Blog | Verisma

Overcoming Staffing Challenges in Healthcare Information Leadership

Oct 4, 2023 | Blog, Health Information Solutions, Operational Outcomes, Release of Information

By Connie Renda, MA, RHIA, CHDA

In my role as the CHIA President-elect, I had the privilege of addressing our California members on a pressing topic that resonates with healthcare information leaders across the industry. Every day, managers grapple with a multitude of human resource challenges, and this struggle is particularly pronounced in the healthcare information sector. In this article, we’ll delve into these pain points, offer a comprehensive understanding of the challenges faced, and present innovative solutions to help healthcare information leaders reach their goals.

Challenges in HI Staffing

Understaffing

Understaffing is a perennial issue that plagues healthcare information management. The demand for skilled professionals often surpasses the available talent pool. A report from the Society for Human Resource Management (SHRM) notes that finding suitable candidates and retaining employees will be paramount for organizations in 2023. However, this search for top talent often collides with budget constraints, creating significant challenges, especially in an era marked by concerns over inflation. Many organizations find themselves handcuffed by hiring freezes or grappling with staff shortages due to employees on FMLA leave, compounding the problem further. The critical HIM duties cannot be deferred and require a dependable workforce, which isn’t always readily accessible when needed.

Skill Gaps

In the ever-evolving healthcare landscape, skill gaps are another major headache for healthcare information leaders. As Forbes aptly points out, the industry is grappling with substantial talent shortages as skill sets struggle to keep pace with rapidly advancing technology. This disconnect between the demands of modern healthcare and the available skill sets places additional pressure on organizations striving to maintain efficiency and compliance in their operations.

Fluctuating Workloads

Fluctuating workloads compound the woes of healthcare information leaders. The volume of work can oscillate dramatically, leading to unexpected spikes in demand that strain an already stretched workforce. Coping with these variations efficiently while maintaining a high standard of service becomes an ongoing challenge.

What Can We Do?

Develop a Flexible Workforce Strategy

Maintaining staff agility is one way to ensure operational continuity and peace of mind. My colleagues had many great ideas to achieve this from cross training to assigning multiple job roles. More experienced staff (or outsourced partners) are motivated by new learning experiences and can help address staff shortages, workload surges, and unique projects. In fact, this is such an effective strategy that Verisma launched a team dedicated for this purpose called Verisma bench.

Consider Efficiency Gains Through Outsourcing

In addition to ROI, many other administrative HIM tasks can frustrate staff who could be spending more time working at the top of their license. Outside partners can alleviate these burdens and improve efficiency, while eliminating the headaches of hiring and training. Verisma, for instance, can manage tasks like prior authorizations, purge projects, inbound document management, and referral management. so staff can focus on what matters most – patient care.

Leverage Technology-Enabled Strategic Partnerships

Strategic partnerships are more than supplemental staff. They’re relationships built on experience, consistency, time, and effort. Better yet, technology-enabled service companies do more than complete tasks – they build for the future. Working with a trusted company like Verisma to help with staffing challenges makes sense and allows you to share the burden of finding a qualified, reliable team to address talent shortages.

Five Ways an FQHC Can Save on Administrative Costs

Aug 14, 2023 | Blog, Compliance & Regulations, Health Information Solutions, Operational Outcomes

Federally Qualified Health Centers (FQHCs) provide critical care for underserved patients nationwide, but on a limited budget supported mostly by donations and grant funding. By focusing on decreasing administrative costs, FQHCs can make their dollars more impactful to patient care initiatives, improving the lives of millions of people across the United States. The following are five ideas FQHCs can consider to reduce their administrative costs to focus their attention on more impactful care within their communities.

ANALYZE FOR EFFICIENCES

In an ever-changing healthcare industry, all organizations are constantly updating process and operations workflows to meet new requirements. FQHCs can implement regular analysis of all workflows to analyze for operational efficiencies. Reviewing patient activities while in the waiting room, as well as what administrative staff may be able to do prior to the patient visit, can ensure that patients are registered, roomed and seen as quickly as possible.

Because of the demand for FQHC visits and services, FQHCs need to make every minute a patient is in the office count. Part of the analysis may include whether offsite staff or partners can provide a more focused, cost-effective way to remove burden and time-consuming administrative tasks from patient-facing personnel. Streamlining staff, provider and patient interaction can create more impactful visit time and allow providers to see more patients in a day.

FQHCs can also find efficiencies by analyzing workflows and refining their tasks and best practices. By optimizing everyday functions and administrative tasks, FQHCs can find areas of savings and eliminate waste. Good examples of common culprits are paper and ink/toner, which can be greatly minimized with smarter filing and scanning workflows.

