Healthcare System Lowers Costs, Improves Patient Care

Facility-wide Solution Facilitates Transition to Electronic Records, Reduces Costs and Doubles Retrieval Rates

CHALLENGE: Improve patient care through better access to records while lowering costs

SOLUTION : Re-engineered records management processes to facilitate transition to electronic records

RESULTS: Improved retrieval rates, enhanced care and savings of 20 percent

"Partnering with RMS, and now Iron Mountain, was absolutely the best decision we’ve ever made. Their team has become an extension of our team. They’re extremely professional, they understand how to meet our needs on a clinical level, and they deliver."

Client: Barbara Manor, senior direct or of Health Information Management, Exempla Healthcare

Formed in 1998, Exempla Healthcare includes three hospitals and a network of clinics serving patients in the Denver-metro area. The organization has a staff of over 7,000 employees and 2,000 physicians. More than 153,000 patients visit its emergency departments each year.

Exempla needed a records management solution that simultaneously improved access to patient information and facilitated their transition to electronic records. In addition, Barbara Manor, senior director of Health Information Management, realized that to gain administrative approval, the solution also needed to reduce costs.

After evaluating several options, Exempla turned to RMS Services — acquired by Iron Mountain in 2007 — for its healthcare expertise and comprehensive management capabilities. In just one week, the RMS team completed a survey that re-engineered the department's workflow and staffing, generating savings that helped fund Exempla's scanning and Electronic Medical Records (EMR) program. As a result, Exempla has improved patient care — retrieving requested records with 100 percent accuracy — while reducing operating costs by 20 percent and positioning itself for a smooth transition to the EMR.

The Challenge: Multiple Records Management Systems Across Facilities Lowers Retrieval Rates and Increases Costs

When Lutheran Medical Center and Saint Joseph Hospital formed Exempla Healthcare, each hospital brought its own records and storage challenges. Dwindling onsite storage space, separate facilities, and poor records management by non-specialty, offsite storage vendors resulted in low retrieval rates of around 50 percent. A third hospital, Exempla Good Samaritan Medical Center, was originally designed to be a paperless facility, without storage capabilities. However, when the hospital opened in 2004, the facility was not completely paperless and needed a storage solution.

While Exempla’s most pressing matter at that time was to improve patient care by enhancing access to records, it also needed an efficient, organization-wide solution to prepare for their imminent transition to the EMR. Exempla developed a task force of senior leadership staff to evaluate storage options and considered a number of possibilities.

"One of the options was to develop a storage facility ourselves," said Manor. "However, our research showed that the initial setup costs and infrastructure required to build out a complete record center were so significant that we could not justify it."

Their team knows healthcare’s complex requirements and really has a handle on how records management should be.

The soluti on: Im proving Accessibility While Lowering Costs with the RMS Solution

Exempla was impressed by RMS’ extensive healthcare expertise and follow through. Where other vendors could not deliver on scale or lacked industry knowledge, the RMS Solution re-engineered Exempla’s record center layout and improved tracking. Despite a tight timeline due to major renovations and expiring leases, all records from the non-specialty storage vendors and the onsite locations were moved on schedule to a dedicated record center and remained accessible throughout the process.

In addition to moving Exempla’s onsite files, 14.5 miles of boxed records that previous vendors had left inaccessible were evaluated for destruction, relabeled, reordered and transferred to the dedicated facility. Re-engineering records management enabled better control over manual processes, patient identification and retention policies, building the foundation for Exempla’s eventual migration to electronic records.

Exempla’s first step toward the EMR was shifting to PACS for medical imaging. With records now centralized, hard copy deliveries of radiology films were discontinued. Record center associates began digitizing pertinent films so radiologists could compare prior and new studies in the same format. Within 24 months, film requests decreased by 80 percent.

The next step was to begin imaging documents not initially created electronically. Exempla required a partner that could prepare, scan, index and QC documents within one day of receiving patient records. The RMS/Iron Mountain team participated in technical training to understand conversion requirements, reorganized workflow and exceeded expectations with a seamless transition plan and timely scanning of patient records at discharge.

The results: 100 Percent Retrieval RATE , Enhanced Care and Savings of 20 Percent

"The RMS Solution is completely turnkey and requires no effort on our part,” said Manor. “Their team knows healthcare’s complex requirements and really has a handle on how records management should be."

Exempla Healthcare has transformed its records management to a smoothly operating process that ensures higher quality care at a lower cost. The savings from Exempla’s record center program helped fund other EMR initiatives, such as film digitization and document scanning. Benefits include:

• 100 Percent Retrieval Rate. Thanks to the RMS Solution, Exempla now enjoys a perfect retrieval rate, an improvement that has a direct and positive impact on quality of care.
• 20 Percent Cost Savings. By outsourcing the entire process to one vendor, annual records management costs decreased by 20 percent and savings were redeployed to fund other strategic initiatives.
• Centralization for Efficiency. Centralizing records allowed Exempla to get their arms around their systemwide storage needs, improve efficiency and heighten security. Locations that previously held files were converted into additional clinical space and a computer training facility. Digitization of centrally stored radiology films decreased hard copy delivery requests by 80 percent within 24 months.
• Faster and Higher-Quality Imaging. Since Iron Mountain took over document imaging, Exempla has experienced a significant drop in turnaround time to under 24 hours and an improvement in the quality of scanning and indexing. Timely imaging has enabled Exempla to meet a compressed timeframe for revenue cycle.
• Industry Recognition. Exempla’s success has become a model for other Colorado hospitals, and many organizations turn to Exempla for advice. The Health Information Management Department was also recognized internally, winning a 2006 award for the project that had the biggest impact on the overall quality of patient care across the entire Exempla Healthcare system.

About Iron Mountai n. Iron Mountain Incorporated (NYSE: IRM) provides information management services that help organizations lower the costs, risks and inefficiencies of managing their physical and digital data. Founded in 1951, Iron Mountain manages billions of information assets, including backup and archival data, electronic records, document imaging, business records, secure shredding, and more, for organizations around the world. Visit the company Web site at ironmountain.com for more information.