Hospital Document Management (Part 2): Document Storage
Hospitals need to select their storage vendor wisely (notice that I didn't say vendors). Things do happen and you are liable for those "what if" scenarios.
As a refresher, here are the four categories we will cover in our Hospital Document Management series:
Today we will tackle storage. We are only focusing on physical storage rather than including electronic storage primarily because this is what most purchased services executives think about when you say document storage. Secondarily, electronic storage uses a lot of technical lingo, so it is very IT focused and would derail or confuse the message of this article.
So what exactly are we talking about when we say physical storage? This is when you put your documents into a box and either store them in your own warehouse or off-site with a third-party vendor.
This is pretty standard stuff, but here are some things to think about.
If you are storing your own records, you need to destroy anything over seven years old, scan everything between three and six years old, and only keep physical copies of records that are less than three years old. Talk to your legal department before doing this because most companies have policies in place regarding this. If your policy is different than what is listed above, please contact me so I can hear from your attorney on exactly why you need to keep physical copies of documents for over a decade.
Unfortunately, I have seen several storage rooms at hospitals (or off-site) housing 12-year-old documents. That’s just wasting precious space. By the way, why are you paying to heat and cool old documents?
If you are storing these documents at your hospital, please stop. There are revenue-generating activities you can use this square footage for instead. If you are storing them off-site at your own warehouse or storage shed, please go visit it and make sure it is up to code and includes the proper sprinkler system.
Hopefully, you have realized that your hospital is not in the document storage business and are utilizing a reputable vendor to handle this service for you. I say reputable vendor because it is extremely important that you utilize a licensed, insured, and bonded company to handle your storage needs. Again, we covered some of the reasons why in the previous post, so I won't go into the details here.
Vendors are going to charge you on a per-box per-month rate. They typically require you to use their boxes, and at a minimum, you will need to use standard size boxes that are 15” or 24” long. The pricing will range based on how many boxes (or storage units as some vendors call it) your hospital is storing with this vendor each month. I’ve seen the pricing range from $.20 to $.90 per box per month.
Ultimately, the price depends on how much business you are giving this vendor, which is why I said "vendor" and not "vendors” at the beginning of this post. There is absolutely no good reason to use multiple physical storage vendors. Here's the primary reason why:
If you store 1,000 boxes with Vendor A at a rate of $.50/box/month, you will be paying them $500/month for years. Then, if you go out and use Vendor B to store an additional 1,500 boxes because you got a better rate of $.35/box/month, you will pay them $525/month for years. That will come to a total of $1,025/month for years.
If you would have taken your full volume of 2,500 boxes out to bid, you most likely would have gotten $.20/box/month, which would have only cost you $500/month for those same years. You would've saved about 50%.
Remember that most hospitals, and especially health systems, have thousands of boxes of patient records stored in warehouses. Therefore, the numbers above could easily be multiplied by 10. Another thing to note is that if you don't have an aggressive records management policy like I mentioned above, you will be paying these storage fees for at least 10 years per box. This stuff adds up quickly.
When a vendor gives you a quote, remember that they are most likely quoting at the 15” standard size box rate. If you use anything else, they will use a multiple (based on the cubic sq. ft. of the box), so don’t be surprised when the bill comes back much higher than the quoted price because someone thought “What’s the difference?” when they started filling up large, legal size boxes.
A big thing that gets overlooked a lot during an RFP is retrieval fees. This is where the vendors charge you more to get your documents out of storage than what it costs to keep them in. I call it a hostage fee. Hopefully, it won’t be a big expenditure for you because you typically only need to get documents back when you are in a lawsuit. The fees range from $5 to $25 per box plus delivery fees, etc.
Storing documents will most likely never go away, even when everyone is using electronic medical records. Hopefully you can convince your organization that they don’t need to keep physical copies forever, like some seem to do. This is a pretty easy category to find savings in just by enforcing some good record management policies and by using only one vendor.
Stay Tuned: Our next post in the series will cover scanning. We will look at the different service options you have including price points and other useful contracting tips.