In-House Document Imaging

Attempting to implement document imaging in-house can often initially seem like a good option, especially since calculating the cost of hardware and software is generally simple.

In fact, there are numerous costs to implement, operate, and maintain a document imaging system over time. Our Document Imaging Costs article provides a detailed list. In addition to equipment, installation, and direct labor costs, there are unpredictable costs long-term such as keeping pace with technology and HIPAA.

A common perception is that document imaging is an Information Systems project by nature. In fact, although there is certainly a strong technical component, it is dwarfed by the operational component. The "owners" of a business office document imaging project should be business office end users who understand and advocate essential retrieval requirements.

The retrieval requirements combined with the characteristics of business office documents create a unique challenge for document imaging in the hospital business office. Several approaches have been attempted to meet this challenge in-house; each has not met expectations.

Traditional imaging approaches are problematic for reasons discussed here.

Another ambitious approach that has ultimately resulted in disappointment is the use of integrated posting/indexing software. Using this software, posters enter transactions information from a batch of document images which are indexed at the same time. There are several problems with this approach:

		Posting from images is difficult. The data entry operations performed by posters require a substantial user interface into the hospital financial system. It is much easier to enter information from the clear type on paper than from images presented on a second or split computer screen. The resulting drop in productivity is surprisingly large.
		Morale suffers as bleary-eyed posters attempt to enter and reconcile postings using online images.
		Poster job turnover increases due to increased stress and burnout.
		Only a percentage of documents will be indexed/imaged. Correspondence and other documents that are normally not seen by posters will need to be routed to the posters for indexing or accommodated in some other way, or not imaged at all.
		Indexing will be a secondary concern for the posters. The transactions posting function will be higher priority. The result is higher than average error rates, forcing the addition of quality assurance staff to continue to meet document retrieval requirements.
		The end result, at best, is a relatively low quality posting operation, and a low quality imaging implementation. Both posting and document imaging are best performed as specialized functions by staff dedicated to one or the other.

In-house imaging implementations may be cost justifiable for small operations (just a few beds) with a relatively low volume of paper. But for virtually all business offices serving over 200 beds, the services provided by Healthcare Reports document imaging facility will provide the best approach for lowest cost and highest quality.