What are Release of Information Services?

One of the most exciting times for me at KLAS is when we complete data collection for a report I’m involved with. At that point, we get to transition from listening to analyzing what our provider friends have told us, allowing us to find answers to questions that we, vendors, and providers have been asking for months. Where is the market headed? What innovative changes are being made? Which vendors are exceeding expectations?

Today, we’re preparing to start analysis for what will be our Release of Information (ROI) report. While KLAS has published data on ROI for years, including in our HIM Services Performance 2015 report, this will be our first report strictly about ROI. While it’s not slated for publish until August 21st, the data I’ve seen so far already has me rearing to share a few details with our provider and vendor friends.

The Importance of ROI Services

Most requests for patient health records come from outside sources. Before these records can be sent, strict and intensive processes must be followed to comply with both HIPAA and HITECH laws. Generally, one step is to get permission from the patient. Each page of a record being requested must be reviewed (usually twice) to make sure that only personal health information that a patient has okayed for sharing is sent to outside sources.

Clearly, it’s crucial to both patients and provider organizations that ROI work is handled with precision. For patients, it’s a matter of personal privacy and safety. For provider organizations, it’s a matter of following the law and remaining protected from litigation.

The expertise required for this work leads about half of healthcare organizations to outsource some or all of their ROI work to a services firm. By providing both software and services, these firms are meant to ensure that patients retain control of their personal information, providers remain protected, and those requesting patient records get the appropriate data in a timely manner.

The Need for Innovation

Despite technological advances and the fact that electronic ROI dashboards are available, most ROI work is quite manual. Nine criteria must be met to comply just with HIPAA’s Privacy Rule, so the fact that little of the ROI process is automated makes for a lengthy job. In addition, many patients who give electronic consent to companies like Facebook and Amazon with the click of a button have to give written consent for their medical records to be shared. No wonder patients tend to get frustrated!

Who is it that hears most patient complaints? The providers. A provider organization may outsource their ROI services to a firm, but the firm works directly with the provider organization and isn’t seen by the patient as a separate entity. Providers want to help and please their patients. As this comment illustrates, they want to see better technology and more automation in the ROI process:

“Our patients have to print and fill out authorization forms and then fax them over to us. That is a very antiquated process for retrieving records. [Our firm] has good back-end processes, but they need better solutions and strategies for patients. We need a portal so that patients don't have to physically bring in their forms. People do things like that with their phones now.”

Other commonly reported issues include slow turnaround times, poor communication about how far along the ROI specialists are in the process, incorrect data being shared, and the wrong amount of information being shared. Many providers feel that their firms have a long way to go:

“[Our firm] needs to go back to the basics. They can't even get day-to-day requests turned around within five days. They are not even close to strategizing and trying innovative things. They need to get the basics down.”

Firm Differentiation

One reason KLAS chose to complete research for an ROI report was to find out where the individual firms are succeeding and where they struggle. While all firms seem to need some degree of innovation, the individual companies have much that sets them apart from each other.

On the plus side Ciox Health, an ROI firm originally created from the merger of HealthPort and IOD, recently announced a new product. They have been touting this new offering’s increased automation and artificial intelligence. So far, customer input on the tool looks pretty positive:

“People seem to be much happier with the new [Ciox Health] platform. It just seems to work much better than what we had before. I know that it is easier for our staff members to print and process requests as they come in.”

KLAS also wanted to validate exactly what Verisma is doing for their customers. Their scores reflect what providers say is a strong focus on catering to customer requests:

“I have spoken frequently with the executive leaders and feel confident that they are listening to us. Verisma's greatest strength is they listen to the needs of their customers to make their product and process better.” 

Claiming the very highest scores as of late, MRO Corp appears to gain their reputation from consistent dedication to a smooth customer experience:

“MRO Corp is very committed to quality and compliance. We feel confident in their leadership, their organizational structure, and their commitment to customer service.”

A Fluctuating Market

While each firm seems able to keep many customers due to their specific strengths, the market is more fluid than it has been in years past. The reasons for this seem to hail from both Washington and a lack of significant changes to most ROI tools.

Ciox Health holds the majority of the ROI market. However, they may have the most to lose after the HIPAA Omnibus regulations implemented in 2013 and altered in 2016. This legislation restricts the amount that provider organizations can charge patients for copies of their records. While the restrictions don’t apply to third-party requestors (such as lawyers or insurance companies), some third parties are now choosing to go through patients in order to avoid paying higher fees. We’re eager to see just how much this workaround is affecting ROI firms.

As previously mentioned, the missing innovation and stagnant quality in ROI technology is causing many provider organizations’ eyes to wander. Will Ciox Health’s new platform convince their customers to stay? Or will the service and relationships offered by smaller firms end up being more important to provider organizations? KLAS and I are very keen to find out. Stay tuned for the ROI report publishing mid-August and a follow-up post on the blog!