By Marty McKenna, Chief Executive Officer, Verisma Systems, Inc.
Healthcare systems across the country are inundated daily by an enormous amount of record requests from patients, attorneys, care providers, payers, government agencies, and other third parties. In fact, it has been estimated that Health Information Management (HIM) departments at major health systems receive over 100 million patient record requests each year. With such a high influx of requests, traditional management practices and any residual manual processes are no longer feasible methods for processing requests for disclosure of information from patient records.
In addition to automating release of information (ROI) workflow, HIM professionals face growing concerns with compliancy and adhering to Health Insurance Portability and Accountability Act (HIPAA) disclosure requirements. For instance, HHS released new guidance concerning individuals’ access to their health data in 2016 that has had major impact on workflow and supporting the operating costs of release of information functions.
Finally, risk mitigation requires greater standardization of release of patient information functions across complex health systems. For example, it is common for guardians or other third parties acting on behalf of patients to request patient’s data. In health systems with multiple clinics and a siloed approach, there is a risk records can be released without proper authorization in place. This release of information can violate the patient’s protected health information (PHI) rights and does not follow proper HIPAA disclosure functions.
Even with technology, standardization of ROI methods is difficult to achieve. One source of complexity is growing health systems encompass many hospitals, clinics, and caregivers; opportunities for inadvertent disclosure abound. The multiple types and sheer volume of requests, as well as time pressures to complete the requests, are challenging. These factors all hinder the HIM department’s ability to keep up with growing ROI volumes. Healthcare organizations need to find solid technology solutions that streamline and align their ROI workflow. To do so, there needs to be an understanding of the current state of ROI and a review of new approaches to automate the process.
The Current State Of Healthcare ROI
In many healthcare systems, ROI practices may be inconsistent across the enterprise. For example, hospital ROI may be uniform and compliant yet ambulatory, home care, and other settings may use inconsistent and ad hoc methods. This breeds compliance issues an, slow turnaround times, resulting in an error-prone process, patient dissatisfaction, and frustrated physician groups.
Today’s information management and governance best practices demand ROI solutions are enterprise in scope in order to strengthen PHI disclosure methods and ensure robust HIM practices across the organization. Dated and passive ROI practices must be replaced with innovative enterprise disclosure management technologies that have the capability to optimize end-to-end workflow.
From Silos To Enterprise: Helping Health Systems Achieve Uniform ROI
Transitioning to an automated ROI solution that provides alignment enterprise-wide will help health systems overcome the compliance and service challenges they face. Leveraging a fully automated ROI solution, healthcare organizations can eliminate outdated, manually driven PHI release practices and make improvements that will benefit healthcare providers and patients alike.
Successful migration to enterprise ROI requires training, education, cross-functional team collaboration, and upgraded technology that supports this system-wide change. The first step for any healthcare organization moving to enterprise-wide ROI is to assess the existing disclosure process and identify gaps and opportunities for improvement. This will enable ROI vendors to set realistic goals that align with enterprise information management and governance needs. Additionally, securing senior leadership support within each department will encourage rapid adoption and build a guiding coalition.
Proper education and training of healthcare staff is crucial. An ROI automation solution, even one that is fully integrated and HIPAA-compliant, will only deliver on its promise if the staff is well trained and capable of utilizing the technology. This is not always the case. There often are physician practices whose office management staff lack training in ROI and its guiding laws, regulations, and the organization’s own policies. They may also need help to integrate the ROI technology with their office EHR and practice management solutions. Thorough staff education and support mechanisms will ensure a smooth transition to enterprise ROI.
Transforming ROI practices from silo to enterprise is by no means an easy task, but it is essential for a healthcare system. With a foundation of a fully trained staff and strong support from senior leadership, ROI automation technology can quickly streamline disclosure management.
The Benefits Of Enterprise ROI
When successfully implemented, the benefits of enterprise disclosure management include:
Successfully centralizing and automating the ROI process improves compliance, timeliness, effectiveness, and patient engagement. In addition, adopting an enterprise-wide ROI strategy will give healthcare systems an edge over organizations that still have traditional, fragmented ROI processes. In the age of healthcare consumerism, ongoing financial pressures, and unclear government policies, providers need to leverage every resource they can to stay competitive.
About The Author
Marty McKenna is the Chief Executive Officer of Verisma Systems, Inc., a health information technology provider focused on delivering Release of Information (ROI) solutions to organizations across the country.