The true cost of maintaining a hard chart, part 1

Where are your old medical records stored? If stored off-site, how do they get there? How many are you currently storing? How long are you storing them? Do you have a retention policy?

The list of questions referencing medical records management for post-acute care could be endless.

Medical records management 101

Typically, healthcare organizations continue to maintain a hard chart for each patient and resident on every floor in every facility. Someone sets up the chart for each new admission by collecting the relevant admission packet documents and placing them in the front of the chart, inserting the blank order sheets, and then adding the past medical history documents to the back of the chart.

Then, the new admission actually crosses the threshold – with more printed documentation from the hospital. Much of it duplicate to the information the referral received when you were first considering them for admission.

In theory, the chart should not thicken anymore, unless your organization receives documentation from ancillary services outside of the facility or it’s not utilizing an EMR. The next step, if you are attempting to provide the hospital records electronically, relies on someone scanning these documents into a shared drive, indexing them accurately, and uploading them wherever content is being stored and managed in your organization.

Now, the patient is discharged and someone must break down the chart. The content of the chart, thicker than it should be with duplicate documents, is stored locally until the masses of paper charts are moved to their final location, and hopefully securely stored … indefinitely.

Facility-level cost calculator

To calculate the true cost of maintaining a hard chart, let’s begin with the paper cost and the reams of paper that you must consume to print the multiple copies of the protected health information (PHI) that you received when you considered the referral for admission.

One copy to the business office to verify the insurance and initiate prior-authorization if needed. Another copy to the medical reviewer to ensure the facility can deliver the proper level of care. Maybe another copy to the MDS Nurses or Medical Coders for additional review.

Now consider this: How many copies are you printing in your facility for consideration of a patient that you may not even admit?

Here are some other costs to evaluate:

  • Paper cost = x/month

Paper can cost up to 31 times the original cost to send information on paper, according to TriplePundit.

  • Printer cost = x/month

All printers need toner and maintenance.

  • Medical records management labor cost = x/month

There is a labor cost associated with maintaining medical records. The individual involved could be personnel hired for medical records management or a clinician, which takes time away from patient care to complete these tasks of medical records management.

  • Medical records management for mergers and acquisitions = x/month

In this day of mergers and acquisitions, how are you managing your old records? Are you copying these old records for compliance purposes?

All the above costs need to be considered again if this is a necessary task.

  • Storage cost = x/month

And finally, the actual cost of storing all these medical records today, knowing the future costs will continue to increase as more documents accumulate over time.

The average four-drawer cabinet costs about $25,000 to fill and $2,000 annually to maintain, according to TriplePundit.

There’s help available

To decrease these costs, consider automating the admission process and capturing all the unstructured documents at the front end of the admission process. This allows you to make the documents available electronically – immediately.

Why wait until the patient is discharged to then complete the labor intensive and costly process of scanning these documents? Document capture and automation will also allow your labor force to do more meaningful work, like providing clinical and resident care, or providing more efficient medical records management of the hard chart.

New efficiencies with medical records management may also allow your workforce to scan in old records or consider outsourcing services to scan the stored charts. Going further, electronically capturing the old records will take advantage the same secure retrieval methods and leverage automation for retention policies.

You can control your paper costs, maintain compliance, and truly move toward a paperless medical record that augments you current EMR. The first step is to take a good look at how you’re managing your hard chart.

In part 2, we’ll take a closer look at how hard chart affect your ability to provide the best patient care possible.

Scott Magers

Scott Magers

As the Account Manager of Post-Acute Care for Hyland, Scott Magers (PT, MBA) brings more than 20 years of experience in outpatient physical therapy, home health care and most recently in skilled nursing facilities. He has served on many collaborative committees between hospitals and post-acute care (PAC) organizations seeking best practice for transfer of care, care coordination and collaboration. His goal is to share these experiences and build on the OnBase platform to showcase the power of enterprise content management (ECM), business process management (BPM) and records management to help PAC providers automate paper-based processes to improve efficiencies, quality of care, and patient outcomes.

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