Optimising medical documentation efficiency

Member Article

Somerset Partnership NHS Foundation Trust optimises medical records

Patient care, positive outcomes and driving operational efficiency is at the heart of the NHS, not least at a time when it is publically acknowledged that it is grappling with financial challenges. In the spirit of necessity being the mother of invention, it’s not surprising that NHS initiatives like QIPP (Quality, Innovation, Productivity and Prevention) are being introduced to help it drive efficiency measures without compromising the quality of patient care it delivers.

One such example where this best practice is enjoying much success is the Somerset Partnership NHS Foundation Trust. The Trust provides a wide range of community health, mental health and learning disability services, mainly across Somerset, but also to some residents of neighbouring counties. It also provides a number of regional specialist services to patients from across the wider south west. Services are provided to all age ranges, and include inpatient care for general and mental illness, minor injury units, a wide range of specialist services in both community health and mental health services, and specialist healthcare for adults with learning disabilities. Many of these are delivered from 13 community hospitals and four principal mental health sites across the county but, as well as seeing people in Trust premises; they are able to offer appointments in other community venues which may be more easily accessible to patients. It makes more than 400,000 patient contacts each year. The Trust employs more than 4,000 members of staff, and has a turnover of £160 million.

To help it in part rise to its QIPP challenge, the Trust is using AutoStore and Equitrac from Nuance Communications to optimise print security, ensure patient confidentiality and reduce errors when capturing patients’ medical records, while enjoying easy integration with its RIO imaging management module.

When two become one

One major document-related issue the Trust faced and had to overcome was its two processes for capturing information about patients. Dating back to 2001, the Trust’s mental health department used a TWAIN driver, running between an MFP’s scanner and a PC, which together were used to convert scanned paper documents into more manageable electronic documents.

Once scanned, the document was stored in file-like folder then named using an elaborate and convoluted file numbering system. It used the patient’s name and a RIO-generated unique identification number, which was typically between 20 to 50 digits long. The laborious process of uploading document happened overnight, with thousands of documents being uploaded every week.

Following their joining of the Trust in 2011, the former Somerset Community Health services used a different process for document capture. A referral letter, for instance, would be scanned into a folder as a PDF then uploaded manually into the relevant patient’s record from within the RiO application. Again, this process was time consuming and introduced the potential for errors to be made which could have a bearing on patient care.

Easy integration between Nuance AutoStore and RiO

In order to optimise those processes and drive great efficiencies, the Trust deployed AutoStore, Nuance’s award-winning solution that orchestrates the capture and secure delivery of paper, electronic documents and data into business applications.

With AutoStore and the RiO Batch Upload Process working in conjunction, the Trust now has an intuitive and easy-to-use document uploading mechanism via the Trust’s fleet of MFPs. AutoStore has a bearing on the accuracy and completeness of patient records because it incorporates dual validation of the information, firstly by the user and secondly by the system, whether the documents being scanned are referrals, patient charts or observation notes. The new system captures key validating Meta Data during the scanning process and uses this data as the basis for the document naming convention, eliminating the former processes and ensuring accuracy.

Simon Eyles, Senior Project Manager at Somerset Partnership NHS Foundation Trust, explains more: “We had to make the document capture process much more efficient and to eliminate the chance of any errors being made. With AutoStore, when we have a letter to scan, we simply enter the NHS number or the RiO ‘A’ number to confirm that is the patient whose record we’re looking for. The system then does a look up, finds the patient’s data and creates a file to batch upload. It is both less onerous and reduces the chances of mistakes occurring.”

Simon added: “Documents have to be scanned against the right patient’s record which is a legal requirement as confidentiality is very important. AutoStore’s easy compatibility with RiO helps us honour this requirement.” Today, over 4,000 Somerset Partnership staff are using AutoStore, ranging from the Trust’s admin staff, to the nursing staff who use it to scan documents themselves.

Simon explains how AutoStore fits in with the NHS’s overall goal to drive productivity. “It helps because when you have more efficient administration processes, it releases more time to care for patients. The less time we spend on admin, the more time we have for the delivery of better, more compassionate care. AutoStore fits in with the NHS’ broader patient strategies and patient goals.”

AutoStore and Equitrac – helping the NHS achieve its productivity and efficiency goals

Helping to provide the Trust with visibility into who is printing and when, is another Nuance solution - Equitrac. A single, cost-effective output management solution that makes it easy to allocate and control document output costs, Equitrac helps reduce print and copy costs, while improving document security and eliminate waste to support environmental sustainability. With Equitrac, the Trust can now charge back print costs to departments, individuals or cost centres. This is possible because Equitrac creates a detailed picture of print spend - by user, device or department - helping Somerset Partnership NHS Foundation Trust to better monitor, manage and measure costs.

A solution the NHS can trust

Simon also explains how the reports help the Trust maximise the use of its existing investment in its print fleet: “The reports help us see how they are being used. With this information, we can make changes to scenarios where devices are either under- or over-used.”

Equitrac’s pull print process for document release has come in for praise, too. “Outside of the obvious security benefits – like preventing sensitive documents from being left unclaimed on devices - pull printing has other benefits, like being able to print to any device. Additionally, as users have to validate their identity before releasing their print, it makes people rethink whether or not they need to print. This plays a role in lowering our print costs.”

Complementing AutoStore and Equitrac is another Nuance solution, is eCopy PDF Pro Office. An enterprise-ready PDF solution, it is the smarter PDF desktop software companion to MFPs. Only introduced recently, Simon explained how it is currently being used to help compile multiple documents from multiple file formats into one secure and manageable PDF format. The completed documents are then reviewed by the Trust’s Governance team, who appreciate receiving and reviewing the documents in one easily viewable format.

Asked whether he would recommend Nuance solutions to other NHS departments or Trusts, Simon stated: “Yes, I would. There’s no question about it. They drive significant cost savings that more than justify their outlay. Productivity, efficiency and patient confidentiality are key to the NHS, and in the context of an efficient document workflow, AutoStore and Equitrac helps us to meet the NHS’s efficiency and productivity goals.”

This was posted in Bdaily's Members' News section by Pete Jackson .

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