Hyland Software's Document Management Blog

Allscripts Customer Experience (ACE) Conference lights up the conversation on open architecture

// August 20th, 2012 // No Comments » // Healthcare // Dan West

At the Allscripts Customer Experience (ACE) conference held in Chicago last week, the big buzz was all about Allscripts’ open architecture approach to healthcare solutions. Allscripts CEO Glen Tullman also talked about it in an article in Health Data Management right before the show began.

“Open architecture is almost a philosophy,” Tullman says in the article.                          

The article notes that Allscripts knows it won’t “figure out every aspect of the integration puzzle,” so they’ll work with major players to make their systems interoperable.

We find this ringing true for almost every customer. We see more and more healthcare organizations choosing a best-of-breed model over a one-suite-fits-all standard. While electronic medical records (EMR) and health information systems (HIS) are crucial to healthcare IT, neither are truly capable of running a healthcare organization on its own.  Healthcare organizations must incorporate and integrate multiple systems to achieve a complete medical record and to run their hospitals efficiently. 

Note that Allscripts isn’t moving to an open source model – releasing a free public version, including source code, that would enable developers outside of Allscripts to create solutions using Allscripts’ code. There are some restrictions on Allscripts’ open philosophy, such as the requirement to join their Developer Program (which includes a fee and signing a non-disclosure agreement) before accessing the Helios by Allscripts™ SDK. Because of these restrictions, some would argue that Allscripts still isn’t as open as it could be. (Check out the comments on this poll from HISTalk to read a little of the back and forth on the open architecture conversation.)

However, the application process isn’t a negative in our eyes. It helps guarantee that the software created with Helios is compliant and secure. As healthcare entities of all sizes are the target of data intrusions and strive to meet HIPAA mandates, this will become ever more important.

And even with a few restrictions, Allscripts’ philosophy is still a significant departure from many other EMR vendors who often try to “go it alone” and don’t play well with other IT solutions. A more open architecture allows IT solutions to find complementary software that enhances existing functionality.

 Just take simple, everyday content like forms, faxes, emails, photos and clinical images. This kind of information is vital to clinical care and revenue cycle processes, but the HIS and EMR systems often don’t handle it well. To manage this information, healthcare organizations are turning to enterprise content management (ECM).

ECM provides the means to capture unstructured content, store it, and make it available as needed to the right people – within the processes and systems they already use, like your EMR or ERP. As a result, processes run more smoothly and crucial information is readily accessible within core information systems.

While ECM systems are integrated with virtually every EMR out there, Allscripts’ open architecture approach allows for a more complete solution that can be more ideally tailored to each healthcare organization’s unique environment. As healthcare IT continues to mature, this interoperability will become more and more important.

HC Reliability Part 4: IT Maintenance

// August 2nd, 2012 // No Comments » // Document Management, Enterprise content management, Healthcare, IT, Uncategorized // Dan West

Last time we covered the second of three key component of a reliable enterprise content management (ECM) solution for healthcare: user access. Without easy access to your organization’s content, users have trouble completing tasks and patient care is slowed. But users are not your only concern. You also need an ECM solution that is easy on your information technology (IT) staff.

True reliability also means finding a solution that does not put a burden in your IT staff – and by extension, your budget.

The more difficult the ECM solution you choose is to support and adjust, the more IT staff you need to run it – translating directly into more employees and more expenses. If the resource demand is high enough, the cost of support and staff could outweigh the benefits you realized from the solution in the first place. Choosing an ECM solution that requires minimal staff to support it is crucial. So choosing a solution that easily integrates with other applications and does not require custom coding has a dramatic effect on the initial cost of the system and ongoing upgrades and maintenance costs. But for this to happen, you need to find the other major component of easy IT maintenance – a reliable vendor.

The right vendor knows the ins-and-outs of your industry and its specific needs and can create solutions that those needs while working to meet the future needs of your organization. But true vendor reliability doesn’t end there. They need to be available to your organization as well.

Let’s face it, the implementation and upkeep of any major solution will have some headaches. But the question is – will the vendor be available when I need them to solve my issues? When it comes to IT maintenance, a reliable solution has a vendor who will always be there to talk or walk you through your problems. So for those times when your IT staff runs into problems it can’t solve, you need to evaluate how well your vendor answers questions and offers guidance. If they really know your industry and your solution, they should be able to lend support to lessen the burden on your IT staff as well as assist in building a roadmap for your future.

Healthcare is an industry that is constantly seeing new laws and regulations come into the fold, so an experienced vendor really pays off. Without it you can end up with a solution that requires a disproportionate amount of support and a lot of problems you can’t fix.

Keeping this in mind – along with the importance of user access and system uptime – will greatly improve your chances of choosing the right ECM solution for your healthcare organization. Because when you break it down, these are the three components of a truly reliable solution. And does your organization deserve anything less?

