A hospital's health information management department is responsible for a variety of functions, including releasing health records per request, a process that requires meticulous compliance in order to avoid financial, and other, penalties. Already dealing with the remnants of a recession, HIM departments are facing immense amounts of pressures, ranging from the HIPAA Security Rule, which establishes national standards to protect individuals' electronic personal health information, to government mandated audits, such as the Recovery Audit Contractor program, that must be adhered to.
As a result, HIM departments have to ensure employees are constantly educated with new regulations that affect Release-of-Information endeavors in order to properly compile a patient's medical record, a very taxing and time-consuming endeavor. Given that hospitals are strapped for cash as it is, losing revenue for unnecessary ROI violations could severely impair a hospital's cash flow. Consequently, there is no better time than now for hospitals to reassess their decision on how to handle the ROI process and consider hiring a certified outsourcing company that maintains an experienced and educated workforce that ensures compliancy with HIPAA and other federal and state regulations.
History of ROI
ROI is a complex process with specific provisions to protect a patient's private medical record. The ROI outsourcing industry was founded more than 34 years ago in order for patients, attorneys, and other authorized requestors to receive medical records in confidence. Every hospital in the US either has an internal or external department that conducts the ROI process, which includes obtaining patient consent, certifying medical records, and determining what information can be released.
The ROI process has undergone significant changes with the advent of technology, as more hospitals transitioned from paper to other forms of media such as microfilm and imaging diagnostics. The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 provided incentives to providers who accelerate the change to a complete electronic health record. The downside to this rapid acceleration has resulted in a hybrid paper/electronic record environment which strains the ROI process.
The Impact of EHRs on ROI
New technologies have changed the health record, and in doing so changed the process of retrieving these records. Compiling a health record has evolved from what was once a simpler process of paper records into a more complex progression into a combination of paper, film and electronic information. With more than 32 steps involved in the process to accurately and securely fulfill a request for a health record, it is essential that the individual releasing the information understands the complexity of an EHR. The co-existence of paper and electronic formats increases the margin of error when processing requests, since the likelihood of omitting critical documentation is increased, causing HIM departments to spend more time and resources compiling a HIPAA-compliant health record.
The HIPAA Privacy Rule, also called the Standards for Privacy of Individually Identifiable Health Information, provided the first nationally recognizable regulations for the use and disclosure of an individual's health information. HIPAA was intended to improve portability and continuity of health insurance coverage, combat waste, fraud and abuse and provide protections to the privacy of Americans' personal health records.