Paper Crisis in American Hospitals · gr/dec03/Executive Survey.US Hospitals Paper Crisis.ppt 3...

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Executive Research Report:

Paper Crisis in American Hospitals

Conducted by Healthcare Information and Management Systems Society (HIMSS)

December 15, 2003


Contents

• Executive Summary• Results Overview• Profile of Respondents• Document Management Issues• Document Management Solutions Needs/Wants• Buying Influences and Behaviors• Recommendations


Executive Summary

Many healthcare professionals would concur that there is a growing paper crisis in U.S. Hospitals. The amount of documentation required is often attributed to mounting government regulations (currently Medicare regulations are estimated at more than 130,000 pages alone), federal mandates and payer requirements. As an example, an estimated 60 pieces of paper are generated for each hospital patient visit.

Unfortunately, the burden and costs associated with the management of documents and related processes are often unaccounted for based on the input received from this survey. As a result, healthcare executives need a greater awareness about how their organizations can uncover hundreds of thousands in cost savings through better document management and control.

This survey helps define what document management is and summarizes some of the greatest areas of concern and desired outcomes for healthcare professionals.

The survey was conducted by HIMSS for Lanier Worldwide. Total respondents as a result of the survey was 164 Healthcare Executives in hospitals, healthcare systems and other facilities nationwide.


Results Overview

1. Medical records management is identified by nearly every respondent as being problematic. Correspondingly, the Medical Records Department was cited as having the greatest challenges with paper management.

2. Dealing with manual registration and admission forms, along with general forms and report management were cited as the next most significant problem areas. The Business Office and Human Resources departments were frequently cited as problem areas for managing and maintaining paper documents.

3. Efficient document distribution, secure access to patient information and ease of finding patient charts are the most desired solutions. Approximately 70% of organizations indicated it is important to address these within six months.

4. Organizations vary widely with respect to how much of their document management equipment is connected to their networks. Their most significant concerns about network connectivity are support, maintenance and compatibility with existing systems.


Results Overview

5. About half (54%) of organizations responding indicated they do not track document management costs in detail and only 28% indicated they actively track and manage these costs. This implies there is a lack of awareness about the high costs associated with managing document.

6. More than three quarters of respondents indicated their organizations spend less than $500K annually on document management.

7. Reliability, service and support top the list of most important criteria for selecting document management solutions.

8. CIOs and Materials Managers are the key decision makers.CFOs have at least some influence among three-quarters of organizations.

9. The majority of respondents (62%) are not aware that Lanier offers advanced enterprise wide document management solutions.


Profile of Respondents


Respondents by Organization

By Revenue By Bed Size

N = 164

7%

2%

19%

32%

17%

7%

13%

11%

Don’t Know

N/A

<$50M

$51M-$200M

$201M-$350M

$351M-$500M

$501M-$1B

>$1B

18%

43%

14%

10%

3%

12%

<100

100-349

350-500

501-750

751-1000

>1,000


Respondents by Title

The majority of respondents came from CIOs and IT Directors.

1%

2%

2%

2%

2%

3%

5%

38%

45%

COO

VP Materials

Other

CEO

Materials Manager

Department Head

CFO

Director IT

CIO


Document Management Spending

The majority of respondents spend between $50K and $500K annually on document management equipment.

Q4: What did you spend on copiers, printers, scanners, faxes and the related forms in your most recent fiscal year?

19%

31%

28%

5%

6%

1%

<$50K

$50K-$100K

$101K-$500K

$501K-$1M

$1M-$5M

>$5M


Document Management Spending

Not surprisingly, spending is correlated with revenue. Three quarters of organizations with more than $200M in revenue spend more than $100K per year on document management equipment.

Q4: What did you spend on copiers, printers, scanners, faxes and the related forms in your most recent fiscal year?

42%

22%

3%

32%

50%

23%

26%

28%

74%

<$50K

$50K to$100K

>$100K

<$50M $51M to $200M >$200M


Group Purchasing Membership

A large majority (75%) of respondents belong to a Group Purchasing Organization (GPO). Of those, 31% belong to VHA and 29% belong to Premier.

Q5: Is your facility part of a Group Purchasing Organization?

Yes75%

No15%

Don’t Know10%


Document Management Issues


Document Management Problems by Activity

Managing paper-based medical record storage and retrieval, dealing with manual registration and admission forms, and general forms and report management were cited as the most significant problems.

Q6: Please indicate to what extent these areas are a problem for your organization.

16%

21%

16%

49%

73%

68%

66%

57%

43%

12%

33%

53%

7%

Other

System Integration

Lost Information or Files

Asset Management

Forms/Report Management

Manual Forms

Medical Records

Significant Problem Somewhat Problematic

= 96%

= 90%

= 87%

= 80%

= 80%

= 65%

= 17%


Document Management ProblemsBy Department

Medical Records, Business Office and Human Resources are most problematic for managing and maintaining paper documents.

Q7: Identify the top three areas that seem most problematic when managing and maintaining paper documents, such as forms, patient charts and reports.

9%

10%

10%

15%

25%

42%

46%

49%

87%

Pharmacy

Other

Laboratory

Radiology

Emergency Room

Admission/Reg

Human Resources

Business Office

Medical Records


Network Connectivity

Respondents vary widely in terms of what percentage of their document management equipment is connected to the network. Three quarters of respondents have less than 75% of their equipment networked. This strongly suggests organizations have much to benefit from improved productivity and lower costs when devices are connected.

Q9: What estimated percentage of your organization’s printers, copiers, scanners and fax machines are connected to the network?

