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Building a Medical Document Management System

Jan25

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1/25/2013 3:20 AM RssIcon

We have had the wonderful opportunity to work with a health care institution in the area of medical document management. Health care industry has one of the most complex of documentation when it comes to medical information, processes, policies, procedures, governance and audit. With a wide array of documentation and the ever changing revisions that are implemented throughout the year, it is really a challenge for healthcare providers to perform their daily duties while keeping up-to-date with the changes that take place in their industry.

The Current Situation

This specific institution has an existing, legacy system that helps catalogue documents. The cataloguing features goes no further than a simple folder hierarchy and the capability to search through document titles and the ability to download them for off line viewing. This poses several issues to their operations.

The Challenges Faced

  1. With the capability to download the document for offline viewing, users normally do not bother to download the latest versions that may be updated subsequently.
  2. The downloaded document can be easily distributed through email (which was the primary way of collaboration). This posed a security risk.
  3. There was no way of controlling changes to the document other than tracking of changes in the document directly. Once finalized, the changes are all accepted and the document uploaded. No history of change management is ever recorded other than those hidden in emails.
  4. When documents were no longer required or newer versions overrode the previous ones, references in other documents were not updated.
  5. Finding a specific text or paragraph was a time consuming endeavor where each document was to be opened and searched. For new residents, this was a major restriction in terms of productivity and access to information.

The Criteria

Having identified the whole suit of problems, the management team required to have a single solution that can potentially eliminate all the issues that are currently being faced. As a result, the solution is to address the following primary concerns.
  1. Implement change & review management
  2. Improve information search and retrieval
  3. Implement referential integrity
  4. Keep it simple for users

The Solution

To really provide the solution, it was important to understand the following:
  1. The nature and format of the content.
  2. The kind of information look up performed by the users.
  3. The process of information change management.

The Approach

Our consultants spent the next couple of months working with the customer to identify the above aspects. Through a collaborative effort, the final outcome was to design an build a system whose ingredients included:
  1. A combination of tagging and taxonomy classification mechanism,
  2. An indexing service for searching through tags or through keywords,
  3. A workflow process to control and audit change management and
  4. A mechanism to identify and track referential integrity checks.

The System

The end result of our efforts was a custom built solution whose primary purpose was to simplify the process of searching for content up to a specific paragraph level using content keywords or tags.

The tags represented medical codes with dictionary meanings maintained as notes. While maintaining the familiar folder structure with documents, the new system enhanced the overall experience through a structured approach of creating and managing the content.

The administration of the content was to be done using work-flow with audit of changes, version control as well as periodic reviews and revisions. A core committee was involved in the final approval prior to publishing the revisions with effective dates. 

When documents were decommissioned, the system had the ability to highlight the referential integrity through broken links highlighted to the administrator as well as to the front end users.

Several roles were introduced to control the visibility as well as ability to perform certain actions in the system resulting in a more manageable audit of the content. 

The Conclusion

Document and content management of highly structured content is very different from normal tagging and taxonomies that are available in most modern content management systems. It requires a combination of detailed functionality in managing such content while maintaining ease of use to the users, who in most cases, are technically non-savvy. A system that organizes such content can generate several positive benefits from reduction in time to access critical information to improved control resulting ultimately in the efficient delivery of medical treatment to the patient.

Read more here to understand the detailed functionality of the system.

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