Bulky, costly forms get the boot at Asante

Face sheet savings are $50,000 annually

The traditional preprinted hospital registration form is on its way out at Medford, OR-based Asante Health System, thanks to a new forms management program that had its first tryout in the patient registration department. The program will save $50,000 a year in face sheet costs alone, says Dianne Beebe, regional manager for patient registration.

Documents previously were printed onto expensive, multicopy forms that had to be fed through a printer, then "torn down," stamped with an embosser card for identification, and distributed to various locations within the hospital, explains Beebe, who oversees patient registration at Rogue Valley Medical Center and Three Rivers Community Hospital, part of the Asante system.

Changing a patient’s address or adding an emergency contact could result in reprints, she notes. Similarly, the department might print 1,000 or more "Important Message From Medicare" letters, for example, and then find that the Health Care Financing Administration had changed a requirement affecting the form, she says. At about $1 per face-sheet form, reprint costs could mount quickly.

With the forms management system from Atlanta-based Optio Software, an employee does the programming for the various forms on site, which means they can be edited as needed, Beebe says. "This is not only a cost saving, it allows us to always have the most up-to-date version of any form at our fingertips." The embosser mark is already on the sheets when they print out, she says, so registrars will not need to emboss the "Conditions of Admission," the patient’s rights forms, or any of the documents associated with a registration.

"It allows us to have a form designed by us," adds Sue-z Barnes, project manager. "We can make changes as they come up. If we need to add a field or make a change on the face sheet, the next form we print will have that change."

In the past, Barnes notes, the request for a particular form would be sent to a printing company, which would send a proof back for approval. The hospital would order in quantities as high as 50,000 to get the lowest price, she adds.

The system also allows users to insert "logic" into the process, Barnes says. "We can tell [the program], If the patient is this type and has this insurance, we want these specific forms to print out.’" In the past, she adds, registrars would have to remember in some cases that a person is a Medicare patient and also an observation patient and pull the appropriate documents from other files.

Another plus is that the forms print in the correct order, so sorting time is eliminated, Barnes notes, and there are different tag lines at the bottom of the sheets, indicating they are to go to medical records or are physician copies. There are no barely legible copies because every form is an original, she adds, "and we don’t have paper jams on the printer anymore. We can use a regular printer rather than one with a feeder on the side, which tends to jam."

The forms also can be directed to different printers, Barnes says. "If a patient comes in for physical therapy, the registrar can send the patient to that department, and the paperwork is there to let [the department] know the patient is coming."

In many cases, in conjunction with a telephone preregistration program, Optio will allow the patient to bypass the registration department completely, Beebe notes. "Also, the patient won’t be involved in waiting while we’re tearing down and assembling forms."

Part of the reason for implementing Optio, Barnes says, was the capacity for printing documents to remote locations. "Our goal is that all the patient’s paperwork will print directly to the nursing station, instead of [registrars] having to deliver it. Everything [nurses] need from the admitting department will be at the printer, and they can set up the chart."

Card soon will be obsolete

Although the face sheets now have the embosser mark, registration still must send the embosser card up for nursing to use on other essential documents for the patient’s chart, such as the nursing assessment form, Barnes says. Once Optio is implemented in the nursing department, the embosser card will not be needed for those forms. "We want to make sure the patient information packet is in one piece [for nursing]," she adds.

"Once nursing gets on-line with Optio," notes Beebe, "we will generate an account number [in patient registration], and the logic can be designed to identify what is needed for them."

Forms that are generated from outside the hospital, such as the physician’s order, will either continue to be embossed or eventually may be identified with stick-on labels, she says.

The embosser card also is used to make labels for laboratory specimens, so Asante is looking to perform that function with another form of identification, such as a bar code system, Barnes says.

Next in line for conversion to Optio is the pharmacy form, a tracking document indicating which drugs are going to which patients, she says. "We’re also looking at other high-usage, high-cost forms to see which ones we’ll use Optio on."

The health system is developing a priority list to determine which department will be next, Beebe adds. She estimates it will take about a year to add all the appropriate hospital forms to the system.

Some forms pose more of a challenge than others, Barnes points out. "The emergency department charts are hard because of the way they’re designed. They’re two pages wide, on really big paper. We’re looking at being able to do it on NCR paper, but it would be on two separate sheets."