Evolving the ROI Process with a Focus on Digitization
In August 2023, For the Record Magazine published a guest article co-authored by Anthony Murray, CISSP, and me. The article is entitled Release of Information: The Digitization of ROI, and includes valuable insights into pivotal shifts in the ROI landscape and how these changes affect HIM teams. Here are several key takeaways from our article.
Insights into the New ROI Landscape
Due to COVID-19, HIM departments had to pivot rapidly as doors closed and patient information requests were funneled through patient portals and other digital channels.
Fast forward to 2023. We continue to see the ROI process evolve with a laser focus on digitization. This transformation is driven by the surge in payer requests and the rapid advancements in electronic clinical data exchange.
- Internal data from MRO, reveals a staggering 36% increase in payer requests for information between 2021 and 2022.
- Payer requests, once tied to specific seasons like risk adjustments and HEDIS reviews, are becoming constant. This shift demands consistent staffing and smarter technology solutions.
- Health systems are embracing automation and forging new relationships to automate information transfer, moving away from traditional copy services and third-party chart chasers.
- The industry is witnessing digital patient information becoming commonplace, prompting a quest for cost effective record acquisition, particularly among payers and health plans.
- As digital exchange rapidly expands, more is expected from our data, especially in terms of quality, completeness, usability, and privacy.
Crucial Role of Digitization
The burden of these new ROI demands falls squarely on the shoulders of Health Information (HI) teams. Manual handling of payer and other medical record (or data) requests is unsustainable. However, granting payers and other requestors ubiquitous access to your organization’s EHR poses privacy risks and is not always the preferred option.
Digitization offers an alternative solution by ensuring contractual response times are met while protecting patient privacy. Four specific benefits include:
- Electronic exchange of medical records and clinical data exchange streamlines administrative tasks while safeguarding patient privacy.
- A digitized ROI process accelerates reimbursement, enhancing cash flow and reducing financial strain.
- Timely information sharing facilitates collaboration between payers and providers to improve patient outcomes and reduce costs.
- A digital model allows teams to focus on higher-value work, enriching career development.
The digitization of the ROI process is just one example of how healthcare data workflows are evolving to meet new industry demands. MRO is proud to serve hundreds of hospitals, health systems and medical groups with services and solutions leading change. I invite you to read our entire article here.