Case Study

Columbia Valley Community Health

Columbia Valley Community Health (CVCH) is a Federally Qualified Health Center (FQHC) that offers medical, dental, behavioral health, pharmacy, WIC and outreach services to everyone in Chelan and Douglas counties in the state of Washington. Their mission is to provide access to improved health and wellness with compassion and respect for all. Established in 1972, Columbia Valley Community Health is now an industry leader and was the first in the Pacific Northwest to achieve the Joint Commission’s Primary Care Medical Home certification. CVCH serves well over 24,000 patients a year between all of its departments and locations in Wenatchee, East Wenatchee and Chelan

CVCH recognized that preprinted paper forms were delaying patient registration, clinical
and administrative processes, as well as making it difficult to get information into the
electronic medical record (EMR) and business systems. In addition, staff members spent
a lot of time chasing paper, which took their focus away from patient care in clinical
departments and value-added tasks in back-office areas. So the clinic looked for a vendor
whose software could help them overcome these challenges.
“One of the reasons we chose Access was their ability to integrate e-forms and electronic
patient signatures with multiple applications, including our NextGen EMR, our ABRA HR
system and Microsoft SharePoint,” said Marc Paskett, Enterprise Content Manager at
CVCH. “We also found that their e-forms solution could be applied clinic-wide.”

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Speeding Patient Processes With Web-Based Forms

For compliance purposes, CVCH must gather the signatures of the patient, the provider
and a witness on an annual consent form. Now this is done electronically using Access’s
web-based forms solution. In the event of an audit or legal proceeding, CVCH could
quickly retrieve the e-form with all three digital signatures, including time-and-date
information to verify when the consent was signed.

"Access’s web-based forms solution enables multiple people to quickly view, complete and sign electronic consents, which are then sent into our EMR system,” Paskett said. “This process ensures we have the signed paperwork for each patient, which protects them and reduces our liability risk. Plus, there’s no paper to deal with.”

CVCH’s charge write-off request is another patient-related process benefiting from the
efficiency of paperless forms. When a patient can’t afford a certain procedure, medication
or service, the clinic can decide to reduce the expense by using funds from its Helping
Hands fund. It was often difficult to find the form and then contact a committee member
to advance the process, requiring phone calls, faxes and e-mails, and causing further
delay. Now, a staff member retrieves the form online from any device, completes and
signs it, and it’s automatically routed to a committee member for review. With a digital
trail, the process is more visible and accountable, and decision making is expedited.

“Implementing web-based charge write-off requests eliminates a paper chase, ensures
each request goes through a consistent process, and helps patients more quickly through
our Helping Hands fund,” Paskett said. “It has saved a lot of time and effort.”

Improving Visibility and Productivity in the Back Office

CVCH also is using web-based forms in its Human Resources department. Any time a
staff member has a change in employment status, such as switching from part time to
full time, the e-form is quickly completed, signed and routed to finance so they can make
changes in the payroll system.
Employee termination/change/review forms are sent to multiple people in different
departments simultaneously. Each person applies a secure digital signature to show
they’ve taken the correct action, such as collecting an employee’s computer equipment.
And when new employees join the CVCH team, a similar e-forms-driven process ensures
they have access to everything they need on their first day.

“We’ve eliminated a lot of manual tasks from employee status change processes with the Access solution,” Paskett said. “We’re also transitioning our 12-page new hire
documentation packet — including a W4 and a technology use agreement — to a paperless version. This will make onboarding more efficient for HR and new staff.

Now that the CVCH team has seen the impact of moving from paper-based to web-based
forms in HR and clinical departments, they are extending the system to other areas. When
the clinic is budgeting for additional FTEs, they can choose a physician, add the position,
and then route the request to two supervisors. The e-form is sent electronically to the HR
team and ultimately to the CEO for final approval.
“Now that we’re using e-forms, documents flow without skipping people or processes, as
was sometimes the case with paper,” Paskett said. “The CEO can see everything that’s
happening with e-forms on a certain date and time, which wasn’t easy with hard copies."

Simplifying Registration With E-Forms and E-Signatures

One of the goals for CVCH when rolling out the Access solution to Admissions was
achieving better information integration with the EMR. Once a registrar sets up a patient in
the health information system (HIS), the Access system accurately places patient names and other demographics on each form. This eliminates the need for patients to write in
these details, and allows the CVCH team to correct errors more easily. 

“With Access’s e-forms system, it’s easy to identify if a patient’s address is wrong and to
correct this information before they apply their electronic signature,” Paskett said.
CVCH is using Wacom 1631 signature tablets embedded in its registration countertops.

A copy of each form is displayed on the patient side and another on the registrar’s side.
The patient signs right on top of the form, which the Access system sends directly into
their EMR through their ECM system. Patients have reacted positively.
“Patients have been pleasantly surprised with our Access electronic signatures solution,”
Paskett said. “They can see the entire form and know what they’re signing, which makes
them feel comfortable.”

Eliminating paper and the manual tasks that accompany the paper process also has gone
over well with the registrars at CVCH.

“The new process is a huge time-saver and the patient services team never leaves
patients to deal with paper forms,” Paskett said. “We’re saving up to three and a half
minutes per form, and each patient signs a minimum of four forms. When you extend
these numbers to a patient population of 28,000, you see significant savings.”

Before switching to e-forms, CVCH used a third-party print vendor for large forms
printing jobs and an in-house print shop for smaller runs. Now, the hospital generates a
lot of its e-forms on demand, a far more efficient process.

“With Access, our overall forms printing has been reduced by at least a third, and this
percentage is only going to increase as we roll it out to other departments,” Paskett said.

As CVCH continues to extend its Access project, the IT team has identified 289 more
forms to convert. The detailed forms assessment that the clinic performed also revealed
that 20 percent of its forms are no longer needed, and an additional 20 percent can be combined- yielding even greater efficiencies.

"Columbia Valley Community Health is finding uses for the Access suite in finance, billing, health information services and other departments that use forms" Paskett said. 

“Access has been great to work with- I can't think of another vendor that has been more helpful." Paskett said. "There are challenges with any IT project, but Access always helps us find solutions. That's the sign of a good partnership."

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“Access’s web-based forms solution enables multiple people to quickly view, complete and sign electronic consents, which are then sent into our EMR system. This process ensures we have the signed paperwork for each patient, which protects them and reduces our liability risk. Plus, there’s no paper to deal with.”


Quick Facts

Location: Wenatchee, WA

Integration: NextGen EMR, ABRA HR system, Microsoft SharePoint

Focus: Speeding patient-centric and business processes, paperless approval workflow, web-based access, compliance

Departments: Organization-wide, registration/admissions, HR, financials, clinical areas

Access solutions: Intelligent eForms, Electronic Signatures, Enterprise Integration and Process Automation (Workflow


Web-based software enables users to quickly access eForms from anywhere.

Users send the eForms to others across the clinic via a secure, paperless workflow.

Patients quickly complete eForms and apply eSignatures using Wacom tablets.

Helping Hands fund submissions are quickly processed through an electronic workflow.

The CEO can see all forms that were submitted, their status, time and date and other information.