Michael Jordan is deeply concerned about all of our undergarment-related needs?

Recently, the AHA repeated its endorsement of OnBase as the enterprise content management system of choice. For hospitals, I like to think that endorsement meets all of the aforementioned criteria of a credible recommendation. The AHA is an organization representing more than 5,000 hospitals and dedicated to the improvement of patient care. Further, the due diligence it conducts prior to offering its endorsement helps ensure a recommendation that aligns with hospital needs and objectives.

As for whether the recommendation applies to you (or even makes sense), that’s entirely your call. No matter how credible the endorsement, it can’t answer that question for you. Instead, look at your organization, its people and its processes. Do you find that content sometimes slips through the cracks? That processes aren’t running as smoothly as they could? If so, then perhaps it’s time to take a closer look at that endorsement and what content management can mean to your hospital.

Mobile ECM: Your Content In Your Pocket

// October 5th, 2011 // No Comments » // Cloud Computing, Document Management, Enterprise content management, Financial Services, Food and Beverage, Government, Healthcare, Higher Education, Insurance, IT // Glenn Gibson

Put mobile ECM into the pocket of your employees

The world of computing has changed. Forever.

These days it seems archaic to have to wait until you get home or to the office just to check your email, because now your email is in your pocket. The idea of printing off maps before heading out on a journey seems crazy because GPS on our phone gives us turn-by-turn directions. Lively pop-culture debates over a pint are now a thing of the past, because we can look up the answers on the internet immediately.

Yes, mobile computing devices have changed the world and changed us.  We expect instant access to information from wherever we are. The iPhone and the iPad, Android, Windows Phone 7 and the Blackberry give us this access like never before.

So what does the explosion in mobile computing have to do with ECM?  Everything. 

Think about it. What is one of the primary driving factors behind an organization developing an ECM strategy? The need to get critical business information into the hands of the right people at the right time. That’s what ECM is all about. 

But what if the right people are in the wrong place at the wrong time? What I mean is, what if the people who are responsible for making important decisions, from approving a critical business expense to agreeing to hire the perfect candidate, can’t physically get access to the information and systems they need in order to execute business decisions, simply because they are travelling or not in the office?   

The reality is that these individuals spend a lot of time on the road and out of the office. This lack of real-time access causes bottlenecks in your processes as the decisions have to wait until they get back online. This causes on-the-fly workarounds with emails and phone calls to get someone, anyone, with authority to make the decision. And once that decision has finally been made, it is very difficult to track all the activity that supports it. 

Yup, bottlenecks and workarounds caused when people who play a critical role in business decisions are out of the office have come to be expected as a normal part of business because, until recently, that’s just how it was. There was no other choice.

But, the world of computing has changed. If the ability to access email from anywhere in the world is not only a reality, but expected in today’s world, why is it any different when thinking about your other important business content and processes?

It shouldn’t be. And when you partner with an ECM vendor who understands this, it is not.

Today you can put your ECM content in your pocket. With mobile ECM applications you are able to not only able access your important content, but also participate in business processes, reviewing, approving and denying requests from wherever you are, directly from your mobile device. 

Now it is likely, for many good reasons that you may not want to make ALL your business information available via mobile devices. If mobile access to your information is part of your requirements when you are choosing an ECM vendor, you should look for a vendor which allows you to control what type of content and processes to make available via these mobile devices. You should choose an ECM system that can truly deliver on the promise to get critical business information into the hands of the right people at the right time, wherever they happen to be.

For your business this is both simple and profound. No more waiting to get back to the office. No more driving to coffee shops just to get access to your system to approve a request. No more bottlenecks caused by business travel. No more un-documented workarounds.  

It is that simple. It is that revolutionary. Because now your content is right there in your pocket.

Thoughts before AHIMA: ICD-10 and your technical environment

// September 29th, 2011 // No Comments » // Healthcare // Jared Blankenship

October 1, 2013. That’s the compliance date for implementation of ICD-10-CM (diagnoses) and ICD-10-PCS (procedures). No delays. No grace period. Just a few days shy of only two years away.

