5 Things You Must Know Now About Release of Health Information

By: Linda Kloss, MA, RHIA, FAHIMA

How are leading healthcare organizations dealing with new regulations and challenges in release of confidential health information?  Verisma explored this question at its first annual Disclosure Management Summit (user conference) this past May and confirmed five critical drivers for transformational change.

1. ROI Volume and Complexity is on the Rise

A typical academic medical center may process over 150,000 health record requests from patients and third parties each year.  Requests are increasing in volumes year–over–year and the typical health system is more complex with the expansion of service lines and consolidations with ambulatory practices.  Electronic health records allow access to digital information, but require careful assessment that information to be released is accurately obtained from multiple systems and often in multiple formats.

2. ROI Process Variation Across a Health System is Costly

The only way to reduce cost is to reduce preventable process variation through an end-to-end ROI workflow design.   Healthcare is coming to understand this and is embracing lean and six sigma techniques across clinical and administrative functions. ROI processes that vary from site to site across the health systems adds costs. ROI is ripe for redesign to realize tangible cost reductions.

3. ROI Process Variation is Risky

ROI is an administrative process that must conform to federal and state laws and organizational standards and policy. The only way to reduce compliance risk is to build in compliance checks throughout the end-to-end ROI workflow and to build in full accountability to track and reduce errors and risks.   Health systems can no longer tolerate inconsistent and ad hoc ROI processes across the enterprise.

4. Enterprise Standardization Reduces Cost and Mitigates Risk

Best-practices in ROI calls for a uniform set of policies and procedures across the entire health care enterprise.  Uniformity in turn, requires technology to guide compliant workflow and allow managers to track and trend processing and release quality and productivity.  Health systems will organize ROI services according to their goals and objectives, but technology-enable standardization is essential whether ROI is centralized, decentralized or outsourced.

5. Enterprise ROI Improves Customer Satisfaction

Best ROI practice health systems report important gains in customer satisfaction from standardization.  Regardless of whether the patient initiates a request at the physician’s office or hospital, the request process is the same and he/she is able to secure the complete record without going from site to site.   Enterprise ROI is an important element of a health system’s overall customer engagement initiative.

It’s time to modernize Release of Health Information with enterprise-wide compliant technology and up-to-date management practices.  Learn how health systems using  Verisma’s ROI and disclosure management technology and services are moving from siloes to enterprise approaches that are reducing risk and cost, while improving the satisfaction of patients and staff. To learn more about how Verisma can help transform ROI in your organization, contact us at solutions@verisma.com or call us directly at 866.390.7404.

In our subsequent blog posts, we will explore and dive deeper into each of these five critical drivers and we hope that you will engage and share your thoughts with us.

A New Day for Release of Healthcare Information

By: Linda Kloss, MA, RHIA, FAHIMA

Historically known as a ‘back office’ HIM function, release of Information (ROI) policies and processes are gaining greater attention for three key reasons:

  1. The number of requests for information and the volume of information per request continue to increase.

People are more aware of the importance of accessing their own information to be informed and engaged participants in their health care. Third party requests are increasing to support a range of expanding uses. While electronic health records (EHRs) and other information technology have digitized PHI, ROI is not accomplished by pushing a button. Information must be retrieved from a range of source systems and it must be reviewed for accuracy and completeness, while assessing responding to requests with the minimum necessary.

  1. New federal access and disclosure guidance promotes patient access, shrinks allowable fees and opens back channels to PHI.

We applaud the 2016 Federal Access and Disclosure Guidance[1] for its focus on increasing individual’s access to their health records. An unintended consequence of the guidance, however, has been an increase in the number of third party requests attempting to circumvent required approaches.   The guidance also reduces allowable fees to the point that they no longer offset the real costs of release functions.

  1. Complex health systems have multiple points of PHI disclosure vulnerability that need to be mitigated.

Each physician practice and hospital that is part of a health system can no longer handle ROI in its own way. Today’s health systems must use consistent policies across the enterprise in order to ensure compliance in protecting the privacy rights of individuals. Health systems must also focus on uniform, efficient practices supported by technology to manage in today’s cost constrained environment.

