A Path Forward for HIM Departments Struggling with Manual Processes & Human Resource Challenges

Healthcare.
Information.
Management.

Each of those words alone is clear, digestible and somewhat benign. In isolation, none conjures up a particularly distinct picture. But, when you string them together as a single term – for the initiated – they take on a scope, scale and level of import that can be legitimately unnerving.

Healthcare Information Management (HIM).

Collectively, these terms refer to a segment of the healthcare industry that is somehow mired in outdated practices. It’s a mission-critical arena that begs for optimization but has unintentionally held digital reinvention at arm’s length. While other areas of our healthcare system are nearly unrecognizable versus how they looked and operated even five years ago, HIM is somehow still defined by manual reviews, manual processes and paper documents (Think about it – nowhere else does the term ‘faxes’ rear its graying head even remotely as much as it does in the HIM arena).

While this kind of inefficiency is increasingly-less-tolerated in many modern workplaces, there’s an even larger stigma associated with the inefficiency in HIM because it’s not just a story about business inefficiency. It’s a story about less than optimal patient care. And the difference between time-sensitive lab results not being accessible stands in stark contrast to an arguably far less important late payment of an invoice or a license application being filed in the wrong place (Though these latter items may sometimes feel like it, they are typically not ‘life and death’ issues…).

The HIM function’s long-time and continued struggle with its addiction to manual reviews, manual processes and towering stacks of paper has only been magnified by the COVID-19 pandemic. COVID-19 stormed in and multiplied every HIM challenge ten-fold. In short, the labor-intensive HIM function is suffering mightily because the pandemic has prompted administrative and clerical staff to leave the healthcare industry in droves because of the increased pandemic-induced stresses and the fear of continued COVID exposure.

This labor shortage is not only directly resulting in slower processing of important medical data, it’s resulting in more errors and an increasing amount of clerical HIM work being pushed on to the backs of physicians and other clinical staff that are trained for and have expectations of interacting with patients and delivering actual medical care. These trained medical professionals are now spending their time:

  1. Manually reviewing and processing patient records
  2. Fulfilling release of information (ROI) requests
  3. Tracking down and securing patient records (wherever they may reside)

1. Manually Reviewing and Processing Patient Records

This task, which demands an inordinate amount of HIM staff time, can be dramatically simplified and made more efficient with an automated data extraction and classification solution.

Whether clinical patient data is being received as paper or in a digital format, the opportunity exists to automate what is now a manual review and classification process. Presently, when paper documents are received via mail or fax, they’re manually reviewed by HIM staff, individual pieces of data are identified and that data is then manually entered into the EHR. Additionally, the document is most often scanned and then manually indexed so that the entire record can reside within the EHR, be searched for and identified in the future. This process is labor-intensive, time-consuming, expensive and lends itself to errors. While this is less than optimal under normal circumstances, it is a nearly insurmountable problem when considered in the context of the staffing challenges that have been exacerbated by the pandemic.

In order to dispense with these inefficiencies and address the staffing shortages head-on, a digital solution is required. There is a collection of technologies that exist which can more accurately and more efficiently execute these processes mentioned above with essentially no human resource required after the initial scanning of a document. While the process is vastly more efficient than a manual process, the output is also superior, with errors minimized dramatically.

  • A simplified account of this type of digital solution effectively works as follows:
  • The patient document is scanned
  • Optical character recognition technology (OCR) reads and extracts critical data from different portions of the record
  • Data is then auto-imported into unique data fields within an intelligent form; “structuring” the data so it can be searched, identified, manipulated and reported upon
  • Robotic Process Automation (RPA) is employed to move all relevant data within the iform into the appropriate records within the EHR
  • The platform then auto-indexes the document and archives it so it can be easily identified in the future

Collectively, these technologies allow records to be processed by machine 24 hours per day. This is one very simple and clear example of the efficiency, productivity and cost-effectiveness of the automated solution. Without the system, a salaried employee would execute manual processes eight hours a day. That manual process was/is defined by significant cost, sometimes poor quality output and limited progress. With the automated system, accuracy is improved, costs are reduced and output is multiplied – as a result of faster processing as well as the 24 hour per day output delivered by the system.

This set of services effectively eliminates the omnipresent backlog of patient records, minimizes errors, results in near-immediate access to important patient data, all while dramatically reducing costs – in many cases by 50% or more.

2. Fulfilling Release of Information (ROI) Requests

Not unlike the processes related to securing, organizing and filing patient data described above, the formal release of medical information (ROI) is also a long-standing, labor and detail-intensive process. However, unlike the automated clinical document filing described, some HIM departments have long-taken advantage of external ROI services.

