EDM for Immediate Access to Emergency Department Records

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EDM for Immediate Access to Emergency Department
Records

• Powering ED Efficiency and Safety
• Ruth Koch, RHIT
• Director, Health Information ServicesHannibal
  Regional HospitalHannibal, Missouri

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Hannibal Regional Facts

• Rural hospital
• 105 beds
• Mission Healthier Residents of our Region
• Hannibal Regional Hospital developed the
  following RISE values Respect, Integrity,
  Service and Excellence
  as its guiding vision
  to provide healthcare to the surrounding region.

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Challenge

• Repeat Emergency Department visits by patients
  with minimal histories decreased efficiency and
  patient care.
• Patients inability to describe their present
  medical condition
• Family member and/or guardian unavailability to
  provide accurate history
• Unreliable or incomplete medication list

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Goal

• Improve overall Emergency Department efficiency
• Access history within 5 minutes of patient
  arrival
• Deliver quality health care in a timelier fashion
• Accommodate increased patient flow thereby,
  increasing the efficiency in the delivery of
  medical care

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The Situation

• Hannibal Regional Hospital installed the
  QuadraMed Affinity HIS system in July 2003
• Enhanced Results Reporting and Health Notes
  applications were made available online for
  nurses and physicians
• ED records remained a cumbersome manual process,
  and not available online

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The Primary Solution

• QuadraMed Electronic Document Management
  (EDM-Imaging)
• Originally intended for Patient Accounts to
  access ED records for liability information
• Benefit to nurses and physicians soon became
  apparent and access to prior ED visit information
  was made readily available
• Coders accessed scanned records through EDM when
  the paper trail failed

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EDM Functionality

• Immediate access to prior ED visit information
  was available when patients return to the ED.
• Scanned on discharge
• Emergency Department Face Sheets
• Physician Documentation T-sheets
• Consent forms signed
• Identification and Insurance cards

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Complete Patient Information

• Other Affinity applications also used to provide
  patient information to all clinicians
• Affinity Registration
• Affinity Patient Charting
• Affinity Enhanced Results
• Affinity Health Notes

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Affinity Registration Enables

• Triage nurses to speed registration (Quick Reg)
• Immediate access to patient identification
  numbers
• Quicker lab and radiology order placements and
  results
• Patients receive prompt care in a timelier
  fashion

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Affinity Patient Charting Enables

• Automated ED nursing assessments
• Prevents duplication if patient is admitted to
  acute care floors
• Allows for more consistent documentation between
  nursing shifts

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Results

• All prior Emergency Department visits are
  available through EDM
• All prior inpatient visits are available through
• Affinity Health Notes
• Affinity Enhanced Results
• Affinity Patient Charting
• Access to ED records decreased turnaround time
  from 151 to 81 minutes with corresponding
  improvement in registration efficiency

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Continued Successes with the QuadraMed Affinity
Applications

• Decreased the delinquent bill hold dollars from
• 1,500,000 to 16,000
• Reduced Bill Hold Days
• Inpatient Outpatient 3
• SDS 3 (cataracts 1)
• Emergency 2
• Reduced Net A/R Days
• 57 Days 06/30/2003 (Pre Conversion)
• lt Live on Affinity 07/01/2003 gt
• 74 Days 09/30/2003 (Post Conversion)
• 43.2 Days 12/31/2005

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For More information Contact

• Ruth Koch, RHIT
• Director Health Information Services
• Hannibal Regional Hospital
• 573/248-5400
• ruth.koch_at_hrhonline.org

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Thank You