Recently, at the AHIMA Health Data and Information Conference in Chicago, I had the pleasure of presenting with my colleague Sherine Koshy, MHA, RHIA, CCS, Corporate Director of HIM at Penn Medicine, about her experience outsourcing Penn Medicine’s release of information (ROI) function.
Our presentation was held in the HIM Expert Theater where we discussed why enterprise-wide disclosure management is so important in today’s healthcare ecosystem.
We had a great time networking among peers and sharing best practices as well as lessons learned along Sherine’s journey. The conference is a busy time with many opportunities for education. So, if you were unable to make our session, here are highlights of the points discussed:
Healthcare and HIT Environmental Scan
HIPAA is still the standard that sets the floor for the privacy and security of protected health information (PHI), but let’s not forget the other federal and various state laws that also affect PHI safeguards and disclosures. We’ve all heard that HIPAA 2.0—the reboot for a modernized version—is coming to catch up with the continually changing healthcare and HIT environments. As part of the healthcare evolution, patients have become more actively involved in their own care, a trend that demands timely and accurate disclosure management practices.
Why Enterprise-Wide Disclosure Management?
As outlined in our presentation, the benefits of an enterprise-wide disclosure management approach include the ability to:
- Standardize workflows
- Review/update policies and procedures
- Improve the customer experience
- Achieve compliance
- Mitigate risk
Nationwide ROI Survey Results
We summarized the results of a survey that MRO recently commissioned to a third party, Porter Research, to find out more about current ROI needs and requirements. The survey found that senior HIM professionals experienced two top business challenges:
- Dissatisfaction with their ROI vendor—including missed service level agreements (SLAs), compliance issues/breaches, and lack of support/poor service quality
- Need for standardization of the ROI process—due to a high volume of ROI requests, multiple locations and need for one single platform: one EHR and one ROI vendor for consistency
The study also revealed five essential attributes organizations consider when searching for an ROI solution or a new ROI vendor. Those include:
- Ease of use—a dependable system that is user-friendly
- Workflow—efficient and effective to ensure timely and accurate disclosures
- Turnaround time—requirements met according to timelines, if not sooner
- Industry reputation—customer satisfaction, company integrity, and staff credibility
- Ability to handle volume—to ensure quality of service does not fluctuate with request volume
Penn Medicine’s ROI Journey
Penn Medicine is located in and around the Philadelphia, Pennsylvania area and includes 6 hospitals (7,163 physicians), 10 multispecialty centers, and 800+ physician practice locations. The system is ranked by U.S. News & World Report as No. 1 in the state of Pennsylvania.
Like many other organizations, Penn Medicine faced challenges with their ROI solution and realized the need to evaluate the following:
- Level of quality—internal issues and patient complaints due to backlog in requests
- Customer service—lack of partnership and trust in the relationship, and a reactive instead of proactive approach when taking on issues
- Patient complaints—increase in complaints across the entire health system
- Staffing—high turnover and inability to keep up with demand for new employees
- Productivity and turnaround time—compliance risk due to missed deadlines
- Technology—platform not user-friendly, inability to integrate with the existing EHR
Ultimately, Penn Medicine made the tough decision to change ROI vendors, and focused on top priorities:
- Ensure excellent customer service and response times to Penn Medicine and, even more important, to the patient
- Create a one-stop-shop model allowing a patient to request records from anywhere in the enterprise at any one location
- Decrease privacy and security incident/breach rates
- Ensure system integration with Penn’s EHR
Many collaborative planning meetings paved the way for MRO to clearly understand Penn’s challenges and to define an effective transition plan for the organization’s future ROI state. A strong partnership was built by creating a team approach, investing in training and resources, and going above and beyond to bring Penn Medicine’s vision to life.
The transition proved to be successful for Penn, measured by the following outcomes:
- Compliant ROI—quality and accuracy improved, turnaround times were met, and productivity levels kept up with high volumes
- Customer service—increased satisfaction by allowing requesters to request and obtain any Penn Medicine record at any location
- Complaints—decreased significantly
- Staffing—low turnover and well-managed staff
- EHR integration—streamlined workflows and increased productivity
- Partnership—mutual trust and transparency between Penn Medicine and MRO
Enterprise-Wide Disclosure Management: Best Practices and Lessons Learned
Along any successful journey, issues must be resolved to achieve success. Partnership is essential. Penn Medicine’s ROI journey provides other healthcare organizations with valuable best practices and lessons learned:
- RFP—Create a multidisciplinary committee, define the process with timelines and due dates, define the most important criteria and attributes needed for your organization, establish a grading document and scale, and communicate regularly with the vendors
- Contracts—Ensure accountability and responsibility between parties in your BAAs, know payer contract verbiage and negotiated rates, and create realistic achievable SLAs
- Technological capabilities and limitations—Ensure ease of use, keep in mind possible integrations such as MROeLink®, maintenance, and downtime
- Communication—Create checks and balances, hold ongoing meetings to touch base (internally and with vendor), ensure all stakeholders are on the same page and change course if necessary
- Partnership development—Ensure transparency, team effort, reliability and above all, trust
This article was originally published on the MRO Blog and is republished here with permission.