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

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!