Reimagining Document Management and Data Abstraction

By Shane A. Peng MD, FAAFP
December 20, 2019

Healthcare organizations run on information. Unfortunately, the documents they must process come in at such a rapid rate that it threatens to overwhelm some organizations.

These documents include clinical information from test results and medical imaging as well as nonclinical infor­mation including advertisements and medical product brochures.

Inefficient management of incoming informa­tion consumes staff time, up to two hours per day per physician by some estimates. It can take five to seven days for some information to reach the appropriate clinician, which can delay treatment and make it difficult to streamline care processes. Patient satisfaction suffers, and outcomes can be negatively impacted.

Five strategies can help with document man­agement in healthcare organizations: digitization, centralization, pushing the burden to the patient, health information exchanges, and outsourcing.

  1. Digitization: The best way to manage paper is to avoid it in the first place. Storing digitized data in discrete locations in EHRs reduces the amount of paper handled and makes it faster and more efficient to retrieve the information as needed.
  2. Centralization: In larger organizations, the use of centralized documents can make the process more efficient. Dedicated staff with specific skills can evaluate documents and route them to the appropriate locations.
  3. Pushing the burden to the patient: Patient portals provide a means to let patients upload their own documents and provide other infor­mation. Prescription refill requests, pre-visit questionnaires, and other information updates can be completed by the patients, which will reduce the number of documents that staff must handle.
  4. Health information exchanges (HIEs): HIEs provide third-party services that take the place of a centralized document handling solution. Relying on technology driven by rule-based processes, documents can be aggregated and organized efficiently. Such arrangements are only useful if a significant number of local healthcare organizations use it so that patient data can be shared effectively without paper documents.
  5. Outsourcing: A third-party document man­agement service can remove the paper-handling burden from existing staff. Some high-performing services employ physicians to help guide the decision-making processes. The key is to use consistent naming and filing con­ventions so that the healthcare organization staff can access the information efficiently.

What does your organization do with the paper that comes in the door?  Come on, be honest. The truth probably is that you don’t even know what types of paper you’re handling, much less what you do with it. It’s hard to make sense of such a huge influx, especially if yours is a smaller business with a bare-bones clerical staff.

The question is, how important is it for you to get more on top of this issue? Are the docu­ments you’re tackling more likely to be office product catalogs or faxed patient data due for entering into an EHR? Obviously, the latter must be treated with far more care than the former.

Another issue to consider is the degree to which you use paper processes to manage your financial affairs. If you handle billing and col­lections largely using online tools, your paper processes will require less tuning than if you collect and request payments largely using paper. Of course, if you’re relying on paper to maintain your practice’s financial health, it’s best to be aware of every step in its journey through your practice doors.

The net of all of this, though, is that manag­ing documents may be more important to your group’s success than you might think. Taking a look at where those catalogs are is a good start toward gaining better control.

Excerpt from Peng: Reimagining Document Management and Data Abstraction, Journal of Medical Practice Management, May–June 2019

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