By Angela Rose, MHA, RHIA, CHPS, FAHIMA and Anthony Murray
More than a year since the outbreak of COVID-19, virtual walk-up windows for patient and family record requests have become the new normal. Fifty percent of traditional health information management (HIM) departments’ traditional walk-up windows remain closed. As HIM departments transition to virtual release of information (ROI) processes, new best practices have emerged. Yet the complexities and priorities of ROI remain the same: staff efficiency, workflow optimization, process control, accuracy, timeliness, and patient satisfaction. This article, told from the perspective of an ROI vendor, provides guidance to implement and support a virtual front desk in HIM.
Automating Patient Requests for Records
For our team, creating a virtual front desk began with a look at nontraditional approaches to receive ROI requests through low or no-touch interactions with people who need medical records. Though paper- based requests via secure drop boxes remain an option, in some cases electronic methods are now integrated into patient portals, enabling patients to log in directly and request their medical records. There are also external applications (eXpress) designed to provide secure, compliant, and efficient ROI workflow. Verifying requests electronically is an essential part of ensuring compliance, beginning with a review of ROI policies and procedures to accommodate modernization. Here are questions to consider:
- Are you flexible with more stringent controls in order to help facilitate electronic exchanges?
- Do you require digital identification, scanning of a photo ID?
- Can you upload or supply the appropriate legal documentation that proves authorization to make decisions or request medical records on behalf of someone else?
- Do you already allow for digital signature? Which types of signatures are permitted? Will exceptions be made for those that are not permitted?
- Are your technologies, workflows, policies, and procedures current with federal and state laws?
A successful transition requires collecting the type of information that can be properly validated to make sure compliance factors are met. And, education and training materials must be updated to reflect changes in policies and procedures.
Education and Training
- To ensure successful transitions, document all changes in workflows
- Provide education and training for patients and employees
- Instruction sheet should have simple language and minimal detail
- Include contact information for immediate assistance
- Give policy and procedure updates via virtual sessions
- Offer quick tips that are easily accessible
- Hold short follow-up sessions to allow for questions
- Give contact information for help with questions and concerns
Improving Patient Access, Engagement, and Satisfaction
When moving the HIM front desk into an electronic environment within a short time, there’s a lot to consider from a workflow perspective. How will you promote tools and direct people to new technologies in ways that offer ease of access? One effective strategy is to create an online marketing campaign. Describe new processes—email with information, next steps, and follow-up. Invite questions and respond with the help they need. Here are three simple tips to achieve patient engagement and satisfaction:
- Listen to feedback, look at satisfaction scores, and evolve offerings accordingly.
- Be conscious of creating a sense of connection and empathy with patients.
- Make sure internal policies reflect the value of electronic intake and referral.
Though patients tend to feel empowered through electronics, they also value communication regarding content and timing. What can they expect to receive and how long will it take? When promoting new technology, keep in mind what matters most to people. In our experience, ease of access, turnaround time, and sense of connection are top priorities that drive engagement and satisfaction as patients take steps to manage their own care.
Encouraging Patients to Actively Manage Their Care
Virtual connection offers opportunities to empower patients with the ability to manage their care through access to records required for informed decision-making. Portals enable patients to engage with their physicians, exchange health information, and store information for future access and sharing. The patient essentially becomes the custodian of their own personal health information. HIM professionals must be acutely aware of what that means and ensure use of the right workflows and language to safeguard PHI. Who is hosting the information? Where is it located and how is it protected? How is it being used for purposes other than what was originally expected or intended?
Transitioning HIM Staff for Optimal Efficiency in a Virtual Environment
To achieve optimal efficiency, it is necessary to update policies, procedures, benchmarks, and expectations. People need to understand new responsibilities and guidelines for accountability in a remote work environment. In addition, consider what the work-from-home experience looks like for remote staff. Data may be displayed differently. Access to systems may not be the same. It’s important to provide a similar look and feel to technology.
We had to figure out how to efficiently establish our workforce in a fully functioning, secure, remote environment at home. With staff working from many different satellite offices, the set of challenges included asset management, risk management, supply chain issues, internet speed and security, network connection protocols, and more. Here are general criteria to consider when moving HIM staff to a remote access environment:
- Policy and Procedure: Workspace requirements, devices, disclosure of PHI, work schedules, incident reporting, remote access/confidentiality agreement, and other related guidelines.
- Workspace and Devices: Privacy and security requirements. Perform routine updates and maintenance on all devices.
- Connectivity and Authentication: Functional, secure internet access with secure passwords and multi-factor access to your network.
- Communication: Messaging, virtual meeting platforms, email, phone calls.
- Education and Training: Virtual sessions and training modules. Provide current reference materials and updates.
Measuring New Workflows and Outcomes
As dashboard reporting and scorecarding continue to evolve, our team is tracking key performance indicators including patient demographics, satisfaction scores, penetration rate, types of requests, and technologies used by various age groups. Understanding the richness of the information we collect, interpret, and analyze is critical to the success of the virtual front desk initiative.
Over the past year, healthcare organizations have sought innovative ways to establish new workflows and alternative methods to ensure the safety and health of workforces and patients. These new workflows and methods are different from our previous way of conducting business and will likely remain with us indefinitely. As a society we have dealt with pandemics in the past and we will pull through this crisis together.
The views and opinions expressed in this article are those of the author and do not necessarily reflect or represent the views, opinions, or policies of MRO Corporation.
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