With the onset of the electronic medical record (EMR), hopesprung that a paperless world would relieve a number of burdens, but thereality was/is that often proprietary systems could not readily communicate,causing other headaches to replace the original concerns.
In an article published in For The Record magazine in December of 2012 titled ”The Changing Face of ROI”, author Cassi Birnbaum, MS, RHIA, CPHQ recounts her thoughts on the promise of the state of the electronic health record following a visit to the AHIMA convention floor in September of that year, highlighting the history of ROI to date (which I will not relate here, the link above will take you to an archived version of the original).
Reality continues to evolve in the face of HIPAA regulation and recent concerns about overcharging for requests have a number of providers rethinking how they handle ROI. One result from these type of lawsuits is that providers, being wary of such activity are beginning to reconsider how PHI is managed.
Given the inherent inefficiencies in the service bureau model do not bode well for their longevity, the options have been few in the past. Many are now considering the option of bringing the service back in house, but how to justify it? Service bureaus have always been reluctant to share their revenue figures with their clients, making an intelligent choice more difficult.
In 2012, ABT Medical, Inc. a longstanding player in the document management arena, introduced ROI+, a cloud-based platform that allows hospitals, practices and outsourcing affiliates manage all of their release requests completely online. Recent discussions with orthopedic practices in particular, show an increased interest in areas of potential ancillary revenue,in which until recently, ROI was not included.
The ROI+ platform provides an opportunity for practices and hospitals to manage their own ROI using nearly the same staff as had been handling just continuing care requests manually. The platform captures the requests, holding them electronically for the requestor who is notified by email of its availability. An invoice is automatically calculated and delivered (if applicable according to State Regulations) with the notification, requiring the requestor to pay the invoice, before they can access the information. The information then remains available through the ROI+ dashboard for analysis, review or audit purposes. This is true whether the provider is managing their requests in house or has outsourced it through an ABT affiliate.
This means the provider not only has complete control over the request, they also have the ability to manage all of the request information and statistics either through available reports, or by exporting the information to and external resource such as Excel for Pivot Table analysis.
This unprecedented level of control allows providers to not only have complete control over their ROI, but actually retain the income generated. This set of tools has made the process so much more efficient that even were that income to be reduced significantly through later regulation, the savings and ability to manage information justify keeping it in house.
The reality of where CMS and other regulators are taking the market means that the traditional service bureau model will likely become less viable in the coming few years. This will shift the burden inevitably back on the provider, leaving tools like ROI+ as a very valuable investment.
Steven W. Kaeppel is COO of NBW Healthcare Resources, LLC. NBW Healthcare is a Fort Worth based medical service consultancy representing cloud based document management and related solutions for specialized medical practices, clinics and hospitals.
