Week 10

I have completed my cost analysis and also learned what must be done so more hospitals and physicians begin using EMR. While I will explain this in my upcoming presentation, I'll give a brief explanation. The equation I must use to calculate the annual cost of record keeping is (Monthly Charge x Cubic Feet x Number of Boxes x Minimum Retention Period x 12 Months x 29 Departments) + Transportation Fee + Storage Fee + Data Entry Fee + Fuel Surcharge + Pickup Fee. The annual cost comes out to about $2.6 million. 

Compare this with EMR, which has two kinds: Onsite deployment, where the servers are at the hospital, and web based deployment, where the servers are with the company the hospital works with. The cost for each comes out to about $500,000-$600,000 for the first year, after adding labor costs. As a result, the savings for the first year would be more than $2 million if switching to EMR. However, after five years, the savings drastically increase, as the annual cost of EMR has a much smaller fee of about $4000-$8000 while the annual cost of paper record keeping  is constant. Thus, EMR would save a hospital about $10.5 million after five years.

While EMR saves a lot of money, it takes time to go through all the departments and data systems to compile the data. In fact, it takes longer to retrieve data from an EMR than a warehouse. Thus, a linked or singular data system must be established for more physicians to start adopting EMRs.

Week 9

I haven't yet finished destroying all the documents that passed their retention periods, so I continued doing that this week. Unfortunately, my mentor and I have not been able to meet with the workers who are supposed to instruct us on scanning the documents, nor have I received all the numbers I need to complete my cost analysis besides the storage, retrieval, fuel, entry, and trip charges. We will meet with them personally during my next shift and hopefully get all the numbers I need, as the cost analysis is the last thing I need to complete.

Week 8

After meeting with representatives of the department whose documents were in question, they told us to destroy all of their documents prior to April 2013. I began going through boxes to check the dates of the records contained in each box and threw them away if the date was before April 2013. I also began polishing up my paper and presentation. I am still waiting on some employees to get back to me with all the numbers I need to complete my cost analysis.

Week 7

I have finally begun going through the several boxes of records. There are about 43 boxes and each box contains records ranging from closed studies to employee records. My job is to decide which records to keep and which to destroy, which I determine based on the state records retention schedule. If the retention is labeled permanent or is a certain number of years that haven't passed yet, then the records must be kept so they can be scanned in. Records such as those based on hospital policies and procedures which I found today must be kept. I found many documents related to employee profiles from more than a decade back. Records such as those must be destroyed through shredding. However, we are not sure yet as to what to do with documents such as the closed studies, because there is another department in charge of such documents. Next Monday we will meet with representatives of that department to determine what to do with that department's documents.

I was asked previously if there was a way for patients to check their own records with a username and password. I had answered no, but I checked with my mentor today and she told me that patients can actually check their records through a program called MyChart. Sorry for the incorrect answer!

Week 6

I have finally begun to start going through the boxes of records at the hospital. While the boxes themselves are only labeled by a series of letters and numbers, the folders inside each box have labels designating what they actually are, such as "Meeting Minutes" or "Education." My current job is to go through each box, match each folder with its category on the records retention schedule, and then put a sticky note on the folder with the year the documents are from, what category the folder is part of, and how long the retention period is. For example, folders labeled "Meeting Minutes" have a retention period of "permanent," meaning they must always be kept. Folders labeled "Hiring/Selection Records" must be kept for a period of three years. There are still several boxes to go through containing hundreds, if not thousands, of documents. Next Monday, my mentor and I will meet with representatives from another department in the hospital who will tell us what to do with the boxes, the documents that have passed their retention period, and how/where to scan in the documents that the hospital must still keep.

Week 5: Quick Update

This is just a small update. While I was supposed to begin looking through the boxes of records the department has, I was unable to begin because of some difficulties that came up, such as how to categorize them, what to do with the records, and who to send them to. We will begin going through the records next week once we have this information. Due to this slight setback, I did data entry instead on several different patients as an ongoing side project.

Week 4

This past week I had the chance to work a little bit with the hospital's system as well as do my own analysis. I was tasked with updating patient information in their electronic system, such as updating insurance information as well as inputting dates.

I conducted analysis on federal and state records retention regulations. I found out that the federal government has set many different retention schedules for several different types of medical documents. Some documents are meant to be kept for three years, while others should be retained for five years. Documents related to Veterans Affairs must be kept for a good 75 years before being destroyed.

Each state government has their own specific records retention regulations as well. Arizona specifically requires patient documents to be retained for six years after treatment by a healthcare providor before being destroyed.

Week 3

Things are going slowly, but the methods in which I'll be conducting data analysis are slowly being outlined. On Monday I attended a meeting in which I was given a task in updating patient information. On Wednesday I worked on updating said information and also began to conduct research at the medical center library concerning federal and state regulations on record retention.

Week Two: Getting Started

            The task I was given during my first week working at the hospital was to update insurance information for several doctors who worked at different clinics around Arizona. The information was kept on a paper document and it was last updated in 2011. For each doctor, I had to call the number listed and verify the address, phone number, and fax number. I would then ask what insurance they accepted. I made a new Excel Spreadsheet and kept all the information on this electronic file.

Week One: Project Description and Goals

Welcome to my blog! Each week I will give details about the progress I am making on my project that I am conducting at a medical center. In this post, I will describe what my project is and what I hope to accomplish. However, the nature of this project can change as the weeks go by.

Due to many state regulations, some healthcare documents are kept in an electronic format. However, the current process involves keeping them in paper format and storing them for many years, sometimes longer than necessary, which results in unnecessary filing fees and costs. My project will require me to research the potential cost savings to a healthcare organization to migrate to the new electronic record keeping from the old filing method. I must examine existing documents and records to determine the types of documents. I will conduct research on the legislature and regulators’ requirement of record keeping to determine which can be filed electronically, for how long, and which can be destroyed. Finally, I will perform a cost analysis based on my determination.

Not only does keeping records and documents in a paper format and filing them manually incur unnecessary filing fees and costs, but it is also more time consuming to look through and find records manually. Storing documents electronically allows for a more efficient method of searching for records. It is also cheaper to keep documents in this manner because normally they do not stay in the system for a long period of time and thus do not incur extra filing fees. Switching to electronic record keeping would impact the hospital by increasing productivity and decreasing costs. Fewer mistakes are also made through electronic record keeping.

            I will conduct mostly internet research to complete this project, but I will make use of interviews with employees at the hospital who work in this field, specifically workers in the department responsible for keeping medical records. One obstacle that I have already encountered is that I do not know what problems I should expect when I am conducting research. Thus, I have no contingency plans in place at the moment in case something goes wrong. However, I hope to offset this unknown by doing more research in this field ahead of time so I can avoid any problems before they come up.

            The goal I have set in place is to use my analysis of the record keeping system to help the medical center completely transfer all paper records to the computer system.