From EDMS to content services – tomato, tomahto? It’s actually apples and oranges

Forty years ago, the terms electronic document management services (EDMS) and document imaging were commonly used to describe both the processes and software healthcare providers relied upon to scan and archive paper documents. The original EDMS products were stand-alone solutions, providing functionality or components that addressed imaging or scanning, workflow, document management, or enterprise relationship management. They were limited imaging and workflow systems typically deployed to support a single department in order to improve paper-intensive processes.

The goals of these first technologies were saving time, improving access to information, and reducing the costs and challenges of handling and storing paper. EDMS systems accomplished this by quickly providing online access to information that was previously only available on paper, microfilm, or microfiche.

As healthcare organizations achieved significant productivity improvements due to these departmental solutions, they deployed even more departmental solutions. But they lacked connectivity and integration. Multiple departments could not share in the knowledge and information achieved by one department. Purchasing did not speak to accounting. Accounting did not speak to customer service. Customer service did not speak to anesthesiology. It was a domino effect of non-communication.

The need to integrate these systems became apparent. Just after the turn of the millennium, integrated systems adopted the term integrated document management.

The evolution begins

Over time, the term “document” also broadened. Not only would it refer to scanned hard copies, but it was also used to refer to digitized Word docs, Excel spreadsheets, PDFs, eForms, CAD files, application print stream output as well as rich media like audio and video files. It also grew to include managed “documents” consisting of information that did not have files associated with them. These included electronic data transmission streams such as 835 and 837 forms as well as XML files.

”Documents” clearly became too narrow to accurately describe what was being digitized and the term “document” was replaced with “content.” The more common term became enterprise content management (ECM) to accurately reflect all types of content that was either being entered or generated into a digital format across an organization.

Given the diversity of the digital information that EDMS systems could manage, vendors pushed to officially rename this space enterprise content management. Therefore, Gartner released the first Magic Quadrant for ECM in 2004.

In the healthcare provider space at that time, organizations did not embrace the “enterprise” in ECM. Providers often used one document management system for administrative departments and a different system for clinical departments. In fact, it was common for a provider to have upwards of six document management systems.

Once again, there was a domino effect of non-communication. These separate systems gave rise to a new term called IT sprawl, where important content was stuck in information silos. For an industry where information and collaboration is not just essential, but critical, this was not good.

Manage content for action, not just archiving

Even though EDMS is still essential, it became clear that storing content wasn’t enough. As the complexity of business grew, so, too, did the capabilities of ECM. Some systems added business process management (BPM) to their portfolios to expedite the processing of routine, and sometimes non-routine, data.

Managing documents and content is not primarily about providing a repository to store them securely. Many healthcare providers and organizations in other markets overlook the fact that the repository was just one part of an ECM system’s set of capabilities. The real value delivered by ECM systems comes from their component capabilities that enable people and applications to make managed and coordinated use of content in the relevant context of care and work performed across the continuum of care.

This is central to the value proposition of the OnBase Patient Window.

In addition, no ECM vendors provided full-featured capabilities to manage clinical images. Healthcare organizations considered the management of clinical images a separate technology play. Healthcare analyst Barry Runyan of Gartner, however, has long advocated that ECM vendors look to extend their abilities so they can also fully handle medical images.

This becomes increasingly true as VNA continues to evolve to satisfy the clinical and business transformation needs of the HDO by providing a content management capability for a diverse range of healthcare images, documents and unstructured data. VNA and enterprise content management capabilities are converging as the healthcare enterprise evolves.

– Barry Runyan, Gartner

Two years ago, Gartner acknowledged that in the healthcare industry, it was once again time to recognize the breadth and the importance of the different types of content and files found in the medical record and embrace both DICOM and non-DICOM images, calling it a convergence of ECM and EMI (enterprise medical imaging.) [1]

The birth of content services

We now find the industry on the cusp of another new era. Enterprise content management is no longer enough. The industry has evolved into content services.

This new term describes the combination of security, access, locations, tagging, analytics, and a number of other applications that benefit content. It also incorporates the services and microservices that work either in an integrated product suite or as separate applications that share common APIs and repositories.

It’s less about focusing on the management of content and more about providing a complete view of exactly the right information at the right time, for the right people, where and when they need it. This allows organizations to utilize a broad variety of content types and to serve multiple departments, workflows, and populations across an organization to better serve the enterprise. It’s about leveraging enterprise content to transform business.

So, is your document management system an apple or an orange? Do you have data stuck in silos? Are you ready to learn more about selecting the right content service platform vendor?

If so, come visit us at HIMSS18 in booth 5743!


[1] Gartner Market Guide for Vendor-Neutral Archives, Barry Runyon, January 30,2017

Kate Barney

Kate Barney, RN, is Hyland’s marketing portfolio manager for the healthcare industry.

... read more about: Kate Barney

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