For those of you dealing with initiatives related to ICD-10 compliance, few dates can hold as much significance. Among those of you headed to AHIMA, I’m sure the term alone induces no shortage of cringes or shudders. Some of you are ready, and that date carries no especially ominous undertones (though maybe some unpleasant memories as you undoubtedly earned that peace of mind through no small planning and effort). The rest of you are likely hovering at some point between “almost there” and “mired in discussions, meetings and general worry.”

Just to outline the scope of work and potential impact of ICD-10 implementation, let’s compare it to its predecessor, ICD-9.

A quick look at that table and one thing is glaringly obvious: implementing ICD-10 means accommodating a significantly greater amount of data. And that’s not even accounting for the requisite duplication of code sets over the two-year transitional phase.

Whatever your state of readiness, I hate to say this, but your work with ICD-10 will likely never be done. I am not referring to the fact that ICD-11 may lurk on the horizon (the good news is that much of the processes established in your migration to ICD-10 should lay the groundwork for those efforts). Neither am I talking about using the code in your day-to-day operations. That’s a given. What I mean is that it will be a constant effort to ensure that your processes and systems remain in a state that supports your usage of ICD-10.

That’s trickier than it sounds. I can think of few healthcare organizations whose technical environment remains constant over a relatively long length of time. Applications come and go. Vendor relationships change. Organizational needs adapt to serve dynamic, evolving communities. As those factors – and others – come into play, healthcare organizations need to ensure that every new module maintains full support of ICD-10 usage (not to mention the myriad of other regulatory standards).

Compounding the issue, you have those systems that might not seem to have a direct impact on ICD-10 implementation. Sure, there are the obvious applications – EMRs, billing systems, encoders and so on. But there are others that probably don’t leap to mind. ECM and document management, for example, may store and report ICD-10 codes on a purely transactional basis, but the fields in their data tables must be large enough to accommodate those longer codes. Don’t let something like that undo your hard work. Scrutinize every system and subsystem, new or old, that touches clinical care and the revenue cycle, however slightly.

If you’re attending AHIMA, swing by booth 413 to learn how ECM technology can support your ICD-10 initiatives and help you maintain a complete patient record.

Build Bridges by Integrating Solutions

// September 14th, 2011 // No Comments » // Document Management, Enterprise content management, Healthcare // Tom Tennant

Let’s talk about “doing more with less” again. We’ve touched on the topic a few times during OTTC, most notably with Hyland Software CTO Miguel Zubrizarreta, who shared his thoughts on the topic with us earlier in the week. (Check out what he has to say here.)

But let’s turn the phrase on its head. What if, when we talk about “doing more with less,” we talk about getting more work done with less steps, less room for error and less frustration. What if we could allow our workforce to work the way they want to work? Heaven, right?

Technology is a tricky thing. It’s there to make our workforces more productive and efficient. To streamline processes and tackle low-level tasks. But there’s a point where technology overwhelms the end-user. Or worse, becomes as inefficient as shuffling papers and filing folders. 

Here’s an example. I spoke with a desk clerk at a hotel on the Strip here in Las Vegas who said she has to open upwards of seven windows to complete her work. She was frustrated and was concerned about frustrating her customers as well. It’s certainly not the way she wants to work.

So what do we do? We can start by building bridges. We do this by connecting our line-of-business systems with tools that allow employees to remain in the solutions they work in most. A tip of the hat to Hyland’s Alejandro Vanegas for sharing the analogy. Vanegas led OnBase’s Application Enabler track this morning at OTTC 2011, Hyland’s technical and training conference.

By ignoring the gap and eschewing connectivity, especially if they are trying to implement an enterprise content management system, organizations risk losing user adoption, especially if users think they have another system to learn. Or another window to open, in the case of our hotel clerk. Or worse, we add to the burden by asking workers to key and rekey information into more than one system.

Integrating solutions empowers users to work in the solutions and systems they’re most comfortable with. It also increases ROI.

But you’ll have to wait a bit to find out about that.