There is a common misconception that the physician practice medical records process follows the same workflow as the Hospital HIM department.
The release of information (ROI) needs are a little different in the physician offices, just as there are some differences in physician coding compared to hospital. As an HIM leader having worked about half of my career in the hospital setting and half in large physician networks, I want to provide what I believe are five critical points to consider when looking for an ROI partner in your physician practices and clinics.
First: Do They Really Know Compliance?
Work with a vendor that not only puts compliance as a top priority but is willing to work with you on all issues related to compliance challenges. The ROI vendor must be an expert in state and federal ROI laws of course, but also be able to work with your teams in the office to educate and establish consistent policies that will reduce your risks, but that also follow your culture and philosophy where possible.
Second: Do They Speak The Language of a Physician Practice?
Listen to their language. Can the vendor speak the language of physician practices as well as that of the larger organization? This is vital for successful implementation. Do the offices have hybrid records? Notes from one visit may be in multiple locations in the charts (e.g., medication list, problem list, update of chronic conditions). Patients often feel they have a relationship with their physician, and poor service can hurt their trust. Physician staff wants to help their patients in all ways possible but often are not aware of ROI laws. It is not uncommon for office staff to inappropriately release to patient family members, attorneys, hold for payment of bills or limit what is sent with a process for ‘physician approval.
Additional considerations; many offices are not capable of providing records in an electronic format as required. Many offices do not charge for pulling records, so implementation is usually a cost saving with a reduction of risk for the practice.
Third: Is Their Implementation History Positive?
Look into their implementation history. Is their process consistent and inclusive? Do they have a trail of happy implementations or rocky? Do they have experts that can provide support with consistent processes and education in all the offices, especially with multiple sites?
Forth: Are They Patient Focused?
Where do your patients fall in their lists of priorities? Are patients considered a nuisance or do they keep your patients as their top priority? Do they have a call center for patients to call directly? Missed calls often lead to patient’s calling the physician’s office for an update. What is their live answer rate percentage? – that alone tells a greater story. Patient satisfaction now directly impacts physician reimbursement, and will become even more of a factor.
Fifth: How Big is The Vendor?
Bigger is not always better. Don’t let size be the greatest determinate of how a vendor will manage your account. Sometimes it’s the little things like, how they treat their employees, how they interact with your patients and their overall dedication to the provider practices they serve. How many layers are needed to solve problems? How flexible can they be? I have found the smaller teams to be much more invested in my departments success.
Sue Chamberlain, MSCTE, RHIA, CCS-P, CDIP,
VP Compliance and Privacy