For those HIM departments who have not outsourced their ROI fulfillment responsibilities, they face another time-consuming task that is further complicated by legal considerations. As a patient’s medical data is legally protected and highly-regulated, the release of that data has to be preceded by careful consideration of a trained employee in order to maintain compliance with HIPAA law. It’s important that all ROI processes follow all protocols for the Health Information Technology for Economic and Clinical Health Act (HITECH) and Health Insurance Portability and Accountability Act (HIPAA).

While ROI may sound like a fairly straightforward process, some fundamental components of the process make it particularly time-consuming. Beyond the very intentional legal considerations that have to be top of mind during every transaction, there is also a customer service-like component of the process given that a third party is involved. Whether the requestor is the patient, another health care provider, an employer, an insurance company, a law firm or any other number of entities, the HIM department’s job is further complicated by the interactions, expectations and difficulties associated with servicing these third parties.

By virtue of providing access to protected health information (PHI), there are incremental processes and details that are part of every interaction such as securing proper authorization forms, redacting protected data from records before releasing, etc. And on the back end of the process, HIM departments are responding to an increasingly large number of audits and finding themselves at greater risk of making medical ROI errors, creating confidentiality breaches and suffering the resulting liability.

Integrations

And finally, with an abundance of digital systems operating within the healthcare space, doctors offices can be challenged by identifying, extracting and transferring data throughout a web of independent EMRs, billing systems and imaging systems. Without a central digital platform to connect these systems and share data, the process of securing the requisite data in any given situation becomes even more complex.

The ability to create technical integrations allows for a smooth exchange of data and accelerates and simplifies the ROI fulfillment process. But the basis of a technical solution is the elimination of ROI requests being submitted by phone and fax. Rather an online portal with a digital ROI form is capable of expediting the entire process by:

  • Integrating with existing data management platforms and data repositories, as well as ROI legacy software
  • Immediately connecting requestors in order to create valid requests in real-time, eliminating paper requests

Beyond the basic benefit of initiating the request in a digital format, this type of solution further reduces the risk of missed deadlines by providing valuable insights such as operational reporting to the executing ROI team and predictive and actionable analytics to management. Sophisticated analytics are delivered via a graphic-rich dashboard, providing unprecedented business insights. A digital platform’s predictive and actionable analytics features identify records and requests that are in danger of missing the processing cutoff period. It determines which data is missing and automatically alerts all relevant parties so the issue can be corrected and the ROI request fulfilled on schedule. Additionally, these custom dashboards provide visibility of open requests, aiding with operations and increasing productivity.

Information can be released in a variety of formats including paper, digital, and the direct delivery of data to EMRs or even archived EHR data systems.

Audit Management

Digital platforms also allow for a more efficient and smooth workflow when it comes to routing payer audit requests. Requesters can submit and manage requests via the ROI platform. Once the requested documents are ready to view, requesters are provided with a link to a dashboard within the ROI platform, which provides simple, secure access to the proper information and documentation. Delivering and routing these requests electronically greatly reduces costs and makes the ROI process more efficient. Payers will see dramatic improvements in efficiency and HIM staff will concurrently be afforded more time to focus on patient care.

3. Tracking Down and Securing Patient Records

One of the cornerstones of patient data management for any healthcare provider is the efficient securing of records from a patient’s previous healthcare provider. For most continuance of care visits, the new healthcare provider will need a copy of the patient’s previous medical files. Without a digital platform in place, like most things, this is a highly-manual and time-consuming process. With a digital platform in place, requesting, receiving requests and transferring files is made dramatically more efficient.

GRM Information Managements as Part of the Equation

GRM Information Management possesses a unique set of assets and experiences that allow us to deliver a valuable, and arguably, a more comprehensive set of HIM Automation services than any other organization in the information management industry. The basis of GRM’s capability is a formidable, cloud-based, digital enterprise content management platform. The platform is capable of easily integrating with a host of other digital platforms, ingesting, processing, classifying and analyzing millions of pieces of data a day. These demands are capable of being met only by a platform that has been hardened and refined by the most demanding data applications in the healthcare industry as well as public sector, finance, legal and a host of other data-dependent industries.

But, technology alone is incapable of tackling the demands and intricacies of healthcare information management. And that is where a more qualitative set of credentials and capabilities set the GRM solution apart. One basic credential is that GRM has deep roots in healthcare. From delivering the largest healthcare system in the US critical legacy data management services to serving small physician groups with a variety of services, GRM and GRM staff possess a deep knowledge of the intricacies of healthcare data management. Additionally, another part of the GRM staffing model allows our clients to offload time-consuming, HR-intensive tasks such as patient chart retrieval from other previous healthcare providers. Equipped with GRM’s technology assets, even these processes, that are largely manual, are dramatically simplified and streamlined.

Ultimately, GRM HIM solutions exist to optimize processes and squeeze efficiency out of the HIM system – resulting in dramatic operational improvements and substantial cost savings for client organizations. While scenarios vary significantly from organization to organization, a suite of GRM solutions very often allows an organization to reduce their human resources costs by in excess of 50%.