Tackling ROI Automation for a Large System

Tackling ROI Automation for a Large System

By Maria N. Ward, MEd, RHIA, CCS, CCS-P

 

West Virginia University Medicine (WVU) has more than 10 hospitals and affiliates across five states. For a system this large, the task of implementing an automated release of information (ROI) workflow was anything but easy. There was variation in policies and procedures, billing methodologies, and staff knowledge at every turn. When tackling this process, Christine Metheny, RHIA, CHPS, CHTS-IM, knew that systems were fragmented. “We thought we understood the layers of process fragmentation, but we didn’t fully know what we didn’t know,” Metheny explained to attendees of her Monday presentation “Automating ROI: Strategies to Improve Timeliness, Workflow, Data Integrity.”

Ultimately, WVU decided that the solution was a technology-enabled ROI system. In order to implement it, five things were needed:

Automate information processing with step-by-step compliance guidance and checks from request through fulfillment, including billing and payment.

  • Rules-based workflow engine that identifies specific request types that are deemed sensitive or critical.
  • Advanced electronic health record (EHR) integration; tools for associates to manage priority requests.
  • Quality assurance processes and technology to efficiently and effectively review requests, maintain records of information released and accounting for disclosures.
  • Analytics to track work in process and work completed; analytics to raise the bar on quality and productivity performance.

The main goal was to standardize processes to improve accuracy and timeliness of information disclosure and reduce the compliance risks. They had to find a cost-effective way to manage the increasing volume of requests across their health system and still support the health system strategy. Enterprise standardization was their solution. Enterprise standardization eliminates extra searches, ensures quality standards are met, promotes productivity, and reduces errors that can increase cost. It also helps staff and improves customer service. While full centralization was not possible, the use of a single software platform allowed the workflow process and compliance and quality standards to all be maintained in the same manner.

WVU is on the road to standardizing and in some cases centralizing their disclosure management functions on an enterprise-wide level by implementing seamless workflow processes that include purposeful quality control. This includes a uniform ROI technology that is well integrated with the enterprise EHR. Improving patient access is also part of WVU’s commitment to patient engagement. “We also believe that solutions must build in accountability to demonstrate compliance,” said Metheny. This includes processes for accounting of releases and the ability to manage priorities.

“We are not done, by any means, but we have made a great deal of progress over the past two years,” said Metheny. They plan to continue to optimize processes that have been implemented and continue to extend the standardization to the remainder of their organization through continual measurement, and focus while and staying customer facing.