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Re-Envisioning ROI Processes

In the era of patient engagement, how a provider handles the release of information is a cornerstone for building trust.

HIM professionals have long assumed the role of fierce protectors of patient information-sometimes even positioning HIPAA as a hurdle for requestors to overcome versus a pathway to greater patient engagement and advocacy.

Despite the tendency to be even more protective due to stringent regulations, HIM must look ahead and re-consider some of their stalwart positions. One of these areas is release of information (ROI) and its relationship with patients and their families.

Looking ahead, HIM professionals will become more open-minded regarding access to information for patients and their families. They will align with HIPAA as an asset, not a barrier. Mindsets must change. For HIM, re-visioning the relationship between ROI and patients is a proactive step in the right direction.

Promoting Patient Engagement

In the era of patient engagement, the ROI process is a cornerstone for building trust in information and loyalty to a provider. The availability of patient portals and online health information is rapidly expanding the role of ROI to meet consumer demands for information while also meeting Stage 2 meaningful use criteria.

HIM professionals and ROI staff should take an active role in promoting, educating and governing patient portals-new opportunities abound. Patient portals open doors to educate and guide patients. Here are several tips for ensuring effective use of portals:

  • Collaborate with nursing and case management to encourage patients and families to register for portals. 
  • Guide patients and families through the registration process, describe what is contained on the portal, and show how to enter and request information.
  • Promote secure portal use to alleviate privacy and security concerns-explain how HIPAA practices protect their information.
  • Provide a simple reference guide with easy steps for using the portal, along with reminders about HIPAA compliance.

Where We're Going

According to a recent ONC Data Brief, 73% of consumers accessing their online records reported doing so to monitor their health, e.g., check on medication or test results. Though 37% reportedly experienced gaps in their information, a majority (60%) found the information very useful, and 90% perceived having access as very or somewhat important. Overall, early findings suggest that individuals do value access to online medical record information.

In the InformationWeek 2014 Healthcare IT Priorities Survey of how providers communicate with patients to improve engagement, respondents said implementing or upgrading patients portals was the best approach (61%), followed by improving web usability (46%); promoting enrollment for patient portal more aggressively, e.g., explaining benefits (36%); adding mobile apps for patients (31%); integrating home health monitoring device (22%); requiring providers to check for patient methods regularly, respond promptly (11%); other (1%); and none of the above (16%).

As the number of facilities reporting implementation of portals increases, education will be the key to widespread use and perceived value. Two ways that HIM can prepare is to expand the role of ROI specialists and centralize information release to patients.

Centralizing ROI Processes

With the threat of penalties and fines for breaches of health information, HIM must evaluate processes and strengthen safeguards to increase privacy and security. Centralizing ROI processes is a viable solution that increases security and mitigates breaches as well as helps streamline the flow of information to patients.

Centralization often begins by bringing in an expert to help with strategic planning and implementation. Here are five strategies to consider:

1. Create a multidisciplinary team and explain the rationale for centralization-how the ROI process can be improved to reduce risk of improper disclosure. Invite input from all stakeholders to identify challenges, set priorities, and develop strategies.

2. Use information flow mapping to determine where the leaks are. Where is all the information? Where is it flowing to and from?

3. Provide ongoing education for all stakeholders, throughout and beyond the centralization process, as needs and priorities shift.

4. Evolve ROI specialists into health record ambassadors, a role that opens the way for HIM to partner with patients, guide the centralization process, and promote HIM's value within healthcare organizations.

5. Use data provenance to manage patient generated health data (PGHD). Patients now have the option to transmit information through a variety of electronic means. Data provenance refers to an organization's ability to track and verify the origin of that information-adding a new dimension to ROI. 

Many organizations are already seeing the benefits of centralization-fewer breaches, more specialized care, improved patient satisfaction, cost savings, and increased efficiency. While the transition is a challenge, it is well worth the effort.

New ROI Careers Ahead

As engaged consumers, patients have an increased level of responsibility for their own care through electronic assess to information. And health professionals must be adept at anticipating requests-managing the flow of data through email, portals, and numerous healthcare apps.

A growing body of evidence suggests that patients with electronic access to health records are more involved, achieve better outcomes, have fewer readmissions, and help reduce their healthcare costs. As ROI ambassadors, HIM professionals are perfectly positioned to promote these outcomes

The risk of improper disclosures is a top concern for executives. Education is essential to reduce the risk of improper disclosures, but preparation through new roles and the understanding of the impact of ROI centralization can assist greatly. Emphasize the penalty structure to executives and show the benefits of ROI centralization from a cost analysis perspective-the potential impact on the overall financial health of the facility.

As organizations evaluate ROI processes, HIM directors and their ROI specialists have a unique opportunity to engage patients as partners, build trust in information, educate executive leadership, and take ownership of ROI. The evolution of HIM goes hand in hand with the re-envisioning of ROI.

Alisha Smith is a health information compliance educator at HealthPort. She can be reached at

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