Duke Health eradicates long-standing regulatory audit hassles

For healthcare organizations, failing to meet regulatory documentation requirements can lead to loss of accreditation and funding, as well as increased legal risks and reputational damage. And, without accreditation, a facility can struggle to attract patients.

Duke Health Integrated Practice formerly kept compliance documentation in big red and purple binders. “As you can imagine, it was tough to stay on top of all the different accreditations and regulatory documents required by the state and the federal government and CMS and the Joint Commission,” said Kenan Erginer, Program Manager, Environment of Care and Radiation/Laser Safety, Duke Health.

Not surprisingly, this paper system was inefficient. So, they used a repository that was created by an external IT team to store regulatory documents and demographic data for the practice’s 110 primary care and specialty clinics. However, this didn’t make the clinic managers’ jobs much easier. Indeed, the repository fell short because it:

• Lacked reporting functionality
• Could not connect with other systems such as the Epic EHR and Duke Directory
• Required users to enter information manually, increasing the likelihood of mistakes

Such limitations could negatively affect patient care and safety. Consider the following: A medication is recalled for safety reasons. If the drug was initially entered into the system manually with an errant letter or extra space, it would not be flagged. Thus, patients might continue to receive harmful drugs.

Seeking something better

According to Kristy Castleberry, RN, Associate Vice President, Safety and Accreditation, Office of Quality and Safety, Duke Health Integrated Practice, leaders decided to build their own application using Hyland OnBase, a content management solution that organizes, manages and optimizes content and processes because of the solution’s success in other departments and ability to populate data from other sources.

“We have enabled hundreds of workflows for various business processes with OnBase to simplify people’s jobs. It supports clinicians, revenue management, quality reviews and human resources,” notes Rob Biddle, Team Lead, Patient Records Management, Duke Health. OnBase’s Workview module, with its low-code solution development, enables users to create applications with minimal coding by using visual tools, drag-and-drop components and pre-built templates. “It is super fast and super easy to put together … so developers focus more energy on the more customized parts of the system,” he added.

To get clinic staff up to speed, the implementation team provided tip sheets that explained each process. “We built a plan, and by the end of 10 weeks, they had the entire thing populated with the documents and data needed,” Enginer explained.

The system is streamlining operations, increasing patient safety and making regulatory audits — a long-standing operational headache — simpler to navigate. When preparing for an audit, the fire safety team can easily see all the most recent fire alarm, extinguisher, emergency light and emergency generator tests before the audit commences. In addition, the system proactively prompts managers to meet deadlines. For instance, if a document requires an annual update, the system sends an email to the appropriate administrator at the 11-month mark, reminding them to prepare what’s needed. 

Securing required signatures electronically is also easy. “Historically, with the old system, staff were printing the list and then having to hunt down a person to have those signatures completed,” said Erginer. These efficiencies have taken at least an hour out of the internal audit process — and are expected to result in even more time savings for Joint Commission audits. Regional directors have reports for broader oversight of their clinics. Clinic managers now easily create high-alert controlled substance posters and can confidently provide documentation to regulators. And everyone can rest easy, knowing that they can quickly and confidently meet myriad requirements. “The clinic leaders absolutely love it,” Erginer concluded.

To learn more, visit https://www.hyland.com/en/resources/terminology/business-process-management/low-code