Media, Pennsylvania

The Challenge

Riddle Memorial Hospital needed help with its release-of-information (ROI) request process, which it placed among its top five departmental priorities.

An independent, community hospital in suburban Philadelphia, Riddle Memorial has 252 beds and records 10,000 admissions, 76,000 outpatient visits, and 29,000 emergency room visits annually. The hospital performs 500,000 laboratory procedures per year. In addition to handling ROI requests from the usual sources – including physicians, patients, health plans and law enforcement – Riddle Memorial also fields requests from auditors on behalf of state-mandated initiatives.

The Solution

Riddle Memorial decided to take control of its ROI request process in 2004.

“It was obvious that our ROI process needed some structure,” says Kelly Henry, director of health information management for Riddle Memorial. “The system in place at the time was little more than a ‘first in, first out’ method that created huge piles of paperwork.”

Riddle Memorial was using a completely manual process to fulfill ROI requests. Sometimes employees had to visit basements in far-away buildings to find the records they were looking for. The hospital often lacked the resources to follow-up on unpaid bills to requestors. It used typewriters instead of personal computers. It wasn’t possible to get a snapshot view of ROI volume, statistics and status.

“Our people were at a distinct disadvantage, simply because the process had never been updated,” says Henry.

The hospital opted for a hybrid business model combining front-office functions performed by hospital employees and back-office management handled by MRO. The hospital and MRO would share revenues gained through more efficient billing practices.


The new system went live in August 2004. It required only a few PCs, two scanners, and the installation of MRO’s ROI Online software package. Henry calls it “one of the easiest projects I’ve ever been involved with.” The cost, she says, was “minimal” and did not require the kind of investment associated with traditional ROI software packages.

With the new system in place, Riddle Memorial employees open the mail and log new ROI requests immediately. Tracking thus begins the moment an ROI request is received. Riddle Memorial personnel conduct research, retrieve information, and use a virtual print driver to capture selected records from the hospital’s document imaging system – then transfer them to ROI Online without having to print or scan. If the data is only available on paper or microfilm, employees use a desktop scanner to capture it.

MRO handles the process, including ROI billing and collections. MRO also fields telephone calls from requestors and supplies and maintains the software at no cost to Riddle Memorial.

“It was a stress-free implementation,” says Henry. “MRO helped us tackle our ROI request backlog. This way, our staff did not feel the pressure of trying to learn a new system along with the added burden of the backlog to scan.”


Before implementing ROI Online, Riddle Memorial did not even know how many ROI requests it was processing. “Now we know everything,” says Henry. “We can track the status of every ROI request and see how we’re performing.”

Henry reports that the hospital’s customers are happier and that staff members are no longer experiencing phone calls from frustrated requestors. The hybrid system has created a more efficient process, all for the cost of a few PCs and scanners. What’s most surprising to Henry is that, despite the revenue sharing arrangement with MRO, Riddle Memorial is bringing in just as much revenue as before.

“MRO’s expertise in billing and collections has positively impacted gross revenues that much,” says Henry. “ROI Online has successfully transformed our ROI process, allowing our team to move on to other priorities while providing excellent customer service.”