The stage for digital release of information (ROI) has been set. The actors (providers) are poised and ready. The audience (each patient) is waiting. Lift the curtain, and let the show begin. Is your organization prepared to deliver an exceptional patient experience?
For many healthcare organizations, digital ROI is one pillar of a larger patient engagement strategy. Digital ROI offers fast and easy access to information that patients can use to improve their health and coordinate care. For others, it remains on the back burner due to an over-abundance of caution or perhaps unfamiliarity.
Although this dichotomy exists at the current time, it won’t be this way for long. Presidential administrations both past and present have cast a vision for a seamless exchange of health information, and now we’re beginning to realize that vision in the form of Health Insurance Portability and Accountability Act (HIPAA)-compliant digital ROI.
Digital ROI will be one of many differentiators in healthcare along with telehealth, in-home primary care, remote monitoring, and so much more. If patients’ needs aren’t met, they will simply seek care elsewhere. As they say in show business, “the show must go on.” Consumers’ needs will change and evolve over time. Healthcare organizations that don’t adapt will be viewed as antiquated—falling behind the times and off patients’ radar.
Digging Into the Details
As healthcare organizations make the shift from manual to digital ROI processes, questions may come up. This is normal. It’s a new process with new workflows and concepts. Following are several FAQs that Ciox has encountered with easy-to-understand explanations that help build the case for why digital ROI is essential now and in the future—and how it can work effectively.
Q: How does the actual release of information occur in a digital workflow?
A: Application program interfaces (API) facilitate the digital release of information. Although the mechanics can be complex, the concept behind APIs is simple: They are the “connectors” that enable multiple systems to share information back and forth. They’re secure, they’re widely adopted, and they work to provide a seamless user experience.
Many non-healthcare industries use APIs all the time. Consider online banking. You insert your personal information into one system that pings your banking information in another system, and voila, you can check your balances and transfer funds between your accounts.
The healthcare industry already uses APIs regularly as well. For example, APIs enable telehealth solutions to connect with electronic health records (EHR). They enable drug data and drug interaction data to flow into EHRs at the point of care. They enable various features in patient portals such as symptom trackers, online bill pay, or the ability to schedule appointments online.
Q: I’m concerned that APIs allow the release of too much information. How can I ensure that only the right information is being released?
A: Work with a vendor that has developed sophisticated filters and processes to protect providers from releasing information to which requesters don’t have rightful access. For example, providers can filter by affiliate locations, physical location, self-pay patients, encounter types, lab orders, radiology reports, and more. Once these filters are applied, the system releases appropriate information consistently every time.
Keep in mind that if health information management professionals are not proactive about owning the digital ROI process, it is possible there are digital exchanges occurring in their facilities to which they are not privy and do not contain the requirements to properly protect PHI.
Q: If we adopted a digital ROI process, would we use it for every type of request?
A: Not every type, but more use cases are becoming available every day. Currently, a majority can be fulfilled digitally, including patient requests, continuity of care requests, and audits (Medicare Risk Adjustment, Healthcare Effectiveness Data and Information Set (HEDIS), and more). A manual process, for example, might be necessary for a request for data going back multiple decades (before EHRs) or an in-person request from a patient. Over time, though, even in-person requests may wane to only a handful. Again, ask yourself this question: When was the last time you entered your bank as opposed to going to the ATM or simply using your bank’s online app?
Q: What is the advantage of digital ROI for non-patient requesters?
A: Many non-patient requesters request large volumes of records at once, straining ROI staff’s abilities to respond in a timely manner and pulling them away from patient requests. Digital ROI limits the stress that these layer onto your staff, enabling them to concentrate on complex requests that require additional verification and focus on patients.
Q: How do I ensure a high-quality digital ROI experience?
A: Digital ROI is proven to provide a higher-quality release due to standardized rules and consistent repeatable processes. Organizations are no longer at the mercy of individual staff review and subjective interpretation of rules. This again allows current ROI staff to transition to a higher-level reviewer role focusing on complex requests and the patient, similar to the transition many coders made as computer-assisted coding became more integrated.
Q: Our manual ROI process seems to be working fine. Why would we want to shift to digital ROI?
A: Because it’s what your patients want. They want to be able to request and receive information easily—when it’s convenient for them and without having to overcome barriers. Isn’t that also the goal of the Information Blocking Rule? To provide ease of access? Ciox found that almost 20 percent of patients request their medical records after office hours and that over 75 percent of patients prefer to receive their record electronically. You can fulfill these needs and help these patients easily with digital ROI.
As in many industries, manual processes have fallen by the wayside in favor of more consumer-centric digital approaches. While it can be daunting to envision a new process working smoothly, the technology exists and have a track record of success. The sophisticated compliance checks are in place. Now it’s just up to healthcare organizations to make it happen. Bring the vision to life. Give patients the experience they want and deserve.