Experience

Serving the region for more than 20 years, Lehigh Valley Physician Group (LVPG) has experienced rapid growth in recent years, increasing in size to include more than 1,000 providers at approximately 160 practice locations. LVPG is part of Lehigh Valley Health Network (LVHN), which includes four full-service hospitals, a children’s hospital and many clinics and ancillary services.

When Tim Adamchik became the director of EMR operations for LVPG, he was tasked with centralizing the organization’s Protected Health Information (PHI) disclosure management processes, namely ROI. “It was one of my top priorities,” said Adamchik, noting that it was “particularly timely as compliance grew tougher while LVPG’s practices continued to grow larger and busier.”

Prior to partnering with MRO, a leader in secure, compliant and efficient exchange of PHI, the physician practices handled ROI within the confines of their own practice. Leadership recognized how an issue had arisen – specifically, the physician group’s rapid growth via addition of new practices – but also knew the variation could open the door to risk.

By creating a centralized department, Adamchik saw the opportunity to create a better model for PHI disclosure management – one that would not only reduce risk but also improve patient satisfaction. In addition, LVPG could establish more comprehensive, accessible tracking and measurement of PHI disclosure management, which was important to leadership as they monitored performance. Lastly, he and the leadership team acknowledged the practice staff’s increasingly heavy workload. Centralizing this function would remove the burden of PHI disclosure management from busy staff, freeing their time for patient care.

Solution

While LVPG’s parent organization, LVHN, had used MRO’s ROI shared services model since 2006, Adamchik elected the staffed model because it alleviated the high variable cost of employees. Not only that, he knew that removing the burden of staying abreast of increasingly complex PHI disclosure regulations from the already busy physician practices would remove another element
of risk.

Additionally, an organization-wide Epic implementation is in the works; but for now, each practice uses either an EMR, paper-based practices or hybrid environment. Consequently, each staff collects ROI requests and faxes them to the MRO centralized hub, which is part of LVPG’s medical records department. To make the process as efficient as possible, the fax transmittal sheet clearly
documents the origin and purpose of the request, thus helping the MRO team better serve the practice managers and patients, ensuring accuracy and the ability to clearly communicate the
status and details of record requests.

Results

In November 2013, LVPG turned over ROI management for 90 physician practices to MRO’s in-house staff. The initial influx of medical records requests was higher than anticipated due to a significant backlog, so MRO brought in additional ROI specialists until the team whittled the queue from 1,100 to 100. Now, the queue never increases beyond 100; the team keeps a close watch and implements measures to keep the number at this target.

Due to the new on-site staffed model, LVPG has a five-day business day turnaround for a request and is usually able to beat this internal service goal. Physician practice staff members enjoy increased productivity in other critical areas such as patient service, claims management and patient payment. The new model has also delivered another perk – additional savings. Through the arrangement with MRO, LVPG provides overhead such as office space and equipment, while MRO takes on the greatest expense – staffing. As long as MRO processes the pre-defined target number of requests, LVPG realizes savings in the form of vendor credit. In particular, diverting customer service calls from the practices has saved time and expedited resolution. In just five months, MRO responded to and resolved 2,100 phone inquiries from requesting parties that included medical record request status checks, questions of how to obtain medical information and methods for resolving HIPAA deficient requests.