In-Depth

Case Study: Rescuing a Hospital Drowning in Paper

How one hospital tapped DB2 Content Manager to drastically reduce its paper and printing costs—and realized other savings to boot

• By Stephen Swoyer
• 03/08/2005

For a modest Michigan hospital, West Branch Regional Medical Center generates a lot of documentation, almost all of which has to be printed, sorted, and eventually filed away. This is enormously wasteful, but it’s also inefficient—especially when files need to be retrieved.

Thanks to a new health information management system powered by iSeries hardware and IBM Corp.’s DB2 Content Manager software, West Branch’s paper deluge is a thing of the past. Better still, the solution has more than paid for itself since going online. West Branch was able to drastically reduce its paper and printing costs, for starters, and it’s now poised to eliminate several full-time positions that were once associated with its document-management process.

“We’re taking probably 80 to 85 percent of the data electronically now, and moving forward, I’m trying to get that as close to 95 percent as I possibly can,” says Randy Lewis, director of information systems for West Branch. “That represents just enormous savings, in materials and other resources.”

Not Just About Compliance

With HIPAA deadlines looming in mid-2001, West Branch tapped Wellness Connection, a computerized patient records system from BlueWare Inc., a healthcare industry ISV that services hospitals in more than 20 U.S. states, as well as in the European Union. As its name suggests, BlueWare is an IBM business partner that markets several solutions designed to run on Big Blue’s iSeries midrange systems. In addition to the iSeries’ native OS/400 operating environment, BlueWare also supports Linux running on top of iSeries.

According to Rose Harr, CEO of BlueWare, HIPAA compliance is really just the tip of the iceberg, at least in terms of the challenges facing many of today’s hospitals. For starters, there’s President Bush’s initiative to overhaul the nation’s patient information systems. The Bush Administration has even distributed a set of talking points that purport to demonstrate just how much catching-up the healthcare industry must do. For example, while per-worker IT spending in most other sectors topped $8,000 during the late 1990’s, healthcare organizations typically spent only about $1,000 per employee.

Clearly, argues Harr, there’s a lot of ground to me made up. “Right now with George Bush talking about the electronic health records, it’s such a hot application in healthcare,” she says. “Hospitals are seeing how important it is, and it’s becoming more and more apparent, [what with] the patient safety issues around not having the right information at the doctor’s fingertips.”

Going Paperless on a Healthcare Budget

In the case of West Branch, a modest regional medical center with a limited IT budget, these difficulties are compounded by a lack of resources, says Lewis. “For a facility that lives and dies off of Medicare and Medicaid reimbursements, many of the big [packaged solutions] were out of our price range,” he explains. “Whatever we decided to go with had to be affordable upfront and inexpensive enough to be managed by a small IT department [going forward].”

BlueWare’s Harr says that the IT needs of hospitals such as West Branch are typically very different from those of their business counterparts. “They are unique in the way that they run their IT. Each hospital has 20 or 25 different departments, but most of the time you’ll see systems that are somewhat integrated” across different processes and departments, she explains. “So we have a professional services team here at BlueWare, and they’re really system-integration experts as well as hospital-process experts.”

BlueWare’s services team helped West Branch implement its new patient records system, along with a new health information management system from healthcare ISV Keane Inc. in less than ten months.

For Lewis, a veteran with more than 20 years of experience in healthcare IT, that was an impressive achievement. “We brought the health information system and phase one of BlueWare up in April of 2002, so we did it within about eight to ten months,” he says. “It was very quick, especially when you consider that we’re a very small IS department, so to implement that, train the users, and put in place not only the software but also the network infrastructure as well—we did an awful lot in a short period of time.”

Success and a Rapid ROI

Nowadays, almost all phases of West Branch’s BlueWare system are online, including a document management component based on IBM’s DB2 Content Manager. The hybrid IBM/BlueWare solution has almost completely supplanted West Branch’s paper-based patient records system, giving physicians and nurses real-time access to historical patient data, such as x-rays and lab results.

This is a vast improvement over the peer-to-peer system it replaced, says Lewis. “It used to be when a patient came into ER, the nursing supervisor would have to get paged, go to medical records on nights and weekends, find that chart, and deliver it up to ER,” he explains. “That could take an hour and a half, depending on how busy they were. Now they have that information available instantly.”

It’s the DB2 Content Manager piece that really makes it possible for the hospital to go paperless, says BlueWare’s Harr. It provides the means to catalog, index, and search a variety of document types, including scanned images and proprietary document formats. In fact, her company’s Wellness Connection software taps DB2 Content Manager as its own middleware piece.

“It’s a part of our middleware, we consider that our middleware, and the reason we picked Content Manager for BlueWare’s information is that we have terabytes and terabytes of information, and we needed a really strong architecture to manage it,” she says. “West Branch generates two million pieces of paper per year, plus other kinds of images, so we needed a strong middleware piece.”

In the future, West Branch hopes to complete its transition to a paperless organization, with DB2 Content Manager once again providing the core enabling technology.

“The last phase we’re in right now is we’re working with BlueWare to help find us a vendor to take all of our old in-patient charts and start scanning them in,” says Lewis, who notes that his organization expects to realize additional ROI once that’s done. “The anticipation on that is that HR has already budgeted to reduce the number of [full-time employees], because everything’s going to be done electronically.”

The Bottom Line

In the final analysis, Lewis says he’s been impressed with the scalability and flexibility of the hybrid BlueWare and DB2 Content Manager solution, along with the underlying iSeries hardware. In fact, he says, iSeries is one of the most turnkey platforms he’s ever worked with, requiring little (if any) hands-on administration. For a modest regional medical center with a small IT staff, this is a godsend, Lewis says. “One of our requirements was that [the solution] had to run on iSeries. Being small, the iSeries is something that’s just really easy to support and maintain,” he explains.

On the ROI front, Lewis says West Branch’s hybrid solution has more than paid for itself. “One of the big benefits was our reduction in paper supplies and paper costs. We dropped our paper budget tremendously—by 30 to 40, maybe even 50, percent,” he says. “One of the thing that BlueWare brought in was the IBM product On Demand, so I can take all of my daily reports and put them online. I don’t have to print anything anymore.”