Effectively and securely storing patient records, while making sure they are available to the staff members in a timely and complete manner, is a common challenge for most mental and behavioral health centers.

With the Integrated Records Management System (IRMS) from Netsmart Technologies, CMHC/MIS users can scan and store images of the documents so that authorized staff members can have immediate access to the information they need, while the original client records never have to leave the medical records department.

A behavioral healthcare organization can quickly find itself awash in forms, files, and records due to insurance provider and managed care requirements, as well as just the nature of a process that depends on documentation. On paper, a single patient’s record could easily include a dozen different volumes, each one up to three-inches-thick. But with the IRMS, an organization progresses towards a paperless office. Using scan and-store technology, all the different forms required for a client—whether they are for insurance, treatment, prescriptions, reports or release—can be maintained through the CMHC/MIS rather than packed away in a file cabinet in the back room, or even miles away in a data storage warehouse.

How it Works
Good medical records practice is good medical records practice regardless of the media used. Netsmart's IRMS helps agencies improve the way they handle records through optical imaging and retrieval.

The process begins when a variety of different documents are input into the system and stored on hard drives or an optical storage device. Anything that can be placed on or read by a scanner can be scanned. This also includes two-sided forms (if you have a duplex scanner; otherwise each side must be scanned separately) and color-coded charts.

During the input process, the documents are encrypted for security purposes. The IRMS also uses indices stored with the image indicating client name, document name, date of document as well as a time stamp for input date and time.

Information can also be entered into IRMS in ways other than scanning. Digital photographs may be entered directly into the system without scanning. Also, records faxed to the organization can be imported as long as the user has a fax modem set up on the scan workstation. The images are then processed through the import process of Kofax Ascent Capture™ and made available through IRMS. Users can do this as long as the imaged file is stored in a standard file format recognized by the scanning software.

Clinicians using eCET® may also store documents and records created with that software directly into the IRMS. And users that have implemented the word processing interface can use UNIX Word Perfect to type information directly into the patient record.

The stored data can then be viewed on any browser workstation connected to the network. This can include clinicians, nurses, receptionists, record keepers and any other staff that has received the proper authorization. That also includes remote staff that has received the proper authorization giving them full access to client information in case of an emergency. Since paper documents aren’t being handled, the IRMS reduces the risk of compromised medical records without affecting access to important information by pertinent staff. From a IRMS view station, authorized users are able to quickly access the forms and reports of a client’s record. These forms may be scanned in or, as in this case, imported directly from eCET.

The Benefits of the IRMS
There are numerous benefits to relying on electronic charts versus paper ones. With IRMS a 1.2-gigabyte hard drive can store approximately 40,000 pages of information. Among that information can be all the forms and reports clinicians generate for a client, but it can also include “outside” materials such as primary care medical records, release-of information forms, school reports, photographs, financial information such as Medicaid cards, or even things like images taken from an art therapy treatment session. Such storage makes all this information readily available to authorized personnel.

The IRMS solution is also a convenient way to make records available between different sites or satellite offices. Not only does this eliminate the need for patients to repeatedly provide the same demographic or financial information, but also it helps ensure that only the most up-to-date information is being referenced.

The use of IRMS also increases record security. A common option currently used by agencies is the use of a courier. However, this practice exposes the agency to increased liability (What happens if the driver is in an accident, spewing files across the highway?) With the IRMS, doctors, clinicians, and record managers as well as those in the financial department—any authorized perso—can access the necessary records through a simple view station.

Finally, the IRMS provides a huge improvement in security, protecting the information found in patient files far more than a lock and key can; a factor that will be even more important as HIPAA legislation becomes active. A full IRMS system protects information at four levels: through system access security; through image and text encryption for secured files; by performing unattended back-ups; and by utilizing WORM (“write once, read many”) technology.

Also, the IRMS can be configured so file access is allowed by user identification rather than patient identification. What this “role-based access” means is, for one patient different agency employees will have access to only the parts of the primary record relevant to their job. For example, the agency clinician could have access to files regarding medicines, demographics, and financial status. The receptionist might access only the demographics. And the Billing Department might access only the demographic and financial records.

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