Ardent Health Services’ subsidiaries own and operate three health systems in New Mexico, Oklahoma and Texas, which include 14 hospitals, four physician practices, 2,264 beds and more than 12,000 employees.

With a corporate health information management (HIM) staff led by Ann Meehan, vice president of HIM1, with corporate HIM project management director, Kimberly Suggs, and a team of HIM leaders in facilities spread over a wide geographic area, Ardent faced thousands of release of information (ROI) requests per month across its enterprise.

Since 2005, Ardent had transitioned through a series of ROI services partners due to unsatisfactory performance. Just a few of the challenges Ardent faced with its previous vendors included: inaccurate data capture, incomplete reporting, fulfillment delays, frequent managerial changes and an inability to process a large backlog of ROI requests.

“They all put forth a good effort, but there weren’t any results,” Suggs said. “It was a painful process to go through so many times.”

Ardent needed a reliable ROI services partner that could not only promptly respond to and process requests, but also provide HIM leadership with the transparency and oversight to ensure that requests were compliantly fulfilled within Ardent’s five-day ROI turnaround policy.


Two of Ardent’s New Mexico facilities had experienced several years of consistently strong Protected Health Information (PHI) disclosure management performance with ROI Online® from MRO, a cloud-based PHI disclosure management solution.

Based on that track record and further consultation with MRO, Ardent expanded the solution in 2011 through 2013 to facilities in Oklahoma and Texas. Although use of MRO’s technology was consistent across the newly implemented facilities, due to the differing HIM department structures at each location, Ardent’s HIM leadership decided to leverage the flexibility of MRO’s shared and staffed service models. This flexibility allows Ardent to use its own staff as well as MRO’s highly trained and experienced employees to maximize efficiency at each location.

“Ultimately, standardizing our ROI staffing across every facility would be ideal, but our facilities are different,” Suggs said. “We did want to tailor the services to meet their needs, and MRO has been excellent in that regard.”


Even with a variety of staffing models, Ardent Health still has a centralized, enterprise-wide platform for tracking PHI disclosure with ROI Online. The organization also standardized PHI disclosure processes and has complete, consistent disclosure policy enforcement and oversight of each request, including its status and delivery.

Improved process oversight and transparency has helped improve the ROI billing accuracy and promptness for these requests, directly contributing to Ardent’s bottom line. To ensure the entire enterprise is updated about its HIM departments’ superior performance, MRO works with Ardent to deliver monthly reports to Ardent’s senior leadership showing compliance with its five-day turnaround ROI policy. Senior leaders are also pleased that ROI turnarounds longer than 30 days, common with Ardent’s previous vendors, have significantly decreased.

Shipping, printing and other paper-related costs were also reduced due to the increase of electronic ROI fulfillment through ROI Online. In the coming years, Ardent plans to collaborate with MRO on other electronic PHI exchange projects to add further automation and efficiencies to its ROI process.

“It’s gratifying to have a knowledgeable partner like MRO that can offer our organization guidance on the latest regulations, but also present opportunities to improve our efficiency,” Suggs said. “We’re confident that MRO will be a long-term partner for Ardent.”

[1] Ann Meehan helped in the development of this case study but has since accepted another position outside of Ardent.