1%

23%

23%

29%

23%

1%

None

<25%

25%-49%

50% - 74%

75% - 99%

All


Network Connectivity by Revenue

There is little correlation between organization size and network connectivity.

Q9: What estimated percentage of your organization’s printers, copiers, scanners and fax machines are connected to the network?

23%

19%

32%

26%

23%

19%

38%

21%

24%

30%

21%

25%

Lessthan 25%

25-49%

50-74%

75% orGreater

<$50M $51M to $200M >$200M


Network Connectivity Concerns

The most significant concerns regarding network connectivity are support, maintenance and compatibility. This would indicate that healthcare executives want some measure of reassurance that there is a strong support infrastructure from a provider.

Q8: What are your concerns with respect to having copiers, printers, scanners and fax machines connected to the network? (Select all that apply).

11%

16%

40%

51%

57%

72%

Other

Installation

Reliability

Operating SystemCompatibility

Maintenance

Support


Document Management SolutionNeeds/Wants


Top Two Solutions

Of all solutions offered, respondents most frequently chose efficient document distribution, secure access to patient information and ease of finding patient charts as most important. Reducing total cost of ownership was chosen by only 22% of respondents. Therefore, an assumption can be made there exists a general lack of awareness regarding the high cost to an organization for document processing and management.

Q10: Out of the descriptions below, what are the top two you would find most desirable?

3%

16%

22%

23%

38%

47%

53%

Other

Accurate Billing Data

Cost Management

Legibility

Finding & Storing Patient Charts

Security

Efficient Document Distribution


Key Observations

Survey responses imply several possibilities regarding the general lack of interest in reducing total cost of document management.

– Total cost of document management may not be significant for many organizations.

– Most organizations are not aware of their document costs or the associated potential cost savings from available solutions.

– Given other pressing issues such as HIPAA, patient safety and overall significant cost reduction initiatives, total cost of ownership related to document management may be a lower priority.


Top Two Solutions by Revenue

Solutions for finding and storing charts is more important to smaller organizations. Smaller organizations also indicate a higher need for security solutions . Efficient document distribution is more of an issue for larger organizations.


32%

65%

45%

60%

40%

43%

59%

47%

30%

EfficientDocument

Distribution

Security

Finding &StoringCharts

<$50M $51M to $200M >$200M


Top Two Solutions by Title

Solutions for security, efficient document distribution and cost management are more important to non-IT respondents. Solutions for searching, retrieving and storing patient charts are more important to IT respondents.


40%

19%

52%

50%

29%

36%

61%

68%

Finding &StoringCharts

CostManagement

EfficientDocument

Distribution

Security

IT Director & CIO Non-IT Respondents


Solution Urgency

For each of the top three solutions (identified in yellow below), more than 69% of respondents indicated it is important to address these in the next six months. Security is the most significant area of concern.

Q11: How important is it that you address the areas you marked in question #10 in the next six months?

58%

61%

67%

69%

74%

76%

81%

Cost Management

Accurate Billing Data

Other

Efficient Document Distribution

Finding/Storing Charts

Legibility

Security


Cost Awareness

More than half of respondents (54%) don’t track their document management costs in detail. Only 28% track costs in detail and actively manage them.

Q12: Which of these statements most closely resembles your organization’s awareness of document management costs?

We Don’t Track These In Detail

54%

We Track These Costs, But Don’t Actively Manage

13%

Don’t Know5%

We Track & Manage These

Costs28%


Buying Influences and Behaviors


Buying Criteria

Nearly three-quarters of respondents (74%) rated reliability as “very important”, higher than any other criteria. Service and support were close behind in terms of importance, with 99% indicating either very important or important. Buyers want their equipment to work and when it doesn’t, they want support to fix it.

Q13: Please rate the criteria for purchasing solutions from document management companies.

57%

45%

34%

35%

24%74%

52%

64%

Cost

Contract Terms

Service/Support

Reliability

Very Important Important


Decision Makers

CIOs and Materials Management have the most influence on purchasing decisions for document management software and hardware. However, the data indicates CFOs and department heads are significantly involved in the decision-making process.

Q14: Who in the organization has the greatest influence when evaluating document management software or hardware such as copiers, printers, fazes or scanners?

11%

40%

28%

31%

48%

48%

42%

34%

19%

50%

11%

26%

2%

6%

9%

13%

13%

22%CEO

COO

DepartmentHead

CFO

Dir or MgrMaterials

CIO

Great Impact Some Impact Little or No Impact


Recommendations


1. Challenge providers to maximize existing assets. When considering options for managing documents, ask questions about the full range of options, from enterprise-level, network-dependent systems to individual systems that include one or two hardware assets.

2. Focus on cost efficiency. Solution providers should be able to demonstrate clearly the ROI of any system and provide case studies from other healthcare customers. Total cost of ownership should also be calculated for the long-term, not just for the first year in operation.

3. Hospitals need to fill in the gaps between paper and electronic documents with a solutions provider that facilitates the transformation of paper documents into electronic formats.

4. Do not sacrifice ease of use. Keep it simple. The capabilities of the technology should remain secondary to the ease of use. Points to consider when evaluating ease of use include: the number of steps involved in a given process; the flexibility of the process to accommodate various or changing workflows and the appearance and navigation of the solution.

5. Demand service and reliability. Look for providers with experience and automated technologies to better support your organization’s needs immediately.


This survey was funded by Lanier Worldwide, Inc., to help support healthcare and medical professionals in the

delivery of cost-effective, quality healthcare.

Please visit us at www.lanier.com/hc

Paper Crisis in American Hospitals · gr/dec03/Executive Survey.US Hospitals Paper Crisis.ppt 3...

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