Detroit, Michigan

The Challenge

Henry Ford Hospital and Health Network is one of the nation’s largest healthcare providers. The auto pioneer himself founded it in 1915 to serve Detroit autoworkers. The group has since grown into an integrated health system employing 14,000 full-time workers and handling 2.1 million patient visits a year.

HFHHN receives more than 42,000 release-of-information (ROI) requests annually, which equals about 1.6 million copies of medical records. The health system’s Medical Records Services Department takes responsibility for all of these requests, whether received at a hospital or one of HFHHN’s 30-plus clinic settings. Until recently, the department found it challenging to route ROI requests to the appropriate departments in a timely manner. Administrators tried to solve the problem through ramped-up employee education and higher demands on the copy service. The effort yielded a seven-day turnaround time on ROI requests. It was improvement, but not a remarkable one.

“We were meeting customers’ needs, but not exactly ‘wowing’ them with our service,” says Karen Schmidt, director for medical record services at HFHHN.

The Solution

To better meet the needs of its staff and customers, HFHHN turned to MRO for its ROI Online system, which integrates workflow for both paper-based and electronic record systems. The solution enables the health system to maintain control of the ROI process while outsourcing the time-consuming “back office” functions. What’s more, the software within HFHHN’s firewall and is inherently HIPAA-compliant.

Schmidt conducted an extensive reference check before selecting ROI Online. “Everyone I spoke with discussed their positive experience in dealing with MRO,” says Schmidt. One health information management (HIM) director was so enthusiastic about the service he worried Schmidt would think he worked for the company.

“I was impressed by the feedback I was getting,” says Schmidt. “We tried to use a traditional selection process by sending out RFPs, but we couldn’t find any companies that were comparable to MRO. And I refused to take proposals from companies that continued to deal in the paper realm.”


In November 2006, HFHHN ended the contract with its existing copy service and switched to ROI Online. The complete transition took only a few weeks and the change was seamless to customers. Trainers from MRO worked beside health system employees to show them, one by one, how to handle new ROI requests.

The health system no longer prints out electronic medical records for a copy service to mail. Instead, staff members forward the records electronically to MRO, which handles the request acknowledgement, validation, logging, tracking, requestor relations/communications, physical distribution of requested information, billing and collection. The ROI Online service sends out records in whatever format requestors want, whether by CD-ROM, FTP, or Web portal.

“The whole process is efficient and stays current with today’s continually evolving laws and regulations, particularly with regard to fees for ROI processing,” says Schmidt.


Phone calls from requestors have fallen by 50 to 60 percent since HFHHN implemented the ROI Online solution. Customers, including patients, no longer have to wonder if their request has been received. Top clients, including high-end insurers and records deposition companies, get Web pages that allow them to check instantly on the status of ROI requests.

The new system achieved a return on investment within the first 90 days of implementation. Implementation costs – to cover the software and a couple of scanners – were so minimal that Schmidt didn’t even put them in her budget. They were paid directly from revenues, which are shared with MRO. These revenues, while considered incremental, are important to Schmidt.

“In the past, my department frequently paid several thousand dollars each month to the copy service,” says Schmidt. “Today, we’re actually bringing in a continual stream of income, even after having to share a part of it with the vendor.”