What do Cleveland Clinic, Allina Hospitals & Clinics, and SSM Health Care out of St. Louis, Mo., have in common? All three health systems implemented Epic's electronic medical record (EMR) system and Hyland Software's enterprise document management solution (EDM), OnBase. While all three have their own health IT goals and vision, the strategy to implement their Epic EMR included the deployment of an EDM solution.

Allina Hospitals & Clinics, based in Minneapolis, Minn., developed a "One Patient, One Electronic Medical Record" philosophy. Patient information will be accessed from one IT system, which is its Epic EMR. The leaders at Allina recognized that as capable as any one system can be, it takes other applications to truly deliver a complete IT package that would then provide complete patient data to its clinicians. Once it chose its EMR vendor, Allina began looking for an EDM solution during the strategic planning of its EMR implementation. It implemented Hyland Software's OnBase suite. The goal of EDM is to augment the EMR's scanning capability and provide the bridge to the seamless access of paper-based documents within its EMR.

SSM Health Care, based in St. Louis, Mo., understood that while it was implementing Epic's electronic health record (EHR) system, it needed an EDM solution to take care of "loose" documents for its EHR. It recognized that paper documents live outside of its EHR system. SSM Health Care's health information management team (HIM) was tasked with enabling its physicians to electronically sign documents that were scanned into the EHR. The healthcare system implemented Hyland Software's solution. Having an EDM tool gave the health system that capability, which is being heavily used by physicians and the HIM department.

Cleveland Clinic's EMR is a hybrid model, meaning it included aggregation of both electronic and paper documents. The nonprofit academic medical center struggled with access to paper documents and needed an EDM solution to augment its Epic EMR. While Cleveland Clinic's implementation of Hyland Software's OnBase was not part of the initial implementation of its EMR system, the solution is considered a Tier One, or core, application because it is heavily integrated with its Epic EMR. When users access data via hyper links in the EMR, they are seamlessly going into the EDM system to get the data – without having to sign on to another system or conduct searches.

All three healthcare systems are early adopters of electronic patient records. And early on, they recognized the need for EDM and successfully wove it into their strategic health IT initiatives.