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Harbor Regional Center Goes Paperless
With Patient Medical Charts
Harbor Regional Center (HRC) is an organization with over 250 employees, of which approximately 150 are counselors who serve over 18,000 persons with developmental disabilities. Each of these clients has a chart. Maintaining this chart in paper form is a tremendous burden for the regional center. Many clients start with the regional center at a very young age, and are with the organization for life, producing an extremely large record.

Besides the sheer volume of each chart, there is also the problem of daily intake of new documents for the client. When a new document for a client comes in to the center, the chart has to be found. Is it with a counselor, or is it in the filing cabinet, or somewhere else entirely? Once located, the chart has to be taken apart, and the document put in the appropriate location in the chart. Then the chart has to be returned to the filing cabinet or counselor. Consider this for the hundreds and sometimes even thousands of documents coming in each day, and it’s easy to see that a very significant amount of employee time must be devoted to this task of keeping charts organized.

Now further consider that each of these charts is unique, there is no backup. If a client’s chart is lost, should a counselor have it in their car when it is stolen say, that file is gone forever. Also, because it is unique, only one person can look at it a time. Security is of course a problem as well. There’s simply no practical way to allow the counselors to do their jobs while the charts are under lock and key.

Overall Impact:
By digitizing charts, documents are now centralized, automated, and structured in the correct location based on a few keywords. Charts can now be located instantly, they are never lost on someone’s desk or misfiled in a cabinet. Records are now backed up daily, as well as having off-site backups maintained for disaster recovery. Secure access can be assigned on a user or group basis so users can only see the documents they need to see for their job function. This makes demonstrating HIPAA compliance more straight-forward.
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To summarize, HRC’s client charts presented a number of distinct challenges:

  • Size – The charts were simply too large to easily manage and work with.
  • Organization – The hundreds of new documents coming into the center each day were generating many hours of work to be filed properly.
  • Backup – Each paper chart is unique and irreplaceable. If lost, it is gone for good.
  • Access – Any client chart can only looked at by the person holding it in their hand.
  • Security – There is no practical way to secure these charts and still allow counselors to do their job.

HRC asked Ray Morgan Company (RMC) to evaluate the situation. We did, and proposed Laserfiche as the solution. Laserfiche is a complete document management system that has all the necessary components to make their case management completely paperless and highly automated. Let’s take a look at how this transformation took place, and what the results were.

The first step was to produce a document taxonomy. This is the procedure by which it is determined how the charts will be organized in the system – how they will be named, how they will be placed in folders, and how they will be indexed. This taxonomy is then used to do the backfile conversion. A backfile conversion is where documents already at the organization are sent offsite to be digitized by a third party service. This allows the organization to start with all their records already in the system and concentrate on capturing new documents as they come in. As part of the backfile conversion, RMC was also asked to migrate records from a previous digital document management system. Using the document taxonomy as a guide, these documents were brought in as well

The next step was to automate the capture of documents into the system as much as possible. To do that, RMC set up a system for each of the secretaries that work with the counselors. If the document is paper, they scan it into their inbox. If it is electronic, such as an email, PDF, or Word doc, they just drag-and-drop it in. From there, they simply fill in the ID number of the client, the name, and the type of document, and it is automatically filed for them. No hunting for the folder. No chart disassembly. A few keystrokes, and the documents is permanently stored in its proper location.

HRC wanted a very simple way for the counselors to access their digitized client charts with a minimum amount of training. By integrating with the HRC’s client management program Virtual Charts, and leveraging Laserfiche’s web-based capabilities, RMC was able to produce a one-click feature whereby a counselor simply clicks a button in Virtual Charts and the client’s complete charts is displayed and any document can be clicked on, opened, and read or downloaded. It is seamless, simple, and elegant.

How did RMC meet each of the above listed challenges by implementing the Laserfiche system?

  • Size – By digitizing the charts, they no longer have any physical dimension at all. Employees no longer have to deal with the sheer weight of a client’s chart.
  • Organization – Capture is now a centralized, automated, and structured process where digital records are placed in the correct location based on a few key words. Charts can now be located instantly. They are never lost on someone’s desk or misfiled in a cabinet.
  • Backup – Now that the records are digitized, they can be backed up daily, as well as having off-site backups maintained for disaster recovery. Having multiple copies of records ensures that if one is lost or destroyed, another is at hand.
  • Access – Multiple users can access the same digital record if they have rights to see that record. A supervisor doesn’t have to spend time tracking down a chart on a counselor’s desk, nor does a secretary have to collect it to add new records, saving everyone time.
  • Security – As all records are now digitized and stored on a secure server, access can be assigned on a user or group basis so users can only see the documents they need to see for their job function. This makes demonstrating HIPAA compliance more straight-forward.

Going paperless provided many additional benefits to the center as well.

Auditors – HRC is periodically audited. Part of this process is providing client charts. Previously this could be disruptive both in the time it took to gather the charts and also in that it meant either making a copy of the chart or the counselor having to do without it for a period of time. Now, Auditors are given access to a very narrow portion of the system, and special versions of the requested files are placed there. This takes almost no time at all. The counselors maintain access to needed charts, and little time is taken getting the charts to the auditors.

Additional Departments – Both the Human Resources and Vendor Management departments at HRC have also gone paperless in ways similar to those described above. They are taking advantage of auto-filing to organize records quickly, and, in the case of Vendor Management, giving web access to documents to members of the staff outside the department as appropriate. This has cut down on their time spent fulfilling records requests.

Mobile – The system also supports access over mobile devices such as iPads. This is a great way for staff members to access records that may come up during a meeting.

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