Increase the efficiency of managing and retrieving patient records

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					Securit Records Management Solutions for Healthcare Providers

                   Increase the efficiency of managing
                   and retrieving patient records, ensure
                   privacy and security compliance,
                   reduce departmental costs and space
                   requirements, and improve patient care
                   within your healthcare organization.
The Challenge
Budgetary constraints, legislative compliance and a desire to improve overall
patient care are forcing healthcare providers to seriously examine efficiencies
and costs within their organizations. One area in which improvements can
be effected is in the use, storage and access of patient healthcare records.

The Paper Problem
Large volumes of paper and computerized material are created at each stage
of the medical process. When a new patient is admitted, they are immediately
registered and transferred to a patient care area. The patient’s medical record
is then initiated, documenting their symptoms as well as a description of the
patient’s wishes for their care. To this file is added the battery of initial test
results performed to establish a direction for care, followed by further testing
records, procedures, medical professional notes, results, correspondence and
other pertinent data. Most if not all of this information is stored on paper in
the patient’s medical record.

It is therefore not unusual for healthcare providers to store hundreds of different
forms and documents in a single medical record. Canada’s Public Health Act
mandates that all patient medical records be securely maintained for a minimum
of 10 years (pediatric records are maintained for an additional 10 years from
the age of majority). To fulfill the requirements of this legislation, healthcare
providers spend millions of dollars annually to store and maintain their patients’
records. This massive volume of paper is generally kept in large basement
storage areas, spaces that are not fully secure and may be prone to flooding,
pest infestation and other forms of deterioration. Furthermore, the documents
are often loosely organized and prone to misfiling or loss.

Organizational Difficulties
It is common practice for ambulatory areas in a healthcare organization to
retain their own copies of patient records, using its own storage methodology
for classifying information, which adds additional complexity to the records
management process. Because there are numerous departments within a

healthcare organization, it is not unusual to have many different storage and
filing systems in place at one time. Creating a comprehensive patient record
can be next to impossible.

Additionally, there may often be numerous requests for patient information that
require retrieving multiple records, sometimes involving several departments.
It consumes an inordinate amount of time and money to locate all of these
historical and clinical records. The retrieval cost as measured in staffing hours
alone is staggering,
                                        The current paper-based medical records systems within healthcare
but this cost becomes                   organizations are flawed on many levels, including:
immeasurable when one                   • Non-standardized records indexing

considers the potential                 • Slow retrieval and access to records
                                        • Unsecured and poorly maintained storage areas
for delays and losses that
                                        • Lost records
impact the quality of
                                        • High cost in staffing hours and salaries
patient care.                           • Unnecessary impacts on the quality of patient care

The Solution
Securit Document Management
Strategies for HealthCare
Having an entirely electronic patient record (EPR) helps to solve the problems
and inefficiencies inherent in a paper-based system. Electronically created and
imaged documents can be stored on a central server within a healthcare
organization for both internal and external access by authorized staff. This
simplifies the process of securing patient records by creating restricted access
and digital tracking of the records viewed or printed.

                                                                         Archival patient records
  The focus of healthcare organizations moving toward a partial or
  full EPR system should be multifold:                                   in paper form can then
  • Eliminate or reduce the amount of paper used                         be stored in one of
  • Catalogue and index existing records with a universally
                                                                         Securit’s off-site facilities.
    applied format
  • Collect documents currently being created in paper form
                                                                         These facilities feature
    and image them into electronic form for inclusion in an EPR
  • Properly store archival paper records in a secure facility
  • Develop an efficient and reliable system to retrieve legacy files

video surveillance security, along with palm readers and access codes to open
magnetically sealed external doors. They are staffed solely by Securit personnel,
all of whom have been bonded, have undergone government security
clearances and have extensive training. In-rack sprinklers and fire suppression
systems ensure the physical safety of healthcare records, while environmental
control programs and above-ground storage maintain their integrity.

Case Study:
Toronto’s University Health Network (UHN)

UHN is comprised of the Toronto General, Toronto Western and Princess
Margaret hospitals. Across the three sites, UHN has currently 910 inpatient beds
and serves approximately 800,000 outpatient visits, 81,203 inpatient visits and
65,000 OR cases annually. In 1999/2000, UHN initiated Project 2003 — an
ongoing, multi-year project aimed at creating a modern and efficient health
sciences facility. In addition, UHN decided to move toward the creation of a
completely Electronic Patient Record (EPR) which would allow for the significant
downsizing of the Health Records department.

UHN approached Securit to help them achieve the downsizing of the Health
Records staff and department. From the very beginning, the company has
been an active partner in managing the migration of their records from a
paper-based system to an electronically based solution.

The first Health Record function to be subcontracted and managed by Securit
was the management of the file rooms. Securit helped the downsizing by
taking over the management of the Toronto General site and Toronto Western
filing rooms. Securit performed their work by indexing each file then using the
patient’s unique medical record number (MRN), which was cross-referenced
to a bar code that was strategically placed on the file. Hundreds of thousands
of charts later, Securit could tell UHN exactly how many files were in their
keeping and where able to track the whereabouts and history of each chart.

Case Study cont’d...
Toronto’s University Health Network (UHN)

Although too costly to image decades of legacy charts, UHN implemented on
a day forward basis, the scanning of Same Day, ER and Inpatient Charts in
April 2004. This enabled the elements of every patient record to be available
electronically to their clinicians.

As part of the process for scanning, Securit assessed, established, trained and
organized a Centralized Collection Area (CCA) within UHN. Securit staff work
within the hospitals collecting inpatient and more recently ambulatory depart-
ments charts each day. Each unit is responsible for ensuring that the chart
grouping of records for an individual patient has a cover sheet that contains a
bar code, which is cross-referenced with the MRN and visit number. Bar codes
are scanned by Securit staff using a hand-held reader, and then all files are
placed in boxes to go for scanning. Each box also features a bar code number,
allowing Securit to track every file within a box.