Whether performed by providers’ own staff or outsourced, there is a need for an end-to-end rethinking of ROI. It is a new day for ROI. Today’s release functions require smart technology to support the end-to-end workflow from receipt of a request through fulfillment. All HIM functions have been profoundly impacted by technology. Technology has elevated staffing for ROI from clerical work to skilled knowledge work. Effective ROI today also requires management tools to monitor and improve productivity and accuracy. It needs compliance guidance and safeguards to ensure that it is being performed according to changing requirements and regulations.

ROI transformation is driven by patients—by all of us—who increasingly rely on timely information for care coordination at home and across our personal networks of care providers. ROI has its roots in the Principles of Fair Information Practice that assert the rights of individuals:

  • to know what information is maintained about them,
  • to obtain a copy in an intelligible form within a reasonable time,
  • to challenge if a request for access is denied or delayed,
  • to have data amended.

HIPAA baked these principles into law and made protected health information (PHI) part of our vocabulary.

Verisma is launching this blog to explore the changing demands and opportunities of this new day for ROI. Over the coming months, authors will focus on key drivers of ROI change, spotlighting solutions and emerging best-practices in the industry.   We hope you will engage with the authors, sharing your thoughts and insights. Together we can accelerate the transformation and modernization of the future of ROI in healthcare.

[1] https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/access/index.html

Verisma Announces $12 Million Funding Round

Pueblo, Colo., November 10, 2015Verisma, the leader in Release of Information (ROI) Automation Systems for the healthcare industry, today announced it recently closed on a round of financing led by NewSpring Health Capital (“NewSpring”), the dedicated healthcare fund of NewSpring Capital. Blue Heron Capital and Jim Crook, former president of IDX Systems Corporation, joined the financing round. Verisma will use the total proceeds to enhance their existing infrastructure as well as grow their sales, marketing and product development teams. The investment will enable Verisma, which has more than a decade of experience in the health technology and services business, to expand their market reach and continue to address the need for compliant, secure and accurate ROI solutions.

“This investment will enable us to expand our organization in response to the growing demand in the healthcare industry,” said James C. Moore II, president of Verisma. “In our first round, it was extremely important that we partnered with firms such as NewSpring Capital and Blue Heron Capital, as well as a widely known and respected business leader like Jim Crook. Their deep understanding of the healthcare services industry aligned well with our expertise and proven track record. We are excited and confident that our new partnerships will be successful and mutually beneficial for our existing and potential clients.”

Verisma is a health information technology provider focused on delivering patented, cloud-based ROI solutions and services to healthcare organizations across the country. The company is a leader in technology-enabled ROI solutions, providing a compelling platform to aggregate and transfer secure patient data. Verisma’s ROI Automation System combines next-generation technology with highly trained teams of ROI, IT, legal and business experts that allows its clients to automate workflow, improve turnaround times and decrease errors. With the explosion of medical information captured by disparate, unconnected systems within a hospital or health system, the need for an efficient and compliant ROI provider is at an all-time high.

“Our mission is to make ROI simple and minimize risk better than any other solution available in the market today,” said Andrew McManus, senior vice president of Verisma. “We deliver on that promise every day for our clients. Now, with this infusion of capital, we will be able to expand our footprint into new geographic locales, as well as continue to serve the many healthcare organizations that rely on Verisma for its superior ROI Automation.”

With over 30 million new patients entering the healthcare system in the first year of the enactment of the Affordable Care Act alone, hospital administrators, HIM management and medical records departments must consider and implement newer and more robust systems to support the rapidly increasing flow of records.

“Verisma’s patented software solution streamlines release of information while increasing compliance and reducing costs,” said Brian G. Murphy, general partner of NewSpring Capital. “This model is aligned with our thesis of using technology to provide efficient and scalable solutions that help drive down costs for healthcare providers. We are thrilled to add Verisma to our growing portfolio of successful healthcare technology companies.”

“Verisma’s patented software solution improves the release of information by automating a formerly manual process, increasing compliance and patient data security — all while reducing costs,” said Tom Benedetti, co-founder of Blue Heron. “Our firm continues to invest in unique and innovative technology solutions to help reduce the costs of healthcare in America.”

