Through its use of RAS, Saint Clare's is further carving into its costs and automating what had previously been a labor-intensive, manual report management process. A capture engine at the PC collects the data. "The printer does not interface to a server because RAS has its own print server. The software takes over and contributes in a profound way to eliminating the paper processes," Temple said.

Saint Clare's also implemented DB Technology's RASi (RAS imaging) document scanning technology.

Kathy Taylor, director of patient access at Saint Clare's, used to Xerox documents, such as patient access forms, authorization cards, patient accounting, and any other paper correspondence and documents. "We would bill the secondary payer, and there were frequently missing documents or data not included in the bill. So, we had to send out a second bill, telling the insurer to disregard the first bill and process the second bill," she said. "That was wasteful. RASi, by virtue of the technology, accelerates cash flow and information for authorization of benefits."

In just one year, the health system has recognized approximately $1.1 million in savings through its use of the scanning technology. RASi, which complements RAS and stores 835 remittance form data electronically, also handles document imaging and scans documents. RASi manages electronic, patient accounting and clinical reports, as well as documents from other disparate systems. Patient information is stored in an electronic patient folder for easy retrieval and distribution. "The system allows us to put a lot of electronic information into readable code. UB forms create documents, as well as cash flow and cash collection, giving multiple people the ability to view the scanned document, including eligibility, consents and appeals," Taylor said.

For example, an electronic ADT type transaction puts the information into an electronic folder and populates it with data fields/information from other sources. This is useful with UB92 and UB04 forms. The technology captures the information that is either scanned in or otherwise electronically fed  into the system. This includes referral forms and numbers, and raw EDI format data, which feeds into the electronic forms and pre-populates the UB forms.

What used to take more than 3 days to copy over now takes just minutes for 3-4 million documents, Taylor said, all the while maintaining the integrity of the data. At Saint Clare's Dover, N.J. facility, another computer provides auxiliary server capacity for the Denville-based health system.

Bob Szwarc, manager of applications at Saint Clare's noted that the health system has a robust disaster recovery plan, which is further enhanced through RAS because of the ability to bring documents up and online quickly after any downtime. Szwarc said that as supervisor he can see all of the data in the system, while others would have more restrictive access, only seeing the data in their respective RAS folders.

Included in the folders that Szwarc showed, is access to employee files, patient accounts and hundreds of individual unique types of file folders. The RAS Manager tool allows users to set up folders to accommodate their needs. The radiology cost center, for example, shows diagnostic and neurodiagnostic costs. Other reports, including daily census activities, breaks down the details by department automatically, with data found in the original "greenbar"-style report.

The amount of flexibility in the system makes its granularity highly valuable for compliance with HIPAA and other regulatory requirements, Szwarc said.

Accounts Not Selected for Billing (ANSB) reports are important at the time of a patient's discharge and in preparing a final bill. The health system uses Monarch to automatically format into Datawatch and green-bar type reports within which data can be moved around into different fields.

"We're able to mark off where things belong, and that capability is now embedded into RAS, so that the data from Excel spreadsheets can be aggregated into the reports," said Michael Reinhardt, senior programmer at Saint Clare's who oversees the RAS product.

Monarch doesn't allow first name/last name ordering, but instead puts the last name first. RASi's report generation capabilities allow the system to perform replacement title functions.

Monarch is unique, but functions exceptionally well in RAS environment. Also, Crystal reports are able pull information into RAS and RASi and their electronic forms. Likewise, case management reports from Saint Clare's' Maxsys credentialing system can be pulled into electronic forms.

From left to right:  Rod Neaveill, Steve Tallau, Michael Reinhardt, Kathy Taylor, Rich Temple, Tero Caamano and Bob Szwarc.

The benefit of the organization's business intelligence software is improved through RAS. It acts as a downtime solution for the system; if the IT system were ever to go down, RAS can pick up again where it dropped off. A campus-wide folder allows IT staff to get the main reports.

The system acts as an agent for patient safety by capturing patient medication profiles every hour for critical care data and every four hours for other clinical data, "so if the system were to go down, the information retrieved would be quite recent," Temple noted. If the system were to be down for an extended period of time, the health systems secondary backup system would kick in.

Through RASi-generated documentation, patients who go to another Saint Clare's location can have access to previous visits. All Saint Clare's health system facilities are connected, so that a patient can go to any one of our facilities and their data would be available.

Note, too, that physicians have up until now not been putting their national provider identifier number on paper prescriptions, but will be doing so in the electronic forms. Through implementation of barcodes, the system will be able to route specific data/information/forms to the appropriate folder on the system.

"Having a powerful tool like this enables us to not only better serve the needs of our patient population, but to realize economies of scale by leveraging the trend toward data automation" Temple said. "We desperately wanted to reduce the 12-foot green bar stacks of paper and turn them into measurable and actionable information. RAS combined with the RASi imaging tool lets us easily convert our data into meaningful information that we can slice and dice into customizable substantial reporting."

In the end, the health system delivers accurate information at every level and for all stakeholders. Saint Clare's is seeing these results.

Mr. Mitchell is managing editor of ADVANCE for Health Information Executives.