August 25, 2014 - The article below first appeared in DecisionHealth's weekly newsletter Home Health Line. For more than 20 years, every weekly issue of Home Health Line has been delivering regulatory news, proven best practices and tools to help your agency provide excellent patient care and increase profitability. For more information on the newsletter, visit http://homehealthline.decisionhealth.com, or call 1-855-CALL-DH1
Going paperless increases agency’s efficiency, saves thousands of dollars
One simple solution has helped an agency save more than $100,000 a year: Being able to fax electronic medical records to doctors through its computer system, without needing to print or mail anything.
Adding a web-based solution offered by Forcura and going paperless has allowed Gaffey Home Nursing & Hospice in Sterling, Ill., to avoid laying off clinicians despite the recent regulatory cuts, says Kim Gaffey, the agency’s owner and CEO.
Forcura’s web-based solution costs the agency about $10,000 a year, was easily integrated into electronic medical records (EMR) and helped the agency go paperless. Clinicians use Forcura to send faxes from the agency’s EMR system, CareFacts, directly to doctors. The technology is secure and HIPAA-compliant, says Craig Mandeville, Forcura’s founder and CEO.
Forcura places barcodes on all outbound documents electronically faxed and expecting completion and signature, Mandeville says. When the document is faxed back to agencies, the barcode “is scanned and automatically linked to the pending document for a team member’s approval.” The document is saved and stored to appropriate patient charts, without the agency needing to use manual indexing.
Gaffey, which covers eight counties and has a census of about 250 patients in home health, hospice and private duty, has been using an EMR system for about 10 years. But while the system had been beneficial for clinicians to document at patients’ bedsides, ultimately doctors still need to receive documentation for things such as certifications and interim orders.
The agency had difficulty convincing doctors to visit a portal it had available to view medical records online— doctors complained about how each agency seems to use a different portal.
To eliminate the portal concern, the agency’s nurses and therapists were driving their laptops back to the office to print documentation, and then office employees mailed the paperwork to doctors’ offices. That process increased the chances for response from doctors, but wasn’t efficient for the agency, Gaffey says.
But then, about two years ago, Gaffey learned about Jacksonville, Fla.-based Forcura, which helps health care providers with document management.
That concept was a missing key that led to cost savings and productivity increases, she says. Other companies, such as eFax, offer online fax services. But Forcura is unique because of its barcoding technology, which makes it possible to track what information has been sent and what information needs to be received, Mandeville says.
Compare costs to benefits
Before deciding whether it made sense to send faxes electronically, the agency performed a cost-benefit analysis, Gaffey says.
The analysis evaluated the amount of ink and paper her agency used per year, the hours spent filing and the hours spent destroying records. It considered the stamps and envelopes used to mail records to doctors. The overall cost was about $65,000 a year.
For the agency’s clinicians to drive to the office to print documentation, Gaffey figures, the agency spent another $5,000 to $10,000 per year. The agency covers a radius of about 80 miles, she says.
Now that the agency uses Forcura, Gaffey believes efficiency increases by her agency’s clinicians — who no longer need to drive back to the office to print — have generated about $75,000 more a year, Gaffey says. Its nurses now conduct about seven visits daily instead of five.
Combined, that approximately $150,000 is a significant amount of money, considering the agency’s annual revenue is roughly $2.5 million, Gaffey says.
Ease into electronic faxing
• Ask doctors what they would prefer. Gaffey polled the doctors who send patients to her agency, asking if they would prefer to receive documentation through the mail or via fax or portals. About 98% of the doctors wanted faxes, “so that’s what we gave them,” Gaffey says.
• Find out how many orders a day your agency produces. Perform daily, weekly and monthly analyses, Gaffey recommends. It wasn’t until performing such an analysis that she learned just how many orders her agency produces. She had assumed it was producing 200 to 300 monthly but learned it was producing about 900 monthly. That’s a significant amount of paperwork and printing, she says.
• Understand that, in the short term, the transition will take time. Training Forcura provided was straightforward, but it always takes a little while to learn how to use a new technology, says Melanie Onrubia-Gonzaga, chief compliance officer for Los Angeles-based Affiliated Home Health Services, which also uses the technology.
— Josh Poltilove (jpoltilove@decisionhealth.com)
