By Linda Kloss

This is the third blog highlighting lessons learned by HIM leaders at health systems in New York, New Jersey, Boston, Delaware, and North Carolina in the midst of the COVID-19 pandemic. Their experiences teach us much about release of information best practices. They also identify broader health information access and disclosure challenges of dealing with this public health emergency. The first blog focused on best practices for protecting the safety of staff through rapid transition to work-from-home and protecting staff that must continue to perform their work on site.

The second blog addressed best practices in adapting release of information practices. By optimizing electronic workflows, health systems are flexing to ensure compliant and accurate work from request through fulfillment. A game changer is use of the Verisma Request App (VRA), which when integrated with the Verisma Release Management, is providing seamless continuity of work regardless of shifting workflows, who is doing the work, and where it is being done.

Our interviews with HIM leaders also described stepped up involvement with patient portals and a new focus on policies and procedures for telemedicine. I might not have anticipated these two areas of best practice as early responses, but it has quickly become clear that this pandemic is accelerating all aspects of virtual health services. In addition to experiences with Verisma’s VRA, interviews highlighted an uptick in use of patient portals. Thus, we identified Support for use of patient portals as a best COVID-19 practice for HIM working in collaboration with IT and others.

Despite years of somewhat sluggish use of patient portals, many health systems are now seeing a marked uptick as patients seek ways to connect and communicate, get test results, and general information. HIM leaders report stepped up involvement in helping patients enroll in patient portals and in supporting them in their use. This has required allocating HIM staff to focus on portal support. An important lesson is to be certain that current portal policies and procedures are documented and capturing changes or special procedures relating to reporting COVID test results and handling questions about those results.

Long standing barriers to broad adoption of telehealth services have been eliminated by recent federal and state regulatory changes. Virtual visits and remote monitoring services have surged for routine primary and specialty care, behavioral, and employee health. In the midst of the pandemic, this is a lifeline. Rapid adoption, however, may strain organizations who may not have robust policies and procedures or a broad understanding of them.

HIM leaders report greater involvement with the ramp up of telehealth and Support for telehealth information needs is another important HIM emerging best practice.  As with portals, they recommend telehealth policies and procedures be reviewed and adjusted as needed. Issues such as enrollment procedures and consents may need sharpening. Identity proofing — provider and patient, handling attachments, coding and health record protocols are cited as areas where HIM expertise is needed.  Telehealth may also increase patient access requests because patients and providers need to review current information to have an effective virtual encounter.

Long after this public health crisis comes under control, virtual health and health information applications will be indispensable elements of care delivery and patient engagement. There are sure to be many important health information best practices associated in this nascent era of virtual health and now is the time to capture these lessons. There is no going back…only going forward.

Once again, I want to thank the HIM leaders who continue to share their experiences as they learn and adapt for business continuity while supporting the needs of their staff, health systems, and the communities that they serve. Please join us on April 29th for our Webinar, COVID-19 Response:  Emerging Best Practices for Health Information Disclosure Management – Part 2