Outsourcing Medical Records Operations Reduces Costs, Increases Efficiency and Improves Patient Care
Hartford Hospital, one of the largest medical centers in New England
Outsourcing medical records management without service interruption, while providing the highest level of patient care
With over 150 years of experience, Hartford Hospital understands the need to adapt and change. Based in Hartford, Conn., the hospital’s mission, "to promote, restore and maintain the health of all the people we serve," is lived out today by renowned medical staff in state-of-the-art facilities. Hartford Hospital has been ranked as a "Top 100 Hospital" by Solucient's 100 Top Hospitals National Benchmarks for Success and scored in the Top 50 for U.S. hospitals by the Consumer's Checkbook.
Staying abreast of patients' needs and medical advances is of the utmost importance to the Hartford Hospital staff. Hartford Hospital has established itself as a national and regional leader. It has one of the largest transplant centers in the Northeast with one of the highest survival rates and it maintains one of the state’s few Level 1 trauma emergency centers, as well as 24 x 7 emergency angioplasty and stroke services.
The Challenge: Creating an Efficient Records Management System
In order to provide the highest level of patient care, Hartford Hospital recognized the importance of providing doctors with quick and easy access to patient medical records, and assuring patients that their records are kept confidential and secure. However, the hospital’s internal records management system was proving to be insufficient. Hartford Hospital housed its files in a leased facility, which included 23,000 linear feet of open shelf medical records and more than 3,000 cubic feet of older medical records on microfiche.
The hospital experienced a number of challenges with their records management system, particularly in the human resources arena. Because the file room was located away from the main department, supervision of the file staff was challenging. Coverage of off-shifts often resulted in employees working alone, which leadership felt was risky.
The Health Information Management Department was dependent on the Hospital's Security staff to deliver records to the main campus. Understandably, this function was often not the Security staff’s first priority. In addition, decentralized medical records were often delivered “unannounced” to the file room when ambulatory clinic areas decided to purge, resulting in overcrowded files and a lack of inventory control.
Hartford Hospital turned to Iron Mountain’s Comprehensive Health Information Management (CHM) Program to manage its health records operations. By partnering with Iron Mountain, the world’s trusted partner for records management and data protection services, Hartford Hospital has the peace-of-mind that its medical records are secure and that records are always available for retrieval.
Before finalizing their decision, hospital management visited Iron Mountain facilities and researched other medical records programs. Iron Mountain was so committed to meeting the hospital’s unique needs that it placed two employees in the Hartford Hospital file room to observe activity levels and practices. By going above and beyond, Iron Mountain gained first-hand knowledge of the Hartford Hospital medical records system so only a month later, the hospital’s active file room was transferred to an Iron Mountain facility. During this time, Iron Mountain transitioned into the role of the medical records staff, while hospital file room employees posted for other jobs.
Generally, the implementation process of a large-scale records move takes at least two to three weeks. Hartford Hospital's entire file room was moved in eight days, without service interruption, to a facility only 10 minutes from the hospital. Iron Mountain also installed a printer connected to the hospital’s internal medical file management system. These measures allowed the request process to become virtually transparent to Hartford Hospital staff. "The Iron Mountain team prides itself in being the expert in records management," explains George Roebelen, general manager of Iron Mountain's Connecticut District. "As a result, Hartford Hospital staff could dedicate their time to the day-to-day activities that keep the hospital running."
Iron Mountain improved the efficiency and accountability of Hartford Hospital's medical records management. Iron Mountain retrieves 300 to 400 medical records daily, making five deliveries to three different locations at the hospital as well as STAT requests as needed. Open channels of communication ensure issues are identified and resolved immediately.
"...our medical records staff have the files they need when they need them, giving doctors the resources to make informed decisions..."
Cindy Pugliese, director of HIM at Hartford Hospital
The results are clear. Prior to implementing Iron Mountain’s CHM Program, Hartford Hospital staff would request all files associated with a patient instead of specifying which episode the medical team required. By streamlining procedures, the number of file requests decreased 20-40%, reducing costs and unnecessary handling time. Additionally, the Hospital implemented a structured process to purge its decentralized files and add them to their inventory system. This provided easier and more accurate accountability to outpatient records.
By outsourcing its records management, Hartford Hospital also improved the response time on file requests. In fact, the Cancer Registry used to order its files each Wednesday, for arrival the following Monday. The first time the clinic put in its request with Iron Mountain, the files arrived the next day. This improved response time eliminated unnecessary file tie-ups, lowering the risk of misplacement and optimizing the time to interfile loose reports. Iron Mountain now manages the loose report filing process as well, eliminating backlogs with daily report filings. When hospital personnel request a file, they can be assured that it’s complete, promoting better patient care and helping compliance with JCAHO’s Information Management Standard 6.60, which mandates a system to assemble required files, for patient care, treatment and services provided.
In addition, Iron Mountain’s SafeKeeperPLUS® system allows for more secure maintenance of files, enabling hospital staff to monitor, track and produce reports. The data collected gives hospital management visibility into activity trends so that the HIM director can re-examine how resources are deployed. For example, when the hospital identified a high number of emergency file requests, the director put new procedures into place to require sign-off on STAT requests, ultimately saving the hospital money. Lastly, the decision to outsource medical records to Iron Mountain has saved the hospital additional real estate, facilities management and HR costs. The hospital was able to terminate its lease with the facility where it formerly housed medical records, decreasing overhead with a 16 percent reduction in staff.
Most importantly, Hartford Hospital’s decision to use Iron Mountain's CHM Program has helped the hospital fulfill its mission of providing quality patient care. Hartford Hospital's Director of HIM, Cindy Pugliese, explains, "I thought it would go well, but not this well. Iron Mountain is without question the best buying decision I could have made. Not only are our medical records secure but our medical staff have the files they need when they need them, giving doctors the resources necessary to make informed decisions based on their patient’s health care history."