Change is the only constant in life, and these days, digital transformation drives much of that change. We see this time and time again in healthcare: The transition from paper to electronic medical records. The shift from in-office care to telemedicine. The evolution from manual to artificial intelligence (AI)-driven medical coding and clinical documentation improvement.
Release of information, or the way in which patients and others ask for and receive protected health information (PHI), has also changed during the last couple of years. Consider the ease with which we request and receive bank statements or credit reports, for example. We’ve all grown accustomed to information requests that yield a rapid turnaround time with minimal effort required. Now, those expectations have entered the world of release of information (ROI). Thankfully, digitizing the ROI process allows for rapid turnaround time and for patients and doctors to access their medical records when they need them.
What is digital ROI?
Digital ROI is the use of technology to request and release PHI as appropriately authorized. This means various types of requesters (e.g., patient, payer, health plan, law firm, life insurance company, government agency, or record retrieval vendor) can request information electronically. From there, providers can fulfill those requests electronically. Due to digitization, there is no time-consuming exchange of paper documents or uncertainty about whether requests were received. Instead, application program interfaces (API) seamlessly pull information from one system and push it to another, and multi-factor authentication keeps that information secure.
Like many digital processes, digital ROI relies on AI-driven natural language processing (NLP) and optical character recognition (OCR). Both technologies augment ROI specialists’ capabilities, enabling them to ensure compliance while also improving the requester experience. When paired with APIs, NLP and OCR streamline straightforward requests so ROI specialists can focus on complex tasks that require intensive patient interaction, phone calls to requesters, or other steps to validate.
Why is ROI compliance important during this evolution?
ROI compliance is always important; however, it’s paramount during the shift to digital ROI. It is also potentially more challenging. Why? In addition to keeping information private and secure, healthcare providers must comply with the 21st Century Cures Act: Interoperability, Information Blocking, and the ONC Health IT Certification Program which promotes interoperability and prohibits information blocking. Essentially, providers must protect patient privacy as HIPAA requires but not stand in the way of the seamless exchange of electronic health information. This is a tall order considering all of the commercial third parties in the consumer data marketplace that want to harvest patient data, often not to help consumers improve their health.
Remember: Healthcare providers are ultimately liable if data breaches occur. HIM leaders must educate patients about the limitations of HIPAA privacy protections while fulfilling their responsibility to privacy under HIPAA. This includes, but is not limited to, a vetting process for API vendors, a robust—yet flexible—validation process for requesters (for example, including verbal requests and electronic signatures), and a dependable system to capture all disclosures.
How does digital ROI affect the patient experience?
Eighty percent of people want to access and view their electronic health records through a website, online portal, an app on their phone, or electronically in some other way. Digital ROI enhances the patient experience because it gives patients exactly what they want: Fast and easy access to their health information, sometimes even providing status updates with the timing of online delivery.
Digital ROI elevates the ROI experience so it’s on par with other non-healthcare industries. Why is this important? Knowledge is power. Patients who are more informed tend to be more engaged in their own health. They can access their information more easily, which means they may be more likely to follow through with referrals to specialists, take medications as prescribed, and comply with health treatment plans. The result? Better health outcomes, lower costs, and more satisfied patients.
Still, healthcare providers must ensure that patients understand their health data rights and limitations, especially when involving third parties that are not subject to HIPAA. This requires a concerted effort to empower patients as regulations evolve. It’s an opportunity for HIM to embrace its role as a patient advocate and educator.
How does digital ROI affect other requesters’ experience?
Digital ROI also enhances the experience for other types of requesters who would have otherwise submitted requests via fax or mail, not knowing whether providers ever received them. This is true for all requesters but especially those that submit and track a high volume of requests (e.g., life insurance companies and attorneys). Being able to submit requests electronically changes the entire process—in a good way. That’s because it prevents possible duplication of effort (i.e., having to call and verify that the requester received the request and resend it if they didn’t). It also removes uncertainty for requesters who can instead focus their attention elsewhere on value-added tasks, knowing with confidence that their request is being reviewed. These efficiencies ultimately benefit requestors, patients, and providers. It truly is a win-win scenario for all parties.
ROI is about getting the right information to the right person at the right time. Digital ROI makes it easier to do this, and it’s also exactly what requesters want. Forward-thinking organizations are embracing this digital ROI transformation regardless of whether their process is in-house, outsourced, or a combination of the two.
Digital ROI is the future of ROI. It’s not a matter of ‘if’ digital ROI will become commonplace—it’s when. Consumer expectations with respect to the request and release of confidential information are changing, and providers’ ROI strategies must change with them.
Remember: The only constant in life is change. It’s about embracing that change—not fearing it.