Literature Review on "Healthcare Bringing Contracted Medical Record Service Copying Back in House"

Literature Review 5 pages (1965 words) Sources: 7

[EXCERPT] . . . .

Deciding whether or not to completely or partially out-source release of information (ROI ) or to bring it in-house the release of information (ROI )copying a not so easy. The information that is being released is extraordinarily important, consequently, the amount of decision making involved in releasing it is enormous. There are many legalities regarding privacy of the information and it needs to be handled correctly . On the other hand, the financial benefit of bring the ROI process back in-house, for partially, or for totally outsourcing involve higher reimbursement and collection rates and these cannot be so lightly ignored (Getz, 2009). A company, for instance, could save anywhere from $5,000 to $20,000 in postage per year, by sending the information through an electronic exchange. (ibid.) Medical care institution are regularly asked to turn over private and sensitive information to various requestors which include private individuals, Life insurance companies, attorneys, physicians, other hospitals, Government agencies, and researchers. These want the information immediately, but with the steeped-up and rigid requirements of the HIPPA confidentiality code and with organizing and putting the various data together -- this can be a huge, time-consuming task for any department. There are enormous amounts of judgment and skill that are involved as well as the fact that RPI specialists are in short demand.

To that end, increasingly more medical institutions are turning to EMR to perform the task. In fact, 84% of facilities are managing in a hybrid environment that consist of partially paper and partially electronic .. EMRS have both their advantages and disadvantages in ROI and need to be carefully considered with through steps taken before their systems are selected and implemented. The winning approach in fact is for a combination of both electronic and skilled manual aid (Arkin, 2007) and this will be discussed in the following essay

To outsource or in-source: advantages and disadvantages

Deciding whether to partially or totally outsource or whether to retain ROI exclusively in-house is also not so easy since each decision carries its particular advantages and disadvantages. Some of the negative aspects for in-house for instance include customization, network costs, it support, license fees, annual maintenance fees and upgrade costs. Some of the negative aspects for contracting on the other hand include recurring expenses, customizations, data interfaces and contract management. The best thing to do, the Gantry Group (2001) advises is to conduct a careful analysis of the costs of outsourcing as compared with the costs of an in-house solution. Outsourcing is generally less arduous and costly than in-sourcing, but caution needs to be invested in doing so since the more complex the character of the processes being outsourced and the orgnaiziaonorganization doing the outproducing, the riskier the entire venture becomes and it may, ultimately, cause irredeemable loss and failure to the company. Greater steps in risk mitigation need to be performed in the latter instance as compared to the former driving costs up. ROI outsourcing, in short, can theoretically bring great advantages to the company. Whether or not to outsource or to retain as in-source is a step that needs to be carefully considered in all of its ramification.

The Five steps to adopting EMR

According to AHIMA (2003), the entire work flow needs to be redesigned in order to successfully introduce EMR into the work environment, and they mention five major steps to implementing this change. In short they are:

The need to determine the technology to understand the technology, plan for it, implement the actual change the post implementation phase where analysis of the program needs to occur. The system has the potential to perform terrific changes for the departments in way of making work easier, more streamlined and reliable for all medical care practitioners conrned. One has to ascertain, however, whether the system corresponds with other interfaces and whether the technology adheres to the same standards that are needed. Before using the new EMR, therefore, the management will have to investigate whether the new EMR interface will need to have new processes in place or if they will need to continue as they were before the change (Lientz & Larssen, 2006) .

All of these stages need to be followed for successful implementation of EMR to occur

There are, besides, also all the incidental details such as finding staffing for the EMR. staffing issues may be problematic given the decreased graduates in the Information Management services and that there is a significant increase in demand (Lientz & Larssen, 2006) . For instance in 2007, Conn stated that anywhere from 10,000 to 15,000 new professionals were needed in the EMR (Electronic Medical Record field) by that there were only 2,500 new graduates available. (an option may be to include non-clinical people to help with the ROI processes: creating theses flexible staffing options, according to the article on Supplemental Health Care helps with the needs of clients and with the commitments to the community.)

If each of these five stages are in place and carefully followed, the system can become an invaluable part of the institution.

Most importantly, management and practitioners -- in fact anyone involved in any part of the ROI, has to be constantly mindful of the HIPPA implications involved.

HIPPA, reinforced by the American Recovery and Reinvestment Act (ARRA) since 2010, is an important part of the procedure in terms of release of information (ROI) (Dooley, 2002). Every medical record that is released has to follow the strict guidelines associated with this legislation. The management needs to ascertain that the patient's rights are not going to be violated in any way and that the staff that are releasing this information are adequately trained on the releasing of this information.

The AHIMA webinar discusses the benefits of bringing ROI (release of Information) back in-house instead of outsourcing it, and how to be successful at doing it. It looks at what is at stake in regards to revenue and control plus what needs to be done to "sell" one's concept to Senior Leadership within the Organization. They discuss the HIPPA requirements along with identifying what needs to be completed in order to ascertain that the Electronic Medical Record System is prepared to bring the services back in-house. Some of the details they mention is that the vendor (if outsourcing or partially outsourcing) has to be in existence for more than 25 years; that the company has to identify the reasons that they want to outsource in order to sell the concept to senior leadership; that in sourcing requires ability to create "Standardized Release Packages" within the electronic record; that vendor information and contracts (in both cases) has to be reviewed carefully; that all fees have to be looked into and budgeted as well as carefully controlled and managed; that a working sheet of objective, budget, deadliness, responsibilities; that options should be considered fro training staff in EMR use;that a budget should be carefully compiled and evaluated; that research should be evaluated; that decisions should be made collaboratively; and that following implementation other decisions and consideration should occur.

Case study of a company that employed EMR and the benefits

An example of a successful company that did as much as was the Lehigh Valley Hospital and Health Network that "had an electronic medical record (EMR) system in place for about ten years, gradually integrating information systems and moving away from paper. "

their objectives in doing so included reducing turnaround times for customers; having more control over the process; and reducing the number of staff focused on fulfilling ROI requests. Five years later, LeHigh noted that their end-results were worth it:

We are leveraging our EMR and managing ROI requests in house, and we're now doing it with an average turnaround time of five days. Whereas our outsourced vendor used five people on-site, we now dedicate just two staff members to ROI and have become a revenue generating department.

We also have transparency. We know everything about our ROI processing operation. While outsourced, we were not involved in the level of our ROI volume. ROI Online has showed us our true volumes, which are higher than we originally projected. In fact, MRO updated our contract accordingly -- to our advantage.

The entire project was essentially cost neutral because, outside of a couple of scanners for the occasional paper record, we used existing hardware and staff. On the other hand, it's revenue positive in that we now enjoy a significant share of the ROI fees.

All of this and we have not received a single service-related complaint & #8230; (http://www.mrocorp.com/lehigh-valley-hospital-and-health-network/)

Conclusion

On the whole, approximate 24% of U.S. hospitals have decided to domestically outsource their ROI using electronic medical record (EMR ) for this end. Some out task just one or more tasks, whilst others have turned over their entire process to a vendor. According to the Association of Health Information Outsourcing Services (AHIOS), nearly 80% of hospitals nationwide outsource the entire ROI function, whilst an almost equal amount of hospitals in-source.

Steps for doing both… READ MORE

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