Healthcare

"Go Off Site to Get Your Archiving in Order"
A Senior Health Care Manager Shares a Challenge and Solution

Records management is at the heart of the regulatory environment for corporate "good governance," mandated by HIPAA and the Sarbanes-Oxley Act. In the healthcare industry, the decision to store documents on site or off site is particularly important because of specific compliance requirements, both at the Federal and state levels. As a result, managers have been forced to look hard at how they archive documents.

Most organizations show little concern for older documents until a legal or accounting question arises. They use empty offices or the corner of a file room as a catchall and storage area, accessible to everyone. Even worse, unsecured basement space without the proper environmental conditions can be the final resting place for years of documents, with little concern for possible damage to the paper. When an urgent need for a document comes up, an unwitting administrative person may spend many hours, often unproductively, combing through disorganized files in the archiving graveyard. Often they either can't find the document, or it is damaged beyond use.

"The cost of not having records lost, fallen by the wayside or stashed away in a supply room is almost priceless," said Jen Kochiss, director of support services for Spectrum Healthcare of Vernon, Connecticut, a firm that manages nursing homes and senior living centers. "Records need to have a real order and system that keeps them secure from fire, theft and improper handling."

Spectrum Healthcare understands the impact of proper records management. They have owned and managed nursing homes and senior living center facilities for nearly 25 years and currently manage properties in the towns of Derby, Hartford, Winsted and Ansonia. Several of these properties - most recently the Laurel Hill Center in Winsted - became Spectrum Healthcare's management responsibility as a result of acquisition. In these situations, it is not atypical for patient medical records to be found in such disarray that searching for a particular record is nothing short of trying to find a need in a haystack.

According to Kochiss, that is not acceptable to management, the residents and their families, or government regulators.

At Laurel Hill, the challenge was to organize disarray into a system that allows quick retrieval of payment sources, access to Medicare/Medicaid history, ability to track patients by past illnesses, and retrieval of those records based on inputs from the patient's conservator.

Kochiss and her team sorted through thousands of files dating back more than 20 years. The disorganized boxes occupied valuable free space in Laurel Hill. Archives dating more than 10 years had to be discarded. Those dating from 1993 to the present needed to be preserved in a way that allowed for easy access. While files from 1992 to 2001 don't need to be accessed frequently, they still need to be protected. Not meeting those requirements makes a healthcare organization vulnerable on several fronts.

"Like any healthcare organization, we have a responsibility to protect the dignity and privacy of our residents," Kochiss says. "Yes, financially we keep a tight rein on things, but we never let our first priority - the residents - fall by the wayside."

At Laurel Hill, the Spectrum Healthcare team used a state-of-the-art file storage system to index each box of files alphabetically, and then tagged each with a bar code. A protected signature sheet held by the records management staff only allows authorized employees to retrieve the records. The system now in place allows all records of current Laurel Hill residents to be easily retrieved, within the hour, between now and the year 2011.

"These records have to be in a safe, secure, and fire-retardant facility," says Kochiss. "To purchase just one of the required fireproof cabinets would cost more than $1,000, and it still wouldn't be properly managed. It makes no sense for us to invest in the real estate, people and resources to do something that is completely separate from what we do. Records management simply isn't our business - patient care is."

Get Ready To Outsource

Responsibility for an efficient offsite archiving plan increasingly falls to the CFO or financial management team. In many industries like healthcare, there are laws that require organizations to manage an extensive inventory of records.

Once it is understood that document retention policies apply both to paper and electronic files, you may still be faced with the more pressing, earlier question - how can my organization justify using our valuable and expensive office or warehouse space to retain information? The answer is that you really cannot justify storing the documents you are responsible for on site.

Those records have to be current and in presentable condition. Records management professionals advocate that organizations protect themselves with plans for more sophisticated storage, security and retrieval plans - to the point where any document can be in someone's hand within hours. That kind of planning is critical to our work.

An organization needs to consider the three critical areas of security, flexibility and efficiency in developing a records management and information services storage plan. Any professional records and information services management company should be able to answer questions about their offsite storage plans for records, specifically in how they can improve security, flexibility and efficiency that your specific needs.

Security

The decision, particularly to outsource healthcare documents, is not about trading one dusty, unprotected warehouse space for another. To ensure that critical information remains safe and confidential, the provider you select must have controlled access to his facility. That means you must determine who in your organization will have access to those records. With your new records management partner, develop authorization lists and physical security systems with specific instructions.

Climate control is also part of security. Documents may become torn, yellowed, frayed and dusty from humidity and other factors. Under corporate governance regulations, inadequate climate control has successfully been used against many businesses.

Security also applies to protection against natural disasters like fires, earthquakes, and floods. Such protection can only be assured with specifically designed facilities. Once the decision to store offsite has been made, by developing a comprehensive disaster plan you can have your records management partner move quickly to achieve the full recovery of important documents, should the worst happen.

Flexibility

As you consider outsourced records management, think about more than the storage facility itself or even Disaster Planning. Who within your organization has the time, know-how and training to organize and access records on short notice, like a regulatory investigation?

Efficiency

The best offsite records and information management partners are more than warehouses - they are professional services providers. When you outsource efficiently, you're getting a pickup and delivery service, potentially a Web-based inventory and retrieval system, and destruction capabilities to accompany the storage, with round-the-clock service, 365 days a year.

Can your maintenance or in-house records managers, who have a myriad of other responsibilities, make the same claim when it comes to records retrieval?

A CFO who values both the bottom line and protection from legal challenges has little choice but to move paper from offices or warehouses to well-managed, environmentally protected off-site storage operations. As Jen Kochiss discovered first hand, the need is very clear and the benefits are immeasurable for the healthcare industry.