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New York Department of Sanitation (DSNY) Customer Story

NYC Department of Sanitation Gets Millions of Medical Records Under Control with Alfresco

Introduction

State and local governments across the United States are investing in enterprise content management (ECM) solutions to transform their operations from a paper-based environment to an electronic environment. Many organizations still have huge volumes of paper records that take up valuable space and are costly to maintain. Worse, paper files are vulnerable to loss from floods, fire, earthquakes, and other catastrophic events. Paper files also negatively impact user productivity, business process visibility, and information governance and compliance.

To gain an understanding of how public sector organizations are putting ECM solutions to work to streamline business processes and improve retention and compliance, we spoke with Joel Binn, Senior Director at New York City's Department of Sanitation (DSNY).

Founded in 1881, DSNY is the largest organization of its kind in the world (many large cities have privatized collection and cleaning operations). DSNY collects more than 10,500 tons of residential and institutional refuse, together with 1,760 tons of recyclables, per day. DSNY employs 7,197 uniformed workers and supervisors plus an additional 2,048 civilian workers and operates a fleet of 5,700 vehicles.

In the aftermath of Hurricane Sandy — which flooded DSNY's clinic — DSNY's Alfresco medical records system proved to be critical for business continuity. "We were able to restore operations from a remote location almost immediately. We would never have been able to do that if we'd been operating on paper records alone," states Binn.

Alfresco Selection and Implementation

DSNY was given initial funding in 2012 to create an electronic medical record (EMR) system to manage the health records of thousands of current and former employees.

DSNY sent out RFPs to several leading ECM vendors and large systems integrators. (New York City was already using three different ECM solutions in different areas.) The bids all came back with price tags that were two to three times DSNY's budget for the project, however. A consultant working on other projects at DSNY suggested that the team take a look at Alfresco.

The DSNY team liked what it saw. It needed a solution that was easy to deploy, and Alfresco seemed much less complex than the other systems DSNY was using. The team also found Alfresco's open source approach very appealing from both a cost perspective and a functionality perspective. With Alfresco, the DSNY team realized it could save on license fees but still purchase the value-added support it needed for its enterprise project, and it could leverage the large marketplace of extensions from the Alfresco community, saving on development costs.

DSNY strives to implement a standard look and feel across all bureaus at the agency as it reduces help desk calls, and DSNY leveraged Alfresco's Java framework to build custom user interface (UI) components. It has also integrated Alfresco with Oracle ERP and workflows. DSNY's Java developers have found Alfresco easy to learn — another plus because it lets DSNY quickly build in-house expertise.

DSNY went live with phase 1 of the new Alfresco-based EMR system in early 2012. It is currently working on the implementation of phase 2 features and is in the planning stages for phase 3. DSNY has approximately 50 users on the system today; eventually, the system will support field operations and will be accessed by hundreds of DSNY supervisory staff.

Benefits of the New System

DSNY has been able to move millions of paper medical records to inexpensive long-term storage — freeing up floor space in Manhattan, which comes at a premium. Its Alfresco EMR system is an important contributor to DSNY's overall sustainability program (over the past few years, DSNY has reduced its footprint in Manhattan from 120 buildings to 80 buildings, significantly lowering operating costs).

The new system makes staff far more efficient. It eliminates time spent filing paper documents as well as photocopying when staff members need to share files. Staff can pull up records immediately with the click of a mouse.

A major benefit of the new system is the ability to mine the information in medical records to uncover trends. For example, DSNY can correlate the number and types of injuries with particular events or look at treatment outcomes. The wealth of analytics that the new system provides gives DSNY the insight it needs to continuously monitor and improve safety practices.

Previously, DSNY had groups of people pulling information from paper documents to create management reports. Alfresco makes it quick and easy to generate all kinds of management reports, and staff can be leveraged for more valuable work.

In addition, DSNY no longer needs to worry about losing its employees' medical records to unforeseen catastrophes. Alfresco ensures the long-term retention of DSNY's critical records.

Challenges

The biggest challenges DSNY faced in its Alfresco implementation were related to resources: DSNY was simultaneously undertaking a large ERP project. It is also in the midst of a long-term migration off legacy mainframe applications.

In addition to dealing with scarce people resources, most city agencies have to grapple with funding constraints, and DSNY is no exception. As an open source solution, Alfresco gives DSNY an important cost advantage.

Future Plans

Binn sees plenty of opportunity to apply Alfresco in additional use cases at DSNY. Once phase 2 of the EMR system is complete, he expects to apply Alfresco to more projects in the legal area. DSNY has already implemented Alfresco for contract management. Other operating areas such as finance and architecture are already scanning their paper documents into Alfresco.

Ultimately, as the large operating units come on board — including the Bureau of Cleaning and Collection, the Bureau of Waste Disposal, and the Bureau of Long-Term Export — there will be thousands of potential users.

Notes Binn, "Our particular agency has historically been very paper based, but we're changing that. We're pulling in electronic documents wherever we can, avoiding the need to scan in paper. And we're digitizing the paper we already have, for example: We've already digitized the blueprints for more than 80 buildings for the architecture department. We're also trying to push out best practices around electronic documents to other groups."

Binn adds, "We can't get rid of paper entirely — there are paper documents we have to keep for legal reasons, and there are still workflows that originate with paper documents. But we are eliminating paper as much as possible using eforms."

Longer term, Binn sees opportunities to use Alfresco's records management and retention capabilities. Notes Binn, "We're just starting to talk about this, and it's really a citywide conversation. But we need to retain medical records for the lifetime of the employee, and city oversight groups need to demonstrate compliance."

Binn is also excited about Alfresco's cloud offerings, noting that "Alfresco is doing a lot of exciting things there that put them ahead of their competition."

Advice

Binn offers the following advice to other customers that are planning similar projects: "Look for opportunities to streamline your operations and simplify. Just because you have 100 different paper forms doesn't mean you necessarily need 100 eforms. Some of those paper forms are by-products of a manual paper-based process — sign-offs, for example. Many of these forms disappear the moment you automate the business process."

Methodology

The project and company information contained in this document was obtained from multiple sources, including information supplied by Alfresco, questions posed by IDC directly to DSNY, and Alfresco corporate documents.

In the aftermath of Hurricane Sandy — which flooded DSNY's clinic — DSNY's Alfresco medical records system proved to be critical for business continuity. "We were able to restore operations from a remote location almost immediately. We would never have been able to do that if we'd been operating on paper records alone.

- Joel Binn, Senior Director, Information Technology