Streamlining staff, provider and patient interaction can create more impactful visit time and allow providers to see more patients in a day.

IMPLEMENT IT IMPROVEMENTS

Information Technology is often seen as an investment and expenditure, but it comes with an upside. In many situations, IT updates can improve and thereby cut administrative costs for the future. Some government incentives like Pay-for-Performance programs also exist to help organizations offset the costs of implementing technologies. Using information technology to capture structured quality data about patient care can be reported to government and commercial entities, in some cases leading to increased reimbursement.

Additionally, as the industry moves from paper to electronic records, converting paper charts to electronic documents stored in the Electronic Health Record (EHR) can reduce administrative spending on chart storage, as well as free up space for FQHCs to pay less rent or utilize space in other ways that support the patient care mission. Ultimately, IT improvements can lead to increased efficiency and functionality and decreased administrative spending in the future.

EXECUTE COMPLIANCE PROTOCOLS

Compliance doesn’t just mean HIPAA. Other regulatory programs require complying with certain objectives in exchange for funding. As the industry changes, meeting grant requirements and alternative payment model metrics is critical for keeping the doors open. By focusing energy into maintaining compliance protocols, FQHCs can avoid losing invaluable revenue sources. Of course, HIPAA is also important! Ensuring the proper protocols are implemented, staff is periodically trained, and quality assurance is in place in accordance with the HIPAA Privacy and Security rules is critical for preventing threats. Good compliance practices also help FQHCs avoid a costly and unexpected HIPAA breach adding to administrative costs and detracting from the mission.

INVESTIGATE STAFFING ENHANCEMENTS

One of the biggest administrative costs to a FQHC is staffing. These costs not only include payroll, benefits and other overhead expenses but also where the staff expends their time while they are on the clock. As FQHCs have a laundry list of items to achieve throughout the day, many staff members find they have too much on their “to do” list and something has to give.

Ultimately, staff members being tasked with too many duties can cause burnout, distractions and procrastination, all of which lead to costly mistakes, extra expenses and, in some instances, tasks not getting done altogether. Organizations like Verisma can help FQHCs reduce administrative costs by providing focused expertise related to specific administrative functions.

Utilizing a Business Associate can reduce the need for certain admin staff functions, in turn alleviating some payroll costs as well as the management tasks inherent in supervising hourly staff. Where workforce is in short supply, one of the greatest benefits of utilizing a partner for functions like document filing and release of records is the ability to focus or repurpose existing FQHC staff. When a partner is handling the administrative tasks, the FQHC staff can focus on patient needs and care. In an era of patient satisfaction and engagement tying to reimbursement, focusing on patients is of the utmost importance to FQHCs maximizing their dollars and serving the community.

ALIGN THE SPEND TO THE MISSION

Changing goals means fluctuating costs; by deploying and following a clear mission FQHCs can zero in on their wildly important purpose. Because FQHCs rely heavily on funding sources, planning too far into the future can be challenging. The mission of the organization, though, will remain steadfast and is the ultimate litmus test in financial planning for FQHCs. If an administrative expenditure doesn’t directly support the mission, is it worthy of investment? Administrative costs can often seep out unexpectedly, especially when the goal line is constantly moving. Reviewing the budget with the mission statement in mind can help FQHCs analyze their supportive and detractive administrative spend.

Need help implementing some of these strategies for maximizing your staff and minimizing administrative costs and workloads? Get in touch at verisma.com/contact-sales.

How Leveraging an HIM Partner Helps Decrease Staff Stress

Apr 26, 2023 | Blog, Compliance & Regulations, Health Information Solutions, Operational Outcomes, Release of Information

“Everything Everywhere All at Once” isn’t just the title of an award-winning movie that many viewers found quite confusing. It’s how a lot of health information management (HIM) employees feel about their jobs. There aren’t enough hours in the day, and one person can’t do everything at once.

Many providers are exploring HIM support from outside partners to take all or some of the weight off their shoulders. The right Release of Information (ROI) and HIM partner can be a reliable and cost-effective solution for ensuring your quality standards are met without burdening you or your internal staff.

Following our acquisition of ScanSTAT Technologies, Verisma now offers a full suite of outsourced HIM solutions in addition to our industry-leading ROI service:

Prior Authorizations

Inbound Document Management

Chart Abstraction

EHR Conversion

Forms Completion

Document Scanning

Referrals

Imagine a world where your team’s health information management responsibilities are supported by industry-leading experts at Verisma. What would that look like?