All files are then sent off-site to UHN’s scanning vendor where they are scanned
and available on-line for viewing by UHN clinicians within 24 hours. This
process allows staff instant access to patient records from anywhere within the
three hospital sites, or externally via a secure link. Unlike the paper system,
multiple users can now simultaneously access a complete patient’s record. Each
individual who uses the EPR leaves a digital footprint that includes their name,
their position, the date accessed and the documents viewed providing full audit
trail capabilities.

With the introduction of scanning UHN eliminated the on-site functions and
servicing of legacy files. The file rooms at both the Toronto General and
Toronto Western hospitals were closed. All paper records were transferred to
Securit’s records facility where management, storage and activities became the
responsibility of Securit.

A link from UHN’s clinical desktop system was integrated with Securit’s information
management operating system. This allows authorized UHN personnel to directly

Case Study cont’d...
Toronto’s University Health Network (UHN)

and seamlessly order legacy files from Securit. The standard delivery mechanism
set by UHN for requested files is delivery to the hospitals the following day.
In emergency situations, Securit can fax charts within 15 minutes, e-mail
charts with their Image on Demand service or perform a physical rush delivery.
In addition there are specific daily deliveries to the OR, Ambulatory areas,
Cardiac Care Centre and Health Records. Says RoseAnn Pacheco, Manager of
the Clinical Information and Records Services for UHN says, “The Securit team
have been great. We actually have certain areas of the Toronto General and
the Toronto Western where they even hand-deliver chart requests. As a fully
functioning Health Record Department, we could not have provided this level
of service.”

UHN’s ambulatory care clinics are now starting to send their charts for scanning
and storage with Securit as space is a concern. Over time as more and more
visits are scanned it is expected that only 5% to 10% of UHN’s legacy files will
ever need to be retrieved by staff. The savings on space and staff will be sufficient.

In 2001/2002, UHN spent $4.5 million annually on health records manage-
ment. By 2005/2006, these costs will have been reduced to just $1.2 million.
In March 2005, UHN’s Shared Information Management Services (SIMS) gave
back approx. $2.5 million to the hospital budget from health records savings
alone. From 2000/2001 to 2005/2006, staffing requirements in health records
were reduced to just 13 employees from its original 90. In the process, UHN
has been able to create usable rooms from the large spaces previously reserved
for storing paper records. In the case of the Toronto Western Hospital, space
occupied by health records decreased from 3000 square feet to less than 300.
The appointment of a full-time security/privacy officer ensures that all UHN
staff are fully trained on the proper access and use of patient records.

  Before Securit                               After Securit
  • $4.5 million on Health Record Management   • $1.2 million on Health Record Management
  • 90 Employees                               • 13 Employees
  • 3000 Square Feet                           • Less than 300 Square Feet

Case Study cont’d...
Toronto’s University Health Network (UHN)

Patient records are stored electronically for rapid and efficient online viewing.
In the rare cases it proves necessary to reference a paper legacy file, they can
be retrieved in a timely fashion from off-site storage. Says Pacheco of her
experience with Securit, “UHN has benefited from having Securit manage their
health record files. They have a way of indexing the charts and making sure
that they’re in the proper numbering sequence, which creates a system where
charts are able to be easily retrieved and tracked.”

UHN has come to value Securit’s expertise so much that Pacheco foresees a
long relationship between the two companies. “Basically, whenever I think of
a Health Records function now,” confesses Pacheco, “I first think, ‘Can I out-
source it?’ If I can, I usually have a conversation with Securit to see if they can
do it. The funny thing is that Securit never says no. They always try to come
up with a solution. That kind of attitude makes for a great partnership!”

Securit ensures the safety and protection of patient information even after
health records have reached the end of their lifecycle. Shred-it is the world’s
leading document destruction company, a company that falls under the
umbrella of Securit. Shred-it ensures the privacy of information and prevents
patients’ records from falling into the wrong hands by performing on-site
shredding before ever leaving UHN or Securit’s off-site storage facility.

  Summary of Net Benefits for UHN
  Securit’s involvement in the creation and management of the patient record’s management system
  for the UHN has resulted in the following benefits:
  • Close to $2.5 million saved over 5 year period
  • Health Records services staff reduced from 90 to 13
  • Health Records management budget reduced by $3.3 million annually
  • Instant on-site and off-site access to EPRs
  • Simultaneous access to EPRs by multiple authorized users
  • Space savings from off-site records storage
  • Safe storage in properly secured facility
  • Time and money saved so able to focus resources on improving healthcare for patients

About Securit                                   About Shred-it
Securit is a Canadian company. Securit          Shred-it, another arm of the Securit Canada
Records Management, one branch of the           company, was founded in 1988 and, with
organization, can either complement existing    more than 130 branches on five continents,
records management programs, or custom-         is now the world’s leading on site document
develop new systems. By integrating the         destruction company.
latest in bar code technology, security and
                                                Shred-it serves more than 150,000 customers
service, Securit provides enhanced online
                                                around the world exceptionally well. We’re
records management and secure off-site
                                                pleased to say that our customers are very
document storage with rapid retrieval access.
                                                satisfied with our services. So much so, that
                                                for the past three years, independent research
 SECURIT RECORDS MANAGEMENT                     tells us that our clients would “definitely
 Corporate Head Office                          recommend our services to others”.
 2794 South Sheridan Way
 Oakville, Ontario, CANADA L6J 7T4
 Phone: 1 866 FILEBOX / 1 866 345-3269 /