Birchill Hospital was buried under paper until it came up with a
healthy alternative
Introduction
There is much more to scanning technology than grabbing graphics
for web pages and inserting them into documents. Scanning is an
essential element of any electronic document processing system and
in those organisations where the move away from paper is starting
to take place, document scanning is a priority task. In such a
situation the requirements placed on a scanning device are quite
different to those required for a scanner in a home or small office
environment.This move towards "paperless" processing is nowhere
more urgent than in the health sector. Patient records, case notes,
x-rays and other imaging results, drug charts, analyses ... there
is an almost endless stream of paper documentation that exists for
each patient. Add to this the paper records for the employees in
the sector and it is clear why the move to electronic storage and
dissemination of records is such a high priority. It also explains
why the Department of Health is investing over £1 billion in its
flagship NHSnet project, which aims, amongst other things, to get
hospitals, clinics, GPs, NHS Trusts and others on-line by the year
2002.The main aims in moving towards the adoption of electronic
document processing are to improve efficiency, streamline working
practices and, most importantly, to improve on the delivery of
patient care. In practice, this means that local NHS trusts and
hospitals are faced with the daunting task of taking their existing
paper documents and turning them into electronic equivalents which
can be disseminated across networks, printed out where required and
stored centrally for easy access. All of this has to be achieved
without compromising patient confidentiality or impacting adversely
on theday-to-day functioning of the hospital.
The case of
Birchill HospitalBirchill Hospital, part of the Rochdale NHS
Trust, is a typical example. Analysis showed that over 50 per cent
of its monthly document output comes from the psychiatric
department. This paper documentation often has to be sent to a
number of disparate wards and offices, in addition to the main
recipients, who include the community mental health nurses housed
in the Sudden Resource Centre. Some of these wards and offices are
many miles away, which meant that case notes - many of which may
extend to several hundred pages - would often have to be delivered
using couriers or taxis. This is extremely expensive and risks the
chances of notes going missing or, in some cases, breaches of
patient-record confidentiality rules.Because of the risk of notes
being lost, it is hospital policy that only copies are sent
off-site. This meant that voluminous case notes of several hundred
pages would have to be photocopied before being sent off. Other
high volume copying work includes regular central government and
local government circulars, hospital policy documents and
departmental memos ( all of which require photocopying and
dissemination.This high volume of paper document generation was
extremely costly and placed a strain on the departmental copying
services. Quality was often poor and no provision was made for the
electronic transmission of documents quickly and securely. The
existing analogue photocopiers were old and unreliable and when it
was time for the service contract to be renewed, the Hospital
decided to look at the most effective way of improving
matters.
Assessing requirementsThe first step in improving
the situation was to undertake a comprehensive document survey to
assess its current and future requirements. The hospital's supplies
manager approached Xerox to undertake the study, which looked at
the complete range of paper based technology installed in the
psychiatric department including copiers, desktop printers and fax
machines.Xerox showed that the Department's needs extended beyond a
new generation of faster, more reliable copiers. It suggested quite
clearly that the best way forward was to invest in an integrated
digital technology that utilised the latest multi-function devices
linked together in a network. It also provided the hospital with a
Total Cost of Ownership study, which enabled the hospital to assess
the leasing and day-to-day running costs of adopting such an
approach.
SolutionsBased on the study's findings, the
psychiatric department has installed six of Xerox's latest digital
Document Centre devices. Five of these are Xerox Document Centre
220STs and one Document Centre 230 LP. Another two digital machines
are due to be put into place in the near future. These new devices
are placed at five different locations enabling the department to
make the fullest use of the digital connectivity that is a feature
of the Document Centre range.The Xerox Document Centres provides
the department with integrated multi-functional devices that can
scan, copy, print and fax in one system. As the majority of the
department's devices are networked, documents can be sent from one
system and then viewed and printed at another. There is no longer a
need to copy a document on a stand-alone photocopier and then have
it sent by courier to its destination. The Document Centre 230, for
example, is being used as a departmental workhouse, providing a
central production environment for eight secretaries within the
department.
BenefitsThe benefits have been enormous. Unlike
the multi-function devices produced for the home or small office
market, the Xerox Document Centre's scanning function operates at
production speeds. For example, the 230ST can scan at up to 30
pages of A4 a minute, providing more than enough speed to cope with
the hundreds of pages that a set of case notes may contain. The
scanned images may then be transmitted electronically across the
network, then printed or faxed.Mike Conway at the department of
psychiatry comments: "Xerox showed us that its latest generation of
digital machines provides a whole new approach ...The key benefit
is that we have been able to integrate our office equipment into
our IT and communications infrastructure within the hospital. This
has long-term implications and benefits in the way in which
information is copied, distributed and accessed by our staff at our
numerous offices. It means that we are no longer reliant on paper
and its limitations."One immediate benefit, and an immediate cost
saving, is that large files of paper-based case notes need no
longer be shuttled from office to office by taxi or courier. The
main beneficiary has been the Sudden Resource Centre, where most of
the notes are sent. Not only is there a financial saving, but the
risk of compromising client confidentiality is vastly reduced.
Security is enhanced because documents are tagged with a unique ID
number and only those users who are logged in and have the correct
ID for the document can access it.A more significant cost saving
has been in the rationalisation of office equipment. Once all the
Xerox Document Centre devices are all in place they will replace 20
desktop laser printers and five photocopiers. The workload of these
various items of equipment will easily transfer to the newer
digital equipment. Fewer laser printers and photocopiers will also
lead to savings in the cost of consumables. There are two factors
at work here. The first of these is simply that the Xerox Document
Centres are much more cost efficient devices, Xerox estimate that
the cost per copy of a laser printer is around seven pence per
page, compared to a cost of one pence per page of the Document
Centres. The second factor is that paper usage is significantly
reduced when people can work directly with electronic copies of
documents. They no longer need to print out everything they
receive, they can work with the notes on-screen for example.In
terms of working practices, there has also been a change for the
better. People no longer need to walk to a photocopier and then
stand and wait until it has made all the copies. A document or set
of notes can be scanned once and then accessed or printed as many
times as required. Furthermore, bottlenecks are reduced because the
system can be scanning and faxing at the same time or scanning and
copying, for example. Because these devices are fully networked,
people can access documents from the desktop. There are also
benefits in terms of the quality of the scanned documents. Staff no
longer have to rely on poor-quality second or third generation
photocopies, they can now access digitally scanned first-generation
files on demand.The work at the department of psychiatry has been
so successful that the hospital is now planning on rolling out the
new technology and work practices to other departments. "We see
this technology as crucial for the Trust for changing the way that
it uses documents and to bringing greater efficiencies to other
departments. Key future applications include the scanning of
patient records, and we see four or five other departments
benefiting from the same kind of infrastructure that we have
successfully put into place," concludes Mike Conway.
Pan
Pantziarka