The Key to a Successful ACO: Access to Information

// July 16th, 2012 // No Comments » // Enterprise content management, Federal Government, Healthcare, IT, Uncategorized // Dan West

An accountable care organization (ACO) is the ultimate balancing act of fiscal responsibility and patient care. According to an announcement on July 9^th by the Center for Medicaid and Medicare, 89 more organizations have taken up the challenge of striking that balance.

But to accomplish this goal, participating organizations need to be able to quickly share clinical and administrative information to other members of the ACO. Otherwise they risk over-utilizing services and creating financial challenges.

By deploying an enterprise content management (ECM) solution in participating organizations, ACOs can have that free-flow of information they need to continue supplying high quality care in a fiscally responsible way.

ECM takes all of your organization’s content, from paper to clinical images to the patient chart, and stores it all in a single, central database. It also integrates with your existing HIT investments to pull and share information between them. This means information is instantly retrievable from any of those applications – making the lives of clinicians and staff much easier by creating a continuity of information across the organization.

But ECM does much more than just capture and retrieval. It also automates the movement of that content to direct it to the right people at the right time, removing redundant tasks like forwarding information. This isn’t confined within the walls of a single organization either, as information and content can be shared between hospitals and other healthcare organizations, making it perfect for keeping information flowing within ACOs. Sharp Healthcare certainly thought so.

Sharp Community Medical Group, Sharp Rees-Stealy Medical Centers and a selected group of Anthem Blue Cross of California PPO members are participating in a commercial ACO pilot in the San Diego area. The goal is for providers to deliver better coordinated care to their patients, with a focus on prevention and chronic care management. The healthcare organizations are currently working through medical management processes, which include physicians receiving authorization for referrals for their PPO member patients from Anthem. Once the solution is in place, Sharp will need to easily exchange case, disease and utilization management information and images with Anthem, explained Cathy Fuhrman, manager of information systems at Sharp HealthCare. The ECM system will take images incoming to Sharp and make them available in the member’s chart through an e-business application.

This allows all of the clinical and administrative patient information to be accessible to all participants in the ACO, eliminating the opportunity for utilization of services.

“If we don’t know that this person has chronic diseases or we don’t have all the images together for that person, we’re not going to meet our financial and clinical goals,” Fuhrman said. “If the patient is managed appropriately, we can get the patient to the right provider.”

That statement describes perfectly the importance of accessibility of participating organization’s content to an ACO’s success.  And ECM is the critical application that makes that exchange of information possible.

Healthcare Reform Upheld: Are You Prepared for the Effects?

// June 29th, 2012 // No Comments » // Enterprise content management, Government, Healthcare, Insurance, IT // Dan West

Regardless of your view on the Patient Protection and Affordable Care Act, yesterday’s Supreme Court decision is a signal to healthcare organizations to continue preparations for change. And if your organization hasn’t started, now’s the time. An analysis of the law by the Congressional Budget Office projects that by 2016 the number of non-elderly Americans covered by health insurance will increase by about 32 million.

No matter how you slice it, this means the potential number of new patients will increase. And along with an increase in patients comes more records, claims and information for healthcare organizations to handle, creating more challenges in areas like admissions, release of information requests and patient billing and finance.

According to an article from The New York Times, paperwork or documentation can take up to a third of physician’s workday. These administrative tasks take away from time spent with patients, limiting their ability to do their jobs. Adding more insured Americans increases the number of patients, records and subsequent paperwork that follows.

If you’re concerned your organization isn’t prepared to handle this increased influx, now is the time to start.

An enterprise content management (ECM) solution is designed to help you overcome these types of challenges. ECM allows you to store all of your organization’s unstructured content – like paper, forms or faxes – in one, central and electronic location. Additionally, ECM integrates directly with the other core healthcare information technology (HIT) applications throughout your organization.

That way, all of your systems are connected, allowing them to share information so your physicians and staff can instantly access the information they need right from the applications they are familiar with. This means physicians can spend more time with patients because they no longer have to waste time hunting down information.

All of this translates into doing more with less – exactly what you need to handle the influx of new patient information. Waiting until you feel the pressure means you have already waited too long. So acting now to develop a strategic ECM process will proactively enable your healthcare organization to manage the increase.  

Making your processes more efficient with ECM means you get the most out of your available resources, so you know you are prepared.

Healthcare Reliability Part 3: User Access

// June 25th, 2012 // No Comments » // Accounts Payable, Accounts Receivable, Back Office, Enterprise content management, Healthcare, IT, Mobile // Susan deCathelineau

Previously, we discussed the first of three key components of a reliable enterprise content management (ECM) solution for healthcare: system uptime. Without system uptime that meets healthcare industry demands, you take away easy access to your organization’s content, which is why you sought out an ECM solution in the first place.