1. You would spend less time recruiting, hiring, training, retaining and scheduling employees.

Finding and hiring new talent has never been more challenging. HIM partners ensure you have the resources required to meet the demands on your organization. Your employees take time off for vacations, illnesses, and leaves of absence, but Verisma is always ready. We have the people and resources to meet your needs every day.

2. You could finally address your backlog.

When you partner with Verisma, you can breathe. Because Verisma:

Allows your in-house staff to focus on patient care
Keeps your medical records department current on requests
Assumes responsibility for HIPAA compliance
Fills the gaps in your department while you still maintain your own processes and standards

A dedicated team of experts can improve turnaround time and thus reduce staff stress while improving patient satisfaction.

3. You would reduce risk and achieve or maintain compliance.

As stewards of data integrity, health information managers understand that Protected Health Information (PHI) responsibilities—from compliance, workflows, training, and coding to document completion—are top priorities. But, realistically, each one of these PHI responsibilities is a full-time job. Recent regulatory changes related to release of information (ROI) are a potentially expensive pitfall as there are steep fines for violations. Verisma has in-house experts dedicated solely to staying on top of compliance and legislative activities. Working with an outsourced team of knowledgeable HIM experts can help you feel confident that your organization meets the new requirements for releasing electronic information. Furthermore, your organization will be compliant with laws regulating strict timeframes under which requests and information must be handled to avoid stiff fines.

4. You would have happier, more focused employees who are more likely to stay with your team.

Additional HIM functions, such as prior authorizations and faxing and scan filing, often fall on staff members with multiple other responsibilities. This necessity to multitask drains staff and contributes to lower job satisfaction.

By working with Verisma, you’ll know dedicated experts are:

Completing forms and requests efficiently and accurately
Improving your physicians’ satisfaction by eliminating the additional work and stress of tracking down accurate patient information
Helping ensure your processes are compliant with current regulations
Available to help train internal staff on new technology or processes

Get back to being in one place and thinking about one thing at a time. Reach out to us today to get started.

How to Use a Gap Analysis to Build Your ROI Roadmap

Feb 27, 2023 | Blog, Release of Information

One of the best tools for ensuring organization-wide ROI compliance is a gap analysis. A gap analysis looks at the entire disclosure management process to give you a sense of where you are today versus where you need to be to achieve and maintain compliance. In addition to compliance, the benefits of a gap analysis include a full accounting of disclosures, improved productivity, reduced paper processing, increased electronic release, improved turn-around time, and improved requestor satisfaction. This is an especially relevant topic given Information Blocking and the upcoming proposed changes to HIPAA, which are presumed to go into effect this spring.

To begin a gap analysis, you must first assess your current state. We can break this down into six steps.

Determine where the ROI flows into departments, practices, clinics, hospitals, etc.
Layout a flowchart of all “on ramps.”
Document the handling of all requests to include how many people touch a request. For example, does HIM forward a copy to radiology, the business office, sleep center, etc.?
Analyze access to systems. Include all steps required to obtain access and what effort is needed to capture all pertinent information.
Review current delivery method options (print, package, mail, email, fax, etc.)
Determine current turn-around time. Start with the actual received date and remember that the TAT clock doesn’t stop and restart every time a request is forwarded to another department or location.

Once you’ve assessed your current state, it’s time to develop an action plan.

Working with a vendor partner who can automate this process will make this step much easier. Your action plan should involve a committee of location leaders or decision makers. You can use the “on ramp” flowchart from the previous step to make decisions on centralizing intake. Then provide access to all source systems to HIM or one centralized group. To reduce the number of patients wanting to review in-person, expand your delivery method options through automated technology like Verisma Request App®. Finally, establish a one-touch process to accomplish an accurate TAT.

The most difficult part of this process is building a unified ROI plan. Change projects are always challenging, especially within complex health systems, but your gap analysis will help as you move forward. Follow these five steps to build and implement your plan.

Recognize the need for change. Get internal support and lay out your business case with benefits. HIM leadership should usually handle this step.
Craft a vision. Your vendor partner can help you strategize for success.
Implement change.
Embed changes in your culture and practices. Make sure old ways aren’t creeping back in.
Review your progress and analyze the results.

If you’d like to learn more about how Verisma can help you conduct a gap analysis and build an ROI roadmap, contact us.

Learn more about the gap analysis process and earn an AHIMA CEU through Verisma Academy.

