- Implement a multi-site DMS that would work with existing business processes
- Make document retrieval easy, accurate, fast and convenient
Document Situation and Work Process in the Lab
Originally, patients needing lab work went to the Outpatient Laboratory during the day and the main hospital Laboratory during the evenings and on weekends. A rolling file folder cart, which stored the paper lab orders, was wheeled back and forth between the two locations. Most of the time when a patient came to the Lab for a test, they brought a written lab order from their doctor with them. If they did not have a written order with them, it meant that the physician had either called or faxed the lab order in earlier that day or that the patient was at the Lab for a standing lab order (a test done according to schedule for a set time). The staff would first have to check the rolling file for one-time lab orders and then check the Rolodex, where standing orders were tracked.
If the patient was at the Lab for a standing order the staff member would note the time and name of the test on the Rolodex, then someone would have to call the other lab so they could update their Rolodex. When a one-time lab order was completed the actual order was clipped to other paperwork from the visit and then sent to the Lab Medical Records Department for filing.
When the hospital opened a third outpatient lab across town, they knew their existing paper-based system would no longer work. They had decided to make all of their records digital, but for a short time they were forced to maintain “identical“ paper filing systems. During this phase the Lab staff would spend 5-10 minutes per patient calling and faxing the other locations to track down one-time lab orders and verify standing lab order schedules. Between all three locations, the Lab tests 250 patients per day and the time spent tracking down information amounted to upwards of 20 man-hours a day. Maintaining the “identical“ systems required constant back and forth communication and was frustrating to the patients and staff alike.
Completed lab orders were kept on file for two years. If the Lab needed to look up an old order, someone would have to go downstairs, find the record, copy it and then re-file the original. One of the other problems with the Lab’s paper based filing system was that previously pulled lab records often did not get re-filed correctly. Accessing an old lab record took a minimum of 30 minutes and it is estimated that the Lab staff spent four hours a week just looking for old lab orders.
Document Situation and Work Processes in the Radiology Department
The Radiology Department was also struggling with the same problem as the Lab - how to temporarily store orders, in this case scripts, until the patient arrived, the procedure was completed, and the information sent to the hospital’s Medical Records Department. Before DocuWare, the Radiology Department stored their scripts in a huge box divided into nine sub-departments. The scripts were placed in the appropriate section and filed alphabetically by patient name.
Because the Radiology Department sees hundreds of patients per day, in total the staff spent 6 hours a day looking for scripts in an enormous box capable of holding 5,000 scripts. Time and again the scripts were out of order or lost and patients would have to wait while a new script was obtained from their doctor.
The majority of the scripts are picked up by the department’s courier, who stops by the physician offices located on the medical campus surrounding the hospital. The remaining scripts are faxed or brought in by the patient.