And we must define user uptime by something more than how often the solution is down. While a system may be up and running it serves little purpose if it cannot provide the content clinicians and staff need, when they need it.

So we have to look at new ways to define reliable user access. First, can the ECM solution retain the content types your organization depends on? If not, how will users access it?

This is where a vendor with a large and diverse customer base becomes important. That signals experience with a number of content types and the likelihood that the solution can handle each. It also suggests that new content types – images, video and the “next big thing” – are already on the vendor’s radar.

Next, look at a solution’s ability to integrate with other applications and systems throughout your organization. Your electronic medical record (EMR) and accounting and billing applications are crucial to your everyday processes. Connecting each to allow instant access from any system eliminates the need for your users to switch between screens. This speeds processes and creates a stronger user experience – even if users never know they’re working in two systems at once. So finding an ECM solution that can integrate with the everyday systems you use the most goes a long way to improve user access to your content.

You also need a solution that can integrate with future applications as well. As your healthcare organization continues to grow, you want your ECM solution to grow with you. Otherwise you could quickly outgrow your solution, shrinking user access and eroding your technology investment.

Measuring user access is not limited to the four walls of your organization. Mobile access to content is also important. Supplying your clinicians and staff with access to the information they need via mobile devices while in the field and at home – whether they have internet access or not – allows them to complete tasks more quickly. Without it, work takes longer to get done, costing you time and money. That means finding an ECM solution with flexible mobile options translates directly into the speed of user access you require.

To have true control over your enterprise’s content, it needs to be accessible at any time. So keeping in mind what content you use, your integration needs and a solution’s mobile offerings is crucial to choosing a reliable solution with the user access you need.

In the next installment of the reliability series, we will talk about how IT maintenance plays into a reliable ECM solution.

Healthcare Reliability Part 2: ECM Solution System Uptime

// June 20th, 2012 // No Comments » // Enterprise content management, Healthcare, IT // Susan deCathelineau

Last time, we introduced you to the key components of a reliable enterprise content management (ECM) solution for healthcare.  This time we will delve a little deeper into the first of those components, system uptime.

Now, system uptime may seem like an obvious measuring stick for your healthcare organization to measure the reliability of an ECM solution. But the reality is that there are several factors to consider when determining how much uptime a solution really provides.

The first factor to look into is stability. Does the solution suffer from frequent or prolonged system crashes? So if you hear from analysts, peers or other customers of the solution that this is an issue, it should be an immediate red flag telling you to steer clear. Otherwise, the risk of your system going down is always present, removing the access to content that led you to ECM in the first place.

When looking at stability, the size and diversity of a solution’s customer base is one of the most useful determining elements. Solutions with a small user base may not be optimized for the strict uptime requirements of the healthcare industry. At the very least, they haven’t been tested and proven in a wide range of real-world applications. On the flip side, a large and varied user base grants the experience and prior knowledge required to create the uptime of a reliable solution.

Another factor that affects system uptime is the frequency and nature of system updates, because overly frequent updates can seriously decrease uptime. Whether it is planned or not, any downtime keeps your users from accessing the content they need. So if a solution is constantly being taken down for updates or bug fixes, it only adds to the existing downtime from problems that may arise.

So when looking for the right ECM solution for your organization, ask about its update schedule and how much downtime can be expected for each. Also don’t forget to ask about how that schedule changes when you choose to expand the solution to more departments in your organization. Do updates become more frequent or take longer to perform? This is an important determining factor if you plan to have your system grow with your organization.

By keeping in mind the stability, user base and frequency of updates, you are on track for selecting a reliable solution with the system uptime you need.

In the next installment of the reliability series, we will look into the importance of user accessibility to your ECM solution.

Healthcare Reliability Part 1: The Keys to Choosing Your ECM Solution

// June 1st, 2012 // No Comments » // Cloud Computing, Document Management, Enterprise content management, Healthcare, IT, Mobile, Software as a Service, Uncategorized, Workflow // Susan deCathelineau

Information and data drive every process in your healthcare organization. But if you can’t get the information into the right hands, your processes can fall apart.

That’s where enterprise content management (ECM) comes in. An ECM solution acts as a central repository for all of the content and information in your organization. By integrating with some of your organization’s most critical systems, from the EMR to your payroll application, ECM automatically categorizes your content and moves it through the appropriate processes. That way, you can always find the information you need, when you need it.

But how do you decide which ECM solution to go with? It may seem obvious, but the answer is the solution you know you can rely on – and not only now, but as you continue to grow.

To put things in perspective, let’s look at Sharp Healthcare. With over 92 million documents contained in its ECM solution and 115,000 more entering its workflow weekly, it has to be sure everything is running smoothly. With this many documents held in a single solution, Sharp needs to know, without question, that the solution is reliable. And so do you.

