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Alliance for Infants & Toddlers Case Study

Electronic Case Records – A FIT for Everyone

What is the Alliance?

Systems Imaging is a PsychConsult Provider

Chosen by Allegheny County as the single point of contact for Early Intervention service coordination, The Alliance enables families to learn what supports are best for their child, save time and cut through red tape in locating the most appropriate supports, focus on positive, practical ways of supporting their child with a variety of daily activities, and participate in these supports in their home and community -- at no cost. The Alliance is dedicated to its mission that all children are valued members of their communities. The Alliance puts families first, guides them through difficult processes, is available at any time to discuss problems and concerns and keeps all information confidential.

Background Information:

The Alliance was maintaining records for the infants and toddlers, ages 0-3 years, requiring service agency care. The paper records generated for these case children were stored in filing cabinets at the Alliance headquarters with an estimated 2,500 record folders. Each folder has an average of 150 pages for an estimated volume of 375,000 pages. The former process was for the Service Coordinators to walk to the file room and request that the File Manager retrieve documents from the folders. The Service Coordinator would sign the document or folder out and take them to their desk for copying and processing. Typically, the Service Coordinator annotated the document and returned the updated forms for the File Manager to sign in and re-file. An estimated 15,000 pages per month were re-filed with this process. The File Manager also reports that an additional 20,000 pages per month are added to the files including: Service Coordination Logs, Consent to Release Information, Parents Rights Agreement (accompanies all evaluation changes), Individualized Family Service Plan (IFSP), and Log Notes. To further complicate matters, building engineers warned the Alliance not install additional filing cabinets due to the stress load on the building floor supports. This was proving to be a very challenging constraint since the caseload for the Alliance was continually increasing.

The Solution

Systems Imaging recommended and deployed a Document Imaging solution to replace the paper filing system with a new document capture and storage procedure. Application Xtender from EMC/Documentum is the repository manager. Using a high-speed Fujitsu scanner and Kofax software, single and double-sided paper records are easily scanned, in black and white or color, to electronic documents and stored in the repository. The child's Early Intervention (EI) Number, Child's Name and Date of Birth, Document Type, and Service Coordinator's Name index each record. The File Manager now scans and indexes all new documents directly into the repository. Kofax Ascent Capture was selected to automate the scanning and indexing process. Templates were designed to use Optical Character Recognition (OCR) for machine printed text and Intelligent Character Recognition (ICR) for hand printed text on the forms or cover pages. Entry of metadata is only required for the text that cannot be recognized.

Using this technology, the Alliance expects to reduce the filing labor by up to 50% freeing the File Manager for other duties. Retrieval of the electronic documents is accomplished via browser-based technology. Using EMC/Documentum's Web Xtender, Service Coordinator can launch queries right from their desktop and receive a result set of qualified documents. They can retrieve all documents for a specific child or a specific document type for all children. The digital images can be viewed, annotated with highlighting or "Sticky Notes", printed and re-filed right from the user's desktop. Because of the security scheme, Service Coordinators can only view documents for children in their current caseload. There is an interface between the repository database and the R-Client for Children legacy application. R-Client for Children maintains the relationship between children and their Service Coordinator. This data is downloaded nightly to repository database to manage security. Long-term storage and archiving of case records is accomplished by migrating obsolete images from the repository to a Magnito Optical drive. EMC/Documentum's Disk Xtender automates this function with no manual intervention. Systems Imaging also wrote and deployed a fully featured Audit Reporting module. Administrators can report on which documents were access by a given user or which users accessed a given child's file. This functionality helps make the solution HIPAA and Internal Audit compliant.

Along with deployment of the hardware and software, Systems Imaging performed the entire backfile scanning for the Alliance. All 375,000 pages were sent to Systems Imaging's scanning center to be scanned and indexed. The resulting images and indexes burned onto a CD-ROM and shipped to the Alliance along with the returning paper files. The images were imported into the repository and immediately available to the Service Coordinators.

Barb Colbert, Operations Director for the Alliance states, "This project could not have gone better! The solution did everything promised and provided the agency with additional applications. The project was well managed and delivered on time and within budget. At first the user community was apprehensive about going paperless but once they became familiar with the system, the ease of operation and support from Systems Imaging, they were sold."

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