Improving Foster Care with Digital Records Management: A KVC Health Systems Success Story

The records of children and families involved in foster care are some of the most sensitive documents any human services organization can possess. They not only contain information that must be vigorously protected due to privacy concerns, but they must also be accessible and searchable by case workers. However, an archive of highly confidential records, available at a moment's notice, and accessible by professionals who are often working with their clients in the field and on the go, is difficult to provide with paper documents.

KVC Health Systems, a nonprofit organization that has provided foster care services in Kansas for decades, embraced the idea of remote records access several years ago. They realized that offering their staff access to critical documents via the cloud could make their process more efficient, improve response times, and create better case outcomes for their clients... even before Covid-19 reared its ugly head.

"It was always part of the plan to transition to electronic records, but none of us envisioned how important it would become with the pandemic," said Angela Hedrick, Director of Policy, Training, and Data Management for KVC. She supports a staff of professionals who work with families who have had kids removed for safety concerns, help families to safely reunite, or help kids reach permanency through adoption when reunification isn't possible. The staff also supports foster homes and relative placement providers. It's a process that has significant consequences for kids and families if things get delayed. Not being able to find a document or information isn't an option.

Creating (and Re-creating) the Archive

KVC got started with their document conversion process by contracting with a case management software company to build their records management platform. Hedrick's team thought that, once it was built, they would scan and load their document archive into it. But as they began to test modules in the new platform, it became apparent that their own document management practices were going to make such a formalized schedule impractical. "The system worked perfectly until we started to enter our own files into it," said Shavonda Thrower, a business relationship manager for KVC and the project manager for the document conversion. "Our old system had a lot of intricacies. Documents could be edited or duplicated, and users could create new file folders and new documents at their discretion." Thrower and the team realized they would have to clean up their data, delete unusable or redundant data, and get rid of extra folders and directories before searching would work with any efficiency. "It was like a tornado of documents in the beginning!" she said.

Learning Through Challenge

Testing the system also made it clear that creating user controls and document lockdowns would be a big part of the solution, but getting KVC's data developer to understand the variety of data variants, types of records, and unique practices of their staff was challenging too. Trying to explain all the details of their file system became overwhelming. "It was Vince and his team from ARC that finally identified all the issues to the programmers," Thrower said. "ARC was able to identify the causes of the problems we were having and lead us in the right direction to fix them." One of the things she appreciated most was ARC's patience in working through the issues. "They never made us feel like we should have known something when we didn't." Vince Pingel, ARC's General Manager for Archiving and Information Management (AIM), said that patience is part of the job. "Most organizations attempting to convert a collection of paper documents into a digital archive have never done it before, and it's a complex process. Educating our clients about what's necessary is critical to the success of the project, and the KVC team came up to speed very quickly."

Consistency is Key

Consistency is at the heart of any document conversion job, primarily because searching for documents often involves distinguishing between very small differences in the way records are named, where they are located within the file structure, or what is being searched for inside the documents themselves. "At the beginning of the project, we made a concerted effort to develop the exact indexing process to be used," Pingel said. The ARC team also reviewed and implemented very specific file naming conventions, right down to examining when spacing would be used, what types of various 'dash' characters could be used, letter casing, and numerics. "I think we frustrated the KVC team in the beginning with all the detail," Pingel said, "But getting it perfect is what makes a system like this work."

Documents in Motion

Once the naming and file indexing system was worked out, scanning documents for the KVC team turned out to be the easiest part – despite taking place nearly 800 miles away. The level of protection and the volume of the job made it a perfect fit with the document management and scanning facilities of ARC's HIPAA-compliant regional scanning center in Houston, Texas. Stewardship of the physical documents was a serious consideration, but ARC has secure scanning centers across the U.S. designed to handle protected health information (PHI), and KVC's documents were in experienced hands. The conversion involved the inventory, bar coding, and transport of 43 shelved metal cabinets containing more than a thousand binders, five four-drawer file cabinets, and just over 600,000 pages. And KVC had made it clear from the start that ARC would have to provide documents on demand during the process, as the records would remain in use continuously during the conversion.

Documents at Your Fingertips

During the conversion process, KVC staff appreciated ARC's quick document retrieval, often within hours. Requests for specific documents would be sent to Abdul Shabankareh, ARC's Director of AIM in Houston, who would locate the documents in their inventory, pull hard copies from their secure storage facility, scan each document individually, replace the paper documents back into inventory so the conversion could continue, and send the digital images to KVC staff who needed them.

Moving Forward

Close to half a million children were in foster care prior to the pandemic, according to a recent report by the U.S. Department of Health and Human Services' Administration, and the public health crisis did nothing but increase those numbers. The requirements to reunify families have been challenging, often because transactional tasks that are required of families usually happen in physical spaces – like courtrooms and offices – that haven't been available over the past year. Kansas has been able to effectively decrease the number of children in out-of-home care over the past year, partly due to innovative technology and practices that have eased the complicated nature of the work. A document conversion project is a daunting one in the best of times, even with the prospect of greater efficiency and better case outcomes. Case workers helping kids and families can't simply stop what they're doing while documents are being scanned into a digital archive. KVC had to keep moving, even when the pandemic hit.

"As our staff continues to practice and get more comfortable with the system, I'm seeing the benefits of it," said Hedrick. "While the staff still has access to offices, case workers writing a court report or family meeting are now able to review the file from home. It's a huge convenience."