Your next question is clear, “What constitutes a reliable ECM solution for my healthcare organization?” There are a few components that go into determining the reliability of an ECM solution: 

• System uptime: This is probably the most obvious way to measure system reliability, and an ECM solution is no exception. System crashes, instability and the frequency and nature of system updates can all negatively affect uptime. The size of an ECM solution’s user base is also important, as solutions without a large, diverse user base are often not optimized for healthcare’s strict uptime requirements.
• User access: While a system may be up and running, it’s of little use if it cannot serve up the content clinicians and staff expect. Strength of integration with other systems, database stability and other factors determine whether or not a physician can see the content they need. When measuring the ease of access for users, speed is among the first things you should look at.
• IT maintenance: Sometimes it’s easy to overlook this, but even when a system has high uptime and delivers content quickly, it may not be truly reliable. A reliable solution doesn’t require a disproportionate number of IT staff for support. Reliability also transcends the technology itself, as the ECM vendor should quickly and efficiently answer your questions and provide guidance. 

Really, it all boils down to one simple question. Are you willing to gamble with the thousands or millions of documents and pieces of content your organization relies on?

If the answer is no (and hopefully it is), you need to do your homework. Where is your organization headed, and what ECM solution has all of the components above to help you get there? Once you can answer those questions, you are on the right track.

From the ER to HR, the right ECM solution can vastly improve your organization. The wrong one only causes more headaches. So make sure when it comes time to choose your solution, you aren’t in a gambling mood.

Make sure to keep an eye out for part two of our reliability series to discover the true importance of system uptime.

Let’s Talk About the ‘Enterprise’ in ECM

// April 9th, 2012 // No Comments » // Back Office, Document Management, Enterprise content management, Financial Services, Food and Beverage, Government, Healthcare, Higher Education, Insurance, IT // Thomas Jenkins

We say it every day: “Enterprise Content Management” or “ECM.” We hear folks throw out words like “enterprise” records management strategy, “enterprise” document management, and “enterprise” capture or delivery models.

But despite all the “enterprise” jargon out there, organizations often find themselves taking a less than enterprise approach. That is, they immediately start off on an initiative of strategy limited to one office, department or division. They make the argument, “We need to increase productivity and see these efficiencies yesterday.”

So we put a solution in place and let it be. But in the long run, the organization or a project management office fails to convey the results to the larger enterprise because they’ve got little invested interest from others outside of their office, department or division – or at the enterprise level.

What happens next? Someone in another office, department or division fails to get their face-time with the project, results aren’t communicated, value isn’t seen, and then they go out and seek an alternative solution or strategy to hopefully realize the same enhancements and see such efficiencies. IT is left supporting multiple applications and different platforms. We hire people to manage individual solutions. We custom code. We pay for maintenance, upgrades and support on several systems. We bring on a business analyst to find out why we’re doing all this. Systems fail, products are sunset. And we’ve now got complex and over-engineered processes and tools cluttering up our day-to-day transactions.       

Whoa!? What happened to our enterprise approach?

And in terms of ECM deployments, now you’ve got multiple ECM systems. And if you haven’t seen it before, now you’ve got multiple lines of business processing and capturing similar documentation in totally different methods. Some users are capturing and classifying directly via Microsoft Outlook. Others are dragging and dropping all over the place. Some are using SharePoint. Remote users still prefer to save documents to their local or shared network drives. And some users are even printing and scanning images back into the ECM system.

If we’re going to talk about streamlining operations and improving efficiencies; tying business and technology together end-to-end; and improving an organization’s ability to collaborate more effectively – those are bigger concepts than just one or two office, departments or divisions can solve. They require participation and a vested interest by all parties. You need to understand the overarching and individual goals across the “enterprise.” Not just wherever the hot button is right now, because with as quickly as markets and strategies can shift, so can enterprise priorities.

So start by taking a more pragmatic, “yes,” “enterprise” approach. Believe it or not, you can always make a new investment in the latest and greatest product or service. However, if you buy into a system or strategy without taking a comprehensive 360 view of how (or if) your users will adopt it, use it, and/or react to it – the benefits and your hard or soft investment in terms of cost and time – may never be realized.

Follow an approach that engages either the entire organization or a select population. Engage more than just local technical experts. Bring in business and subject matter experts, executive or senior leadership, and the frontline employees. Understand what each office, department or division is working on today and what they need to deliver tomorrow. What’s prohibiting them from doing so? What are their challenges? Their goals? And what does long-term program success look like?

So the next time you say “Enterprise Content Management,” or “ECM,” think to yourself are you really talking about Enterprise Content Management? And what can you do to ensure you and your organization are getting the most out of your investment? My answer: think about your approach. Define a strategy and a path for who, what and where to engage. And then you’ll realize the real benefits of what Enterprise Content Management and OnBase can be.