View On-Demand Course

Advancing Information Sharing: Understanding EHI

Dec 20, 2022 | Blog, Compliance & Regulations, Information Sharing, Release of Information

This blog summarizes the content from Verisma’s ROI Roundtable Webinar. The full recording and slidse are available.

Get Recording & Slides

The information blocking definition of electronic health information (EHI) includes the entire scope of electronic protected health information (ePHI) that is or would be in a Designated Record Set (DRS). Prior to October 6, 2022, the definition of information blocking was focused only on the subset of EHI that is represented by elements in the United States Core Data for Interoperability (USCDI) v1. As of October 6, 2022, all EHI falls within the scope of the information blocking definition.

What is and what is not EHI for purposes of information blocking regulations? In Verisma’s Nov 2022 ROI Roundtable Webinar we heard from two experts with the ONC – Rachel Nelson JD, Branch Chief, Compliance and Administration Branch, and Dan Healy, Policy Coordinator, Compliance and Administration Branch on what EHI is and how its definition relates to but differs from the definition of ePHI under the HIPAA Rules. The speakers provided important facts related to current information blocking policy and what healthcare organizations and providers should bear in mind specific to information blocking regulations as they review and update their technical capabilities and workflows in context of their DRS (Designated Record Set) to ensure they are sharing EHI consistent with all applicable laws. Some highlights from their presentation follow.

What is EHI as defined by the information blocking regulation? According to ONC, EHI is as follows:

“Electronic Health Information (EHI) means electronic protected health information (ePHI) to the extent that the ePHI would be included in a designated record set as these terms are defined for HIPAA.”

The scope of EHI is relayed was shared in the following ONC graphic that can be found at HealthIT.gov:

The expansion is “only” PHI that is in an electronic format. Noted in the webinar is that EHI is “electronic health information (ePHI) to the extent that it would be included in a designated record set.” Further explained during the webinar was that EHI “is individually identifiable health information, that is maintained in electronic media or transmitted by electronic media.” If the ePHI is included in any of the following records and not in the exclusions such as psychotherapy notes, then it would be considered EHI:

Medical records and billing records of a provider about an individual
Enrollment, payment, claim adjudication, and case or medical management record systems maintained by or for a health plan.
Records used in whole or in part to make decisions about individuals

What is not EHI was explained as well. For example, such things like psychotherapy notes, information complied in anticipation of, or for use in, a civil, criminal, or administrative action or proceeding, employment records health information, and de-identified protected health information. EHI is not limited by when the information was generated.

Organizations should be looking at what they now include in their designated record set policy and revise if necessary, to ensure the that their policy includes the full scope of EHI that is now in effect as of the October 6, 2022 expansion of the EHI definition beyond the current USCDI v.1 definition. Working with your Release of Information vendor is important as well, so they are aware of exactly what ePHI is defined in your designated record set and how to access all the ePHI for disclosure purposes. Many resources such as an EHI Fact Sheet, recorded Webinars, and an Infographic are available on https://www.healthit.gov/.

Dan and Rachel also spent time going over the Information Blocking definition and explaining how that relates directly to the exchange of ePHI. More details and explanation of the Information Blocking Regulation was shared with the attendees. Points that have caused some questions from health care providers and others in the health IT field were clarified. Information Blocking applies to “actors.” Actors are:

Health Care Providers
Health It Developers of Certified Health IT
Health Information Networks (HINs)
Health Information Exchanges (HIEs)

Exceptions to the Information Blocking Rule, which have caused a lot of questions from “actors,” in particular the “Content and Manner Exception” where it is not considered information blocking if the actor does not have all the requested EHI in their possession, cannot be shared using the technology requested, or where it must be “withheld due to laws or is permissible to be withheld, such as under the Preventing Har or Privacy exceptions.” One example would be if it would be impossible for an actor to segment out psychotherapy notes from the EHI. Another would be the cost to comply would be prohibitive. Other examples were given as well as resource information available on ONC’s Cures Act Final Rule website. For more in-depth information on Information Blocking, resources can be found at https://www.healthit.gov/ where there are fact sheets, Webinars, and FAQs.

Health Information Management leaders should be reviewing all the policies and procedures related to release of ePHI, especially their designated record set policy to ensure they are following the updated requirements that went into effect on October 6, 2022 and working closely to ensure their ROI vendor is up to date on all the requirements to ensure there are no risks of information blocking.