 About New Spring Capital

Founded in 1999, NewSpring Capital invests in dynamic companies with the goal of partnering with management teams to develop their businesses into market leaders.  This philosophy has been a key tenet of NewSpring Capital’s approach to investing, and the success of our current and former portfolio companies demonstrates our commitment to offer consistent advice and support through any economic cycle.

NewSpring Capital has raised over $1 billion of committed capital supporting more than 100 portfolio companies across our growth equity, healthcare, control buyout and mezzanine debt funds.  For more than 15 years, our team of seasoned private equity investors and successful operators have partnered with management teams to provide them the financial resources, strategic guidance and a powerful network to assist them in achieving their goals.  Our experience has enabled us to effectively stand by our companies as they launch new products, expand into new areas and ultimately realize their full potential.

About Blue Heron Capital

 Blue Heron Capital is an operationally focused lower market private equity firm based in Richmond, Virginia. Blue Heron supports portfolio companies with a team of proven industry experts, including C-level executives and successful entrepreneurs with decades of experience building and managing vibrant businesses. The firm invests in buyout and growth equity opportunities in the healthcare, security, and business services industries.

About Verisma

Verisma is a health information technology provider focused on delivering unparalleled Release of Information (ROI) solutions to the healthcare industry. The company’s flagship ROI Automation System, Verisma® Release Manager (VRM), is utilized by well-known health care organizations nationwide. VRM automates workflow to improve turnaround times, reduce errors, and drive down costs — effectively automating medical records release while delivering comprehensive release audit capabilities. It is the only release technology with integrated HIPAA guidance and compliance review support. For additional information, please visit our website at www.verisma.com, call 866-390-7404, email solutions@verisma.com or follow us on Twitter @verisma

*US Patent Numbers 6,804,787, 7,191,463, and 9,049,314


It’s All About the Patient – Or Is It? Understanding Your Other Customers’ Needs and Ways to Deliver Superstar Service

The mantra of healthcare is “focus on the patient” and those of us in healthcare and healthcare IT live in a patient-centric world. However, for hospitals and healthcare organizations, the patient isn’t our only customer. In fact, there are many others who fall into that category and require a high level of customer service. This is extremely evident in the departments that interact with those authorized to request and receive copies of patient records.

We have to remember it’s NOT ONLY about the patient…there’s more to consider.

In the Release of Information (ROI) world, our customers are other healthcare providers, attorneys, payers, schools, and law enforcement, just to name a few. It’s the Health Information Management (HIM) department’s responsibility to make sure that ROI requests are met and completed with a high level of satisfaction. Given the variable types of documentation needed, requirements about the level of patient data that can be legally shared, and the sheer number of requests, it’s a challenging and time-consuming process.

So how do we ensure efficient and error-free customer service?

The key is technology-driven ROI workflows. In an age of technology-driven healthcare, so many healthcare providers still rely on manual ROI workflows where requests are touched multiple times during processing and request tracking is done in a log book or on a spreadsheet. This is a recipe for poor customer service based on an inability to quickly and accurately provide information about request status, generate invoices and distribute the requested patient information.

Patients want access to their doctors and hospital staff because the human touch is a cornerstone of patient care. But requestors simply need the information they seek. Think of it like this: Rarely do we call airlines unless there is an issue, we simply book tickets and check flight status online. The same goes for requestors. Technology provides an efficient way to request and retrieve information. And, efficiency goes a long way towards maintaining customer satisfaction.

ROI automation provides benefits to both the healthcare organization and the requestors:

  • Requestors can retrieve information they need independently.
  • Requestor satisfaction rises because self-sufficiency is built into the ROI process, where it has never been before.
  • HIM departments can respond quickly and automatically to requestors.
  • Hospitals can quickly distribute information, track data and reduce errors.
  • Healthcare organizations can ensure they are complying with strict federal, state and organization regulations.

ROI is one of a handful of touch points your customers have with your healthcare organizations. Let’s strive to make this experience the best it can be. With the right guide in place, the entire universe is within easy reach!