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Southcom

When Napoleon and later Hitler failed to reach Moscow in large part because their troops were starving to death on the field of battle, it may well have been true that an army traveled on its stomach. In today’s world of warfare it can just as truly be said that the United States Department of Defense travels on its paper...tens of thousands of pounds, untold millions of pages of paper.

Old paper, new paper, even some occasional blue paper, thick paper, thin paper, handwritten paper notes and reports, multi-sheet forms, paper typed on ancient Underwood 15s and similar machines by the blazingly fast index fingers of 100-word-a-minute clerks, paper printed out by the earliest generation of dot-matrix mainframe computer printers and by the latest,greatest models of networked laser printers. Paper fed into typewriters or single-sheet printers askew, paper with its content faded and almost gone, paper scarred by multiple staple holes, dog ears and paper clip imprints.

Paper...hundreds of thousands of sheets of which annually wind up in the three-person office of Staff Sergeant James A. Kiezer at the Army Health Clinic SOUTHCOM Patient Administration Division in Miami.

“Basically, what we do is provide a serviceman or woman copies of their records for things like filing a VA pre-separation claim prior to their retirement date.Under the former process the amount of time it could take to get these records depended largely on where the service member’s record was located,” Kiezer said. “It could take a month, it could take 45 days or even three months, and they wouldn’t be able to file their pre-separation claims until after the paperwork got here and was copied, which could take up to a week.

One of the major roadblocks to an efficient pre-retiree workflow is the sheer volume of paper that accumulates and follows each member of the military around the globe during the course of a 20-to-30 year career. By the time an individual’s records reach the Patient Administration Division office they are jammed into one to three densely packed volumes of 300 to 700 pages each.

Making the creation of a streamlined digitizing pipeline even more difficult is the nature of the papers in those folders. Created and filed over decades in commands scattered around the world, they vary widely in size (standard and legal sheets to small factor forms), image quality (from handwritten to poorly typed to letter-perfect printouts) and attributes (onion skin originals, carbons, standard weight sheets and heavy-weight forms.)

Systemwide, the problem has been exacerbated by a paper trail that wound around and through four or five medical departments, each of which had their own equipment or outside contractor for digitizing records...frequently for the sole purpose of producing yet another printed copy

According to Kiezer, each record was basically being scanned five times,compressing the time between the 180-day period allowed for requesting preseparation files down to days or often, days minus.

An eight-year veteran of various medical records departments within the Department of Defense, Staff Sgt. Kiezer had long felt the logjam could be broken by digitizing each document only once...a single pass through a dedicated,high-output, high-performance scanner that would create easily searchable PDFs and file them in a single, maximally-secured medical portal accessible by every authorized DOD stakeholder.

The fact that his assessment, that speed-burning, highly-accurate workgroup scanners with superb paper recognition and handling capability could revolutionize both the digitalization and distribution sides of the equation, was accepted is not the surprising part of this story – today’s computer-driven military thrives on innovation, particularly innovation that breeds efficiency...the drone program standing as, perhaps, the all-time exemplar of that.

The jackpot in this story is that only eight months after the first scanner went online in Miami, the “revolution” is gathering speed way faster than some expected. It is delivering results almost exactly as planned, with the unforeseen bonus of zero downtime for repairs or replacements of consumables such as rollers or lighting arrays. Except for scheduled maintenance for roller cleaning,James’ scanner is always on the job.

WHAT A DIFFERENCE A RANK MAKES

Though Staff Sgt. Kiezer had long been convinced that dedicated scanners could do the job the Patient Administration Division’s “hulking, oversized All-In-One document management machines” weren’t doing, it wasn’t until he “moved up in rank a bit and got a little input into procurement decisions” that he was able to make his presentation – a “sales pitch” largely researched on YouTube, which just might be a first for any military organization anywhere, not just the U.S. DOD.

“Some might think it’s funny, but I YouTube scanners … many different brands of scanner hardware until I finally found a company whose claims for their hardware dovetailed perfectly with our needs and applications and whose trade paper and user reviews generally supported their claims.” he says. “Next I researched their programs and found one that would work well for us.”

If this were Hollywood, the success that followed with Kiezer riding off into the sunset would have made a suitable grand finale. Being this is the DOD and not Disney, however, the Sergeant only gets to ride off into the Miami sunset at the end of a summer’s work day, and one crucial scene remains to be screened, a scene defining the on-the-job test cycle that every company interested in bidding on the contract was mandated to participate in

“I’d already pretty much made my mind up what we wanted and was hoping none of the other companies would want to bid,” said Kiezer. “But it turned out I had nothing to worry about, comparing the one scanner to the other pretenders was like comparing a Ferrari to some Beetles.”

There are numerous ways to tie up and nail down a successful case study of this nature: The less than 30-minute learning curve for office workers. The extremely accurate scanning of old paper MRI, EMG and retinal scans. The time-slashing advantages of being able to “toss” near-cardstock award citations, onion skin action reports, multipart forms and the occasional upside down or horizontally skewed document “into the stack” and have them scan perfectly.

Any and all of those would be a good closer.

But in this particular case, these excerpts from Staff Sergeant Kiezer’s official report on the scanner “road test,” an unclassified document used with the permission of Staff Sgt. Kiezer and his commanding officers, is a better summation than any we could devise:

They test fired it on a file which was almost 300 pages and it took three minutes...that single 300-page file would have taken 6-8 hours with the old (AIO) scanner. They did four files this morning in 20 minutes.

This is huge. It will greatly reduce manpower and (help us) avoid the 6 - 8 week wait that is the norm at other bases which send their medical files to a third-party scanning facility. Additionally, we increase the security of the files by not sending them to a contracted scanning firm.

Greatly reduced scanning time (three days to one hour), and producing searchable documents in PDF format also greatly reduces VA pre-separation claims process by months. By being able to scan records at a high speed we are able to send the medical record via PDF to the SM (serviceman or woman) and the VA. This eliminates the VA having to send the paper record to their scanning site, which can take five to six weeks to scan into their system due to (the current) backlog.

(This way) SOUTHCOM Clinic sends the medical record via PDF, the VA drops the PDF into their record system and calls the service person the next day to make an appointment.

Challenges

Implementing an efficient pre-retiree document workflow at the Army Health Clinic SOUTHCOM’s Patient Administration Division in Doral that can handle the vast volume of paper that accumulates

Solutions

Deployment of high volume document scanners which can process with extreme accuracy the scanning of old paper MRIs, EMG and retinal scans providing time-slashing advantages of being able to feed award citations, onion skin action reports, multipart forms and the occasional upside down or horizontally skewed document and have them scan perfectly.

Results

The ability to scan a file of almost 300 pages in 3 minutes;which would have taken 6 to 8 hours using the old all-in-one scanner; greatly reducing manpower and avoiding the 6 to 8 week wait that was the norm at other bases which send their medical files to a third-party scanning facility. An end product that is searchable (PDF) substantially reducing the Veterans Affairs’ pre-separation claims process.

What we wanted was to give a service member his or her copies within an hour – instead of five or six days – so he or she could send it to the VA and make an appointment for the next day.
Staff Sergeant James A. Kiezer, Army Health Clinic SOUTHCOM Patient Administration Division in Miami