You already know about EMR, PACS, RIS, and HIS. Now get ready for ECM.
Enterprise Content Management is another important entry in the glossary of health information technology. Think of ECM as a way to handle all the other information that doesn't fit neatly into the data fields of the electronic medical record (EMR).

"EMRs are great at what they're meant to do. They're data repositories, a database of all the structured health information of a patient since the inception of the system," said Andy Kuo, Healthcare Strategist at ECM provider Laserfiche, based in Long Beach, Calif. "But there might also be unstructured content--referral letters, emails from other physicians; the patient might bring in their own history on paper--that is not easily integrated into the fields of an EMR. That is one of the pieces on the clinical side that ECM encompasses."

Laserfiche (pronounced "laserfeesh") has been around since 1987 and the federal stimulus investment in electronic medical records is putting their ECM technology on many people's radar. The company is well established in public sector data management and has several state CMS contracts for content management in Medicare and Medicaid.

As reported in DOTmed News, as a precursor to the health care reform effort, about $20 billion was earmarked in the federal stimulus act to fund electronic medical records implementation. Part of that effort will need to ensure that data doesn't fall through the cracks, and that accountability and compliance are achieved. This puts Laserfiche in a solid position with its ECM offering and government experience.

"The government is primarily worried about collecting and sharing data across enterprises, organizations, and hospitals. ECM's value in that equation is to provide some structure for all the unstructured content that the EMRs might miss," Kuo said. He noted that there is some overlap between EMR and ECM and some practitioners may need both. An example might be physicians who get EMRs through their hospital affiliation but need to incorporate records in many formats from their own medical practices.

The company's clients include doctors' offices, hospitals and surgery centers. Quite often, as these organizations adopt electronic records, they find that older records don't fit neatly into new systems. Examples include dictations, photos, and videos as well as paper documents. ECM from a third party can help to get all that additional material organized into the patient record. And ECM is more than just scanning paper. It's a suite of software products including workflow tools to manage business processes, with audit trails for facilitating compliance.

"ECM is more of an infrastructure solution. It's not just for EMR, because it also supports the back office--HR, credentialing, billing--all of those departments that have primary line of business software but also need to integrate that additional unstructured data. End users don't always see value in it until they see a shortcoming in their current systems," he said.

What's more, the end user physician or nurse might not even be aware of the ECM. "It's really middleware. With the right integrations into EMRs, users don't have to be able to see where the unstructured information comes from as long as they get information when they need it."

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