Background

Maintaining accuracy and compliance for release of health information requires a foundation of effective management practices. Health information management professionals must develop management practices that support the disclosure process and ongoing oversight. Without these practices in place the disclosure process suffers to meet privacy and legal requirements and most importantly the continuation of care process is disrupted. This information exchange must operate effectively to support accurate and timely processing. As stated under HIPAA code of regulations 45 CFR 164.524(b)(2), “the covered entity must act on a request for access no later than 30 days after receipt of the request” (HHS). Requests for disclosure of protected health information (PHI) originate from providers, patients, patients authorized representative, or law enforcement. More thorough requests for information are required for legal processes, disability claims, audits and e-discovery requests. These comprehensive requests require additional work processes to meet legal and regulatory requirements. This highlights the need for strong management practices that support the disclosure process.

Project Purpose

My capstone project at Rogue Regional Medical Center (RRMC) and Three Rivers Medical Center (TRMC) deals directly with the challenge of balancing the release of information processes without effective management practices. The release of information process is the main hub for the exchange of health information at both Asante locations. Asanteuses EPIC, an electronic health record (EHR) which enables access to health records and logging of record requests. The main focus of this project is to determine optimal staffing levels to support the current release of information workload. Along with necessary adjustments in the EPIC workflow to maintain the timely and accurate processing of requests. These staffing and workflow changes must support a quality assurance program that provides oversight for the release of records process.

Results

Rogue Regional Medical Center and Three-Rivers Medical Center ineffectively uses the release of information module in EPIC, resulting in inefficient workflows that threaten to derail timelines and compliance. Inadequate training, high volumes of complex requests, and system based functionality difficulties exacerbate the problems. Inconsistency in the handling of requests is also present between the two locations. Recommendations for improvements include the hiring of a release of records trainee. This new staff member will take the administrative processes and effectively use the EPIC release of records module to log requests. This will automate the workflow saving time and enabling EPIC to compile accurate reporting that tracks requests from receipt to fulfillment. Hiring a release records trainee also give RRMC and TRMC the added benefit to prepare for long-term succession planning.

Significance

The effective use of EPIC along with workflow and staffing changes will support quality assurance reporting. Providing the foundational management practices required to support the release of information process. Such management practices include breach management, accounting of disclosure, and backlog management. This will provide the effective management practices required to oversee the release of information process and support the information governance program under development at Asante.