Print Solutions Magazine

For decades, the Baby Boomers’ sheer number has forced businesses and governments to heed them. Their needs and desires have influenced everything from public policy to automobile design.

As Boomers age, health care is the latest industry to feel their collective force, and it’s ill-prepared. State and local governments, reeling from budget cuts and rising costs, fret about physician, nurse and pharmacist shortages. Health care providers face rising malpractice premiums and overhead costs. At the same time, patients demand more attention, expertise and value for their money. “It really is a mathematical equation. The country has to prepare for an overwhelming influx of patients when the Baby Boomers enter the 65-plus age group,” says Darlene Gish, principal of The Write Choice, a St. Paul, Minn.-based business that develops information and content-based products for the health care industry, including forms, patient education literature and legal contracts.

Between the years 2000-2050, the 65-plus age group is projected to increase by nearly 148 percent—from 35 million to 86.7 million people. By comparison, the Census Bureau estimates the overall U.S. population will rise 49 percent during that time period. The 65-plus demographic will make up 20.7 percent of the population in 2050. “If you look at the number of prescriptions written in the United States, 44 percent of them are written for people age 65 and over,” Gish says. “That describes the impact of that age group on the health care system.”

The demographic outlook spells opportunity for print professionals. As the health care industry evolves, a trend is to streamline paper-based and electronic documentation processes. To a large extent, the industry has no choice. Federal legislation, such as the Health Insurance Portability and Accountability Act (HIPAA) mandate the adoption of document- and record-sharing standards. Distributors are well-positioned to help health care clients maximize workflow efficiency, and as a result, gain more business.

“Documentation is essential to the work that hospitals and doctors do,” Gish says. “It’s absolutely required for the business, and that’s because you have compliance issues. You have risk management issues that have to be documented in case there’s a legal claim. An understanding of how this documentation process will be changing is important.”

The documentation process in health care facilities relies on technology more than ever. Health care providers and insurers expect forms automation and electronic archiving to cut costs, improve the quality of patient records and keep them compliant with standards. When forms automation first entered the scene, distributors worried that it would replace their business. Over time, it became apparent that paper and other printed products still have a place in health care facilities. One format doesn’t dominate the other. Instead, successful distributors integrate electronic and print-based products to provide the best solution for any given facility.

In broad terms, forms automation is the process by which traditional paper-based forms are converted to an electronic format. The goal of forms automation solutions is to streamline document flow through all areas of the hospital, but the level to which it exists varies from facility to facility. In essentially paperless offices, the forms would be viewed exclusively online. A more common scenario, however, takes place at North Texas Hospital, Denton, Texas, where templates are stored electronically, but staff members print the forms with variable patient information from any printer.

Chris Rowton, account executive at Exalt Printing, Flower Mound, Texas, and Lisa Marta, its owner, sold forms automation software to Trophy Club, Texas-based Cirrus Health, a developer and manager of health care facilities, including North Texas Hospital. In a textbook example of how distributorships can penetrate the health care market as document management consultants, Rowton convinced Cirrus Health to adopt forms automation. “Initially, they looked to us simply to print all their internal forms on a regular basis,” Rowton says. “We began talking to them about forms automation, and they immediately recognized the efficiencies and cost savings that it would provide.”

Exalt Printing and software developer FormFast, St. Louis, designed nearly 40 forms for the North Texas Hospital, such as face sheets, consent forms and privacy forms. FormFast converted the forms to an electronic format and installed software that allows the hospital to merge patient data and print the form from a laser printer. “They don’t have to put a patient’s ID label on every form that comes through,” Rowton says. “They can preprint a form and populate it with all the patient demographic information, and that pack follows the patient during his stay at the hospital. They have the ability to print one-off documents on demand if they need it in admissions or anywhere in the hospital.” FormFast software also allows the hospital to modify forms templates when changes are necessary to comply with new standards.

It seems counterintuitive for a print distributor to sell his client electronic forms, but Rowton’s cost-effective solution helped build a relationship with Cirrus Health. “I knew that if we were able to make a great impression on the customer by providing them new technology that would simplify the way they do business in the printing environment, that would give us the opportunity to pick up additional business,” he says.

In fact, Exalt Printing was asked to provide supplies and printed products unaffected by forms automation, including wrist bands, patient chart files, medic alert labels, ID labels and stock paper. Cirrus Health also indicated that it would look to Exalt Printing to help initiate forms automation at more of its facilities. “I really feel that forms automation is taking over in the health care arena,” Rowton says. “If you’re not addressing forms automation in health care accounts right now, someone else will be soon. You can bring this new technology to your accounts now and separate yourself from being just another forms printer or be left out in the cold.”

Distributors selling to health care prospects must recognize the relationship between electronic documentation and the health care industry’s need for compliance. The federal government is pushing for widespread adoption of electronic medical records. “There’s legislation going on right now that’s forcing hospitals to adopt EMRs,” says Mike Kelly, regional sales manager at FormFast. “The basis is [the federal government] wants all hospitals to be able to communicate patient information back and forth, so you’re starting to see more and more hospitals move away from hard, chart records, to an electronic-based system.”

A national-based health information network would allow physicians to access any patient’s records. “Let’s say you go on vacation and you’re involved in a serious car accident,” says Gish of The Write Choice. “When you go to that hospital, and they’re working on you there, they’ll be able to electronically get permission to get your records. Right now, it takes an immense amount of time and documentation for that to happen. An electronic framework for a company will allow that to happen in minutes.”

Congress initially nudged the medical industry toward electronic documentation by passing HIPAA in 1996. A key component of HIPAA called for standards governing the electronic transmission of health care information. Electronic billing, insurance claim submission, health plan enrollment and other electronic transactions must follow standards adopted by the Department of Health and Human Services and developed by private sector organizations with input from professional organizations and stakeholders. The standards address security, privacy, storage and transfer of medical information. To lower return-on-investment barriers, the Centers for Medicare & Medicaid Services (CMS) offers free billing software to enable electronic transmission of Medicare claims. At the same time, CMS announced that it won’t accept non-HIPAA compliant electronic Medicare claims starting October 2005. Also, legislation pending in the Senate earmarks technology grants and loans for qualified facilities to achieve interoperability.

Despite the government’s involvement, the health care market has been slow to incorporate EMRs. A study released in March by the Center for Disease Control’s National Center for Health Statistics shows that only 31 percent of hospital emergency departments, 29 percent of outpatient departments and 17 percent of doctors’ offices use electronic medical records.

It’s evident that print-based forms are still in demand, but selling them to hospitals requires distributors to re-conceive their business models. Approaching health care prospects as document management consultants rather than print experts creates opportunities for distributors to sell print and electronic products. Ultimately, electronic documentation is a blessing in disguise, Rowton says. “From a distributor standpoint, it’s a whole lot easier to manage an account without all the individual forms that hospitals use, because there’s constant change, there’s constant revision, so there’s a lot of labor involved,” he says. “If you’re doing forms automation, you set it up on the front end, and then it’s self-sufficient. It leaves you the ability to spend more time looking for other opportunities in the hospital, such as marketing, ad specialties and different supplies.”

Andrew Brown is assistant editor at Print Solutions. Email him your comments at abrown@PSDA.org.