By Linda Kloss

Every crisis brings about change, some transient and some permanent. Last week we learned about ways that the COVID-19 pandemic changed day to day release of health information (ROI) and accelerated the transformation of access and disclosure. We are grateful to these terrific HIM leaders who shared their 2020 experiences and forecast for changes yet to come: 

  • Stefanie Brumberg, RHIA, Corporate Director, HIM Services, ChristianaCare, Newark, DE
  • Steve Eddington, MHI, RHIA, Director, HIM , Boston Children’s Hospital, Boston, MA
  • Susan Tabickman, RHIA, HIM Manager of Operations, NewYork-Presbyterian Hospital, New York, NY
  • Lauren Zuckerman, RHIA , Director, HIM, Garnet Health, Middletown, NY

With 2020 barely in the rear view mirror and the pandemic still raging,  the experiences of these four prestigious health systems are remarkably consistent. Here are the major 2020 changes in release of information:

  1. ROI is now predominantly performed by an offsite workforce

Work from home is a familiar part of the HIM scene for transcription and coding, but unless outsourced, ROI was generally performed on site. This changed overnight and importantly, panelists agree that it is unlikely to return to its pre-pandemic state.  Success in this abrupt transition challenged managers to find new ways of supporting their workforce.  Lessons learned underscore that a team does not have to be physically together to properly function well together. Flexibility, effective communications, and composure under pressure have been managerial traits contributing to this success. 

2. ROI is now technology-supported knowledge work

Remote work is only possible if guided by workflow technology that ensures a consistent and compliant process and accountability. The pandemic accelerated recognition that ROI can no longer be decentralized clerical transactions relying on faxes, paper processing, phones and service windows. It must be a largely paperless automated workflow that is uniformly executed.  Panelists agree that the end-to-end workflow is not yet fully optimized, but the basics are in place and optimization will be the work of the next several years. This is important from a service and compliance perspective, but it’s also essential as sources of revenue to support the function are shrinking.

3. Request and release goes digital

Powered by the Verisma Request App™ (VRA), digital requests and e-release has quickly transplanted paper requests, walk-up windows, and faxes. One panelist’s health system had implemented VRA before the outbreak of COVID-19, two others accelerated implementation as part of their rapid response, and the fourth is implementing an expanded version in the near future. All agree that digital requests and e-release is the new normal and that while we are in early stages, the VRA technology is an essential part of access and disclosure management.

4. ROI begins a shift from reactive to proactive

The COVID-19 response has ushered in a new paradigm that positions ROI as an enabler not a barrier to access. Consistent with recent federal policy, the fundamental mission of access and disclosure management is most likely forever changed.  Future goals will be to anticipate patients’ needs for information and make it easier for these needs to be met. There will be plenty of challenges as this new paradigm takes hold. With greater patient access, comes increased requests for amendments and corrections.  Interoperability, expanded access to EHR information via portals and other health information ecosystem changes will shape continued ROI transformations. ROI no longer operates in a vacuum. Teamwork around a vision of patient access and secure disclosure is the new normal. 

Despite the challenges of the past year, panelists agreed that their resourcefulness has been an important contributor to their leadership successes. ROI isn’t what it was a year ago.  COVID-19 accelerated many changes that have already redrawn the landscape. With new building blocks in place, complex information management challenges abound. Still, in the words of one panelist, “it’s a great time to be in HIM, as usual.”