AHIMA22 Overview and Takeaways

Oct 26, 2022 | Blog, Health Information Solutions, Information Sharing, Operational Outcomes, Release of Information

AHIMA22 brought us to Columbus this year, the capital and heart of Ohio. It’s been three years since we’ve all been together and there was so much catching up to do! The American Health Information Management Association (AHIMA) is the leading voice and authority in health information where the associated experts work at the intersection of healthcare, technology, and business. Today more than ever, in an era where technology drives change and efficiencies on one hand and on the other hand increases the risk of interfering with privacy and security, managing the complexity of patient’s information is critical. Healthcare professionals must ensure that sensitive health stories remain accurate, accessible, protected, and complete at all times.

We all know the tremendous effects COVID had on our healthcare and the gaps it highlighted in our systems. It changed the workforce landscape with an increased need for healthcare professionals and the reality that jobs require more technical skills than ever before. AHIMA22 highlighted the emerging changes and responsibilities that healthcare information management professionals face today.

The conference kicked off with sessions on “Design Thinking for Innovation in Healthcare” and “What Does it Take to Become a Revenue Cycle Executive” and a marching band performance! There were over 40 in-person sessions led by health data experts and visionaries, new product tech demos in the exhibit hall, networking opportunities, and social events with over 3,00 attendees. Thinking back on all that I heard and witnessed at this convention, there are a few key takeaways I’d like to share:

Design Thinking for Innovation in Healthcare

This workshop kicked off the conference and set the tone for the rest of the week. Design thinking process is a theory that many startups and innovative companies use to solve real end user problems and it’s one of my favorite methods to use to develop user centric products. Design thinking is taught at top universities like Harvard and is adopted by brand name companies such as Apple, Google, and Samsung. It’s a 5-part problem solving approach you can apply in both your organization and your daily life. It centers around end user challenges and how to put aside limiting beliefs and our own perspectives to solve a problem based on observation and thinking outside the box.

“Healthcare requires continuous innovation to meet the needs of patients and providers,” says Mary Ann Sullivan, MA, CCMP, senior director, professional development and education operations and innovation at AHIMA. But important stakeholders are not always considered when new interventions or processes are designed. This can lead to products and services that do little more than gather dust, while the underlying issues remain unaddressed. “Design thinking,” Sullivan says, “can be used to improve clinician-patient workflows, healthcare spaces, customer service, and community programs.” In a healthcare landscape where there are so many silos, this methodology can be useful to bridge the gap and deliver real solutions that bring back the patient to the center of care.

Privacy and Security

AHIMA22 had top experts on information blocking, electronic health record vendor efforts to protect privacy and achieve interoperability, cyberthreats, and risks associated with the Internet of Medical Things (IoMT). There is an ongoing responsibility to understand and comply with laws that govern the privacy and security of health information. It’s important to learn unique security gaps and how to mitigate the IoMT risk as healthcare increases its use of devices that interact directly with patients. Furthermore, understanding the current drive to achieve an interoperable landscape requires heightened privacy and security.

Consumerism

The last several years was a turning point in healthcare with consumers finally empowered to make more informed decisions about their health. AHIMA22 included a focus on consumerism with sessions that offered incredible insight for health leaders to learn about new and emerging technologies and roles in health information that place the patient at the center of it all. Returning consumers to the center of patient care will impact healthcare for generations to come. Healthcare professionals can be both patient advocates and liaisons to help patients better understand the ever-changing environment. The pandemic has accelerated patients’ usage of health-related digital devices, which can provide more productivity, but also isolates the patient from human care. Healthcare professionals need to understand technology and find ways to humanize the experience.

Data

There were many lectures and vendor demos of products related to data. Because we use the science of collected information to have predictable results in a complex system, more data can lead to more informative decision making. This is vital because health data, including population health information, must be accurate and trusted as many strategic and patient care decisions rely on it. Also, health data and data models have a significant impact on business intelligence and initiatives. It can shed light on gaps in the systems or reasons for failure in the workflows and showcase and inefficiencies. Data governance is the yellow brick road to health data integrity and must be followed to ensure the reliability of the data. Organizations seek to improve patient care and outcomes through the collection of Social Determinants of Health data. Health data lies at the center of interoperability and interoperability is the key to getting the right information at the right time to the right person. Here at Verisma, we have a leading data and analytics tool, that is easy to use and all the reports related to Release of Information can be customized in a easy to understand format to drive real engagement with the process of providing real and accurate health records.

It was interesting to flow between so many fascinating topics while acknowledging how much the role of Health Information Managers is changing. That’s why Verisma is changing ROI for a changing world. I look forward to showing you the new products and services we’re developing to support you!

If you or your colleagues plan to attend AHIMA’s virtual conference in November, don’t miss Verisma’s session on the top disclosure management trends.

« Older Entries

Next Entries »