An HIT Moment with … Chuck Demaree, Access

An HIT Moment with ... is a quick interview with someone we find interesting. Chuck Demaree is CTO of Access of Sulphur Springs, TX.

What’s the continuing role of electronic forms as hospitals move to EHRs and other systems?

First, we have to establish a basic understanding about forms. A form is merely a structured tool to collect and organize data. Whether it is paper or electronic, its purpose remains the same.

Electronic forms can be placed in two categories. Online forms are primarily used for data acquisition. Managed output forms re-structure and automate the distribution of data in either a printed or electronic format. 

Hospitals need both types of forms going forward. The online, outward-facing forms collect data from sources that may not be connected to their hospital network, such as patient homes, clinics, and physician offices. Managed output forms organize data from the many disparate systems used in a hospital into a normalized format prior to routing forms into a document repository, or ECM/EDM system, as part of the EHR. This also becomes important if a Legal Health Record (LHR) ever needs to be produced for litigation purposes. 

What are some examples of workflow, productivity, and information needs that for most hospitals can be met only via the use of electronic forms?

Most health information and EHR systems — including those from Siemens, Meditech, Epic, McKesson, and Cerner – utilize some sort of workflow, but there is almost always another process or workflow that takes places even before the HIS or EHR is used. Today, that workflow is still a manual process that is either verbal or written. It is difficult to build a system that can address all the varied processes that exist. Electronic forms allow a hospital to address each process uniquely by designing a form or set of forms and custom workflow to address that process. 

Some examples are patient scheduling or pre-registration from home, feeding a registration or scheduling system. Automating acquisition of data from systems such as endoscopy, EKG, and perinatal and normalizing the structure of the data and routing and indexing the documents into the document repository. Adding electronic signatures and barcodes to existing forms and systems that do not currently provide that capability, such as discharge instructions or patient teaching documents. Business and back office functions, such as human capital management, purchasing processes, and accounting output such as checks or direct deposit notices.

If a hospital has already purchased an EHR, what would they do with your systems that would benefit patients?

Some EHRs have very nice patient portals to access the patient’s medical information, but not all patients are technically inclined or have access to the Internet. Some patients still prefer a physical document, and sometimes that is the only method for transferring data from one hospital’s EHR to another.

Our systems can provide outward-facing secure data acquisition across the Internet for patients and practitioners who are not on the hospital’s network. They can also easily control the format of data before it is printed or aggregated into an EHR. Controlling and normalizing the format of data makes it easier to read and find the information needed. This helps expedite care and reduce mistakes.

What is the role of electronic forms during system downtime and disaster recovery?

This goes back to the purpose of the form as a tool. During a downtime or business continuity episode, well-designed forms make it easier to continue to move patients through the clinical process and still capture data in a structured and familiar format. If these forms are barcoded with the form ID and the patient ID, then automatic indexing of this data into the document repository becomes much more efficient and less prone to error or misfiling.

Do hospitals intentionally use electronic forms as an alternative to entering data manually into a cumbersome online system?

I think there are a limited number of choices for hospitals to fine tune a system to make it easier for their staff and patients. We have many customers that use our output management products to automatically capture disparate medical device and clinical system data and redistribute it into an EHR or document repository. We have others who have chosen to not purchase employee or patient self-service systems and instead use our online forms solutions to create their own user-friendly front end for data acquisition.