Hospitals are increasing their printing activity, resulting in a drain on revenue

In the era of electronic health records, it may seem counterintuitive that hospitals would be increasing the volume of their printed documents. But that's precisely the case, and this lack of efficiency is leading to rising costs at a time providers should be tightening their belts.

Research from CynergisTek shows that the average 1,500-bed hospital prints more than 8 million pages per month, and with an average cost of four cents per printed page, the costs add up, equating to about $3.8 million of spend per year. And that's not even factoring in the expenses of printing equipment and maintenance, which can drive costs up even further.

Sean Hughes, executive vice president of managed print services at CynergisTek, said that in the case of printing, inefficiency begets inefficiency.

"We've been watching healthcare organizations," he said. "The expectation is that, with the advent of the electronic health record, we'd see a decrease in the amount of pages printed. What we see is the opposite -- it's actually 11 percent more. Even with the implementation of the EHR, we've taken on more data and disjointed workflow processes, and it takes more pages to account for those inefficient processes."

The data shows that 60 percent of hospital print volume originates from EHR systems. While it's not exactly feasible for a hospital to curtail its EHR usage, there are costs on the print side that hospitals often don't consider. Most, for example, fail to truly examine device acquisition costs. Whether leasing or buying the print equipment, there's money tied up in those devices.

Technical support represents another oft-unexamined cost, and there's also a price tag tied to storing and shredding the documents being produced.

"All of those costs need to be combined so you can truly understand what your cost-per-page is," said Hughes. "What we generally see is that hospital organizations have a click rate four to five times higher than they anticipate it being. 

"Imagine you have a single copier in your department that has a $200 lease," he said. "It's a penny and a half per page, so people assume that's what they're paying. But they're really paying $200 plus the penny and a half. Eight million pages a month, 96 million pages a year. When the average cost is four to five cents per page, simple math tells you this is millions of dollars."

The biggest thing hospitals lack, said Hughes, is a print remediation plan that takes everything into effect. Most will concentrate only on one area, such as the print volume going to their copiers, and neglect others, such as how many pages are being printed in color versus black and white. 

Looking at purchase volume history allows an organization to calculate what their future rates will be, but rarely is everything taken into account cohesively, said Hughes. His advice: Drive down print volume.

"Their effort should not just be about achieving the lowest price point per device based on historical volume, but considering, 'What could my volume be?' If you drive reliance on the printed page down to its absolute minimum, you optimize the environment."

The first step to addressing this print problem is to inventory and assign costs to all components of the print environment, from copiers and fax machines to supplies, support services and document storage. That results in a more complete understanding of the total cost of ownership, expressed as a comprehensive cost per page.

Next, CynergisTek recommends creating a committee comprised of representatives from IT, security, supply chain, finance and operations, and any other affected area. The focus of the committee should be to calculate an all-inclusive cost per page, reduce overall print volume, reduce the numbers of print devices and their usage, simplify invoices and eliminate fragmented program management.

Finally, use accounting approaches to provide actionable data. For example, 76 percent of organizations using a common EHR platform continue to print consent forms instead of using eSignature applications. And 10 percent of hospital print volume may be related to fax. Automated fax solutions can easily be introduced in most healthcare environments.

Even reducing the number of copiers and printers in the fleet can drive efficiency. Hughes said most devices at most healthcare organizations are only used to about 35 percent of capacity, and in some cases only 11 to 15 percent of printers in the fleet are being used at all.

"From a granularity standpoint you have the ability to affect change," he said. "You can work the finance and support facets of your organization and drive this. You can start to align and benchmark your organization to those metrics.

"Really what's happening in healthcare today is the dialogue is finally starting to shift," Hughes said. "You're getting beyond the first layer of data. We're starting to see organizations dipping their toes in. They're seeing they need to make a change."

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com