Upgrading digital printing equipment, adding Web-to-print and wide-format put HealthSouth Print Solutions on road to recovery.

By Erik Cagle

MIS: An Essential Element

When he was first named director of Print Solutions, Danny Kirkland was tasked with devising a central ordering system that would mesh with parent company HealthSouth’s purchasing system. The in-plant had been using a particular MIS solution for a number of years, but a change within the organization required all purchases to be routed through an approval process.

“If a purchaser from a hospital orders forms, it has to get approval from that hospital before it comes to us, so it’s verified,” he explains. “[Our MIS], at that time, could not import anything, so I was challenged to get that XML from the approval from the system without having to key it in. Three years ago, we’d get orders from fax, e-mail, online, or phone call, and a human would key orders in. This caused errors, duplication, just a host of problems.”

The answer was at Print Solutions all along. Kirkland liked the open-ended architecture of the FileMaker database software. The in-plant created a new database with FileMaker, called Elements, that acts as the MIS and tracks all the jobs.

“When someone orders something through PTI MarcomCentral, it places that XML into an FTP site for us, then our [purchasing] system pulls the data in and routes it to the approval it needs,” he says.

Once approved, the data moves to the Elements system, which creates the project automatically. The beauty of the system and MIS in general, Kirkland says, is that it allows the projects to be routed to their production or distribution destination without human intervention—it’s a closed loop from point of entry to point of printing. All jobs are saved to a central server that Elements links to, providing for future ordering.

Most impressively, the shop’s business has ballooned from 2,500 orders per month to 5,000, without the need for adding customer service employees. In three years, Print Solutions reduced the amount of farmed-out printing from 40 percent to less than 5 percent, and Kirkland attributes it to changes associated with the MIS enhancement.

“We were able to increase job counts by marketing ourselves, creating a centralized ordering system and making an MIS system that all linked together,” he says. “In my mind, the thing that gives us a leg up, is we are subject matter experts for the things that they print. So when hospitals order collateral pieces and forms, they know it’s been through legal, been through quality, been through the clinical review. This is what HealthSouth wants them to use. That, to me, is our single thing that gives us value over another company.”

Not long ago, the CEO, COO and CFO of HealthSouth—one of the nation's leading providers of physical rehabilitation—visited the organization's Print Solutions facility, located 15 miles from its Birmingham, Ala., headquarters. The occasion was to celebrate the shop's acquisition of an HP Indigo 7600 digital press and an EFI Rastek wide-format printer.

There was ample reason for jubilation. The in-plant had reaped 20 percent-plus growth in each of the previous two years and was tracking to post 18.5 percent growth for 2013. Danny Kirkland, director of the in-plant, appreciated the significance of the visit by HealthSouth's executive hierarchy.

"The CEO said we had come a long way, and that Print Solutions was one of the most talked-about departments in the organization," Kirkland proudly notes.

Three years earlier, that wasn't the case. Turnaround times were viewed as unacceptable. The organization lacked a centralized ordering system. Processes needed improvement. Plus, the shop only produced about 60 percent of the organization's printing.

HealthSouth had undergone some process changes of its own, followed by a corporate evaluation of certain departments. The in-plant was on the verge of being closed down.

"We were unaware," Kirkland admits. "When you're immersed in day-to-day activities, you don't realize you have a problem, and if you do, you rationalize it to justify. It got to the point where [the option of closing the in-plant] was on someone's desk. That was a real wake-up call."

HealthSouth wanted its in-plant to succeed, and made some suggestions of steps it could take to improve viability. Some changes were made in management, including elevating Kirkland to director.

Service Improvements

In the past three years, Print Solutions has added the aforementioned digital devices, implemented a streamlined and effective management information system (see sidebar) and acquired the PTI (formerly Printable) MarcomCentral Web-to-print online ordering interface. The in-plant bolstered its product and service offering with a stronger wide-format printing offering and turned promotional products into a $1.5 million cash cow for the department.

Recently, Print Solutions also established an LLC (Print Promotions Group) targeting outside commercial work. Kirkland hopes that, within five years, it will account for half of the in-plant's revenues—and that's without losing any focus on, or volume from, its number one customer, HealthSouth.

Speaking of volume, Print Solutions now handles between 96 and 97 percent of the parent organization's printing needs. If that's not an answered wake-up call, it's certainly a powerful start.

A cost center in nature, Print Solutions produces $7.2 million in revenue backed by 30 employees in its 26,000-square-foot facility. The shop averages 5,000 print and promotional projects per month, nearly doubling its output of 2,500 to 3,000 from three years ago.

Its customers are the 100 hospitals throughout the HealthSouth chain and, by extension, their patients. Forms represent a lion's share of the printed materials. Each patient requires interdisciplinary daily documentation (IDD) forms to be filled out three times a day, and Print Solutions sells roughly 7,000 of these daily.

Another major product is the wellness information technology and health (WITH) binder that is produced for every patient. These binders act as a guide for patients, to walk them through the post-admission phase of their rehabilitation at home.

Kirkland notes that many of the 11,000 different documents that are produced are in the process of being standardized to minimize the paper deluge. The goal is to phase out offset printing, which at this juncture is used on runs in excess of 2,500. The in-plant currently runs a four-color Heidelberg DI Pro, a two-color Shinohara and three smaller Heidelbergs, along with a Halm Super Jet.

One of the in-plant's biggest annual jobs is producing the HealthSouth employee benefits package, of which 16,000 are churned out every October. Each package contains variable pieces—several pages, a booklet and a number of collateral pieces—which are inserted and mailed.

Marketing Materials

Print Solutions also works closely with its creative department to produce marketing materials for HealthSouth. A strong creative department enables the organization to maintain brand and message consistency and keeps the work in-house. The creativity is used on the online store as a template that can be versioned to include a hospital's logo and specific information about that location.

"As a service, we try to ease their day-to-day activity by giving hospitals a one-stop shop where they can...order collateral, business forms and as much promotional products that we can put on there," Kirkland notes. "It keeps them from having so many touch points."

The online store, first instituted three years ago, quickly became large, bloated and somewhat unwieldy. In late 2012, the decision was made to use PTI's MarcomCentral, and in the span of a few months, ordering became faster and easier.

The HP Indigo 7600 and EFI Rastek wide-format printer were both put through the cost-justification process around the same time, with the Indigo coming online in March of 2013, followed by the Rastek a month later. The 7600—one of two HP Indigo digital presses at the in-plant—handles admissions and clinical documentation, along with marketing material for patients and doctors, business cards and stationery.

Variable data jobs include the benefits package. Hospitals also rely on Print Solutions to provide lists for employee candidates, such as targeting nurses in a certain geographic region with images depicting physical and occupational therapy in a recruitment package. Marketing materials are also important for use by hospitals at HR recruiting fairs.

Wide-format Success

The Rastek is already paying dividends. Prior to installation, Print Solutions was unable to print on board substrates, and instead cranked out posters and banners on aqueous Epson printers for mounting onto foam board, a process so labor-intensive that it was difficult for the in-plant to compete. With the Rastek, Print Solutions has produced one-way graphics for windows, static clings, wallpaper, board and glass.

"Its flexibility of what you can put in it and on it, as opposed to a typical roll