Phoenix Children's Hospital Improves Service And Timely Revenue With Verisma's Release Of Information Technology And Expert Support

Since the hospital’s founding in 1983, Phoenix Children’s Hospital (PCH) has provided hope, healing, and the best health care for children across Arizona. Over 80 percent of pediatric subspecialists in the metropolitan area and 50 percent of pediatricians in Maricopa County are associated with PCH’s ambulatory and acute care network. Use of an electronic health record system (EHRs) and other information and workflow technology is an enabling strategy for communications, patient safety and quality, and organizational efficiency across PHC’s growing network.

Changing Information Challenges
In 2011, PCH’s Health Information Management (HIM) service determined that its current Release of Information (ROI) vendor could not keep pace with the growing volume of third party requests for health information defined as protected health information (PHI) under HIPAA. Turnaround times were unacceptable and billing for these services lagged. Further, it was difficult to monitor and hold the ROI vendor accountable. HIM set out to update its inefficient ROI process.

“Our previous ROI vendor could not provide adequate support or service. We had a backlog of overdue invoices and chronically slow turnaround times. Patient and other requestor satisfaction was unacceptable. We had no useful management reporting or reconciliation, no opportunity for revenue sharing, and we were constantly entering data into multiple systems.”

Robin Furlong, MS, RHIA, Director, Health Information Management

ROI is the process of disclosing patient-identifiable information from the health record and other sources to patients and authorized third parties. Like other information management functions, ROI processes are greatly impacted by IT and the overall increase in requests and uses for health information. PCH selected Verisma as its new ROI partner because Verisma alone offered:

• Proven next generation, cloud-based, certified solutions to automate and deliver comprehensive release management
• Secure, HIPAA-compliant ROI workflow technology
• Integrated HIPAA guidance and compliance review support
• Extensive analytics, audit and reporting capabilities

Five years later, Furlong concludes, “Verisma’s ROI automation system is quick to deploy and very intuitive. Our managers rely on the dashboard reporting, as it provides an excellent snapshot of everything that is in the system. We always know where we are across all measures.”

PHOENIX CHILDREN’S HOSPITAL:

• US News & World Report named PCH to the Best Children’s Hospital top 50 U.S. pediatric hospitals list
• Leapfrog named PCH as one of twelve Top Children’s Hospitals
• Nearly 1,000 pediatric specialists across 70 pediatric subspecialties offering inpatient, outpatient, level one trauma, and emergency care

CHALLENGE:

• An antiquated ROI outsourced service that was no longer meeting PCH’s needs
• Chronic backlogs in fulfillment and billing
• Customer service complaints
• Lack of robust accountability

SOLUTIONS:

• Implemented Verisma Release Manager
• Introduced consistent HIPAA compliant ROI workflows
• Managed costs through shared revenue
• Implemented a shared staffing model for optimal efficiency

RESULTS:

• Disability request turn-around of 24-48 hours
• Zero backlogs in release and billing
• High customer service scores
• Full accountability through the ROI lifecycle

A Transformed Process

PCH’s HIM staff enters third party requests for information into Verisma Release Manager (VRM). VRM guides and tracks the entire ROI workflow from initiation through fulfillment, including billing and collections. Verisma staff processes ROI requests securely and efficiently, with a fully accountable chain of trust.

“We value the HIPAA guidance integrated into every step of the VRM-enabled process, enabling staff to make consistently compliant decisions. We also value the process transparency allowing us to be more effective in our compliance assurance monitoring.”

Cindy VanEimeren, RHIT, PCH compliance manager

Before implementing VRM, PCH frequently experienced a two-month backlog of disability requests impacting patients waiting for disability payments. With VRM automated disability request processing, PCH was able to turn around requests within 24-48 hours. With VRM, a database of requestors is built and maintained efficiently. VRM handles the entire billing and collections process for third party requests. PCH has freed staff time to focus on requests for information from patients or exchange of information for care coordination.

Trust, But Verify

VRM’s multi-stage QA methodology and Verisma Analytics, give PCH sightlines into the ROI processes and end-to-end accountability. Verisma’s QA Team ensures that all processed requests are managed accurately and in a timely fashion. They help PCH and Verisma to identify opportunities for continual workflow improvements to reduce costs and eliminate errors.

Utilizing Verisma Analytics, PCH tracks release processes from any device in real time. These include volumes, turnaround time, and workflow errors. Verisma Analytics also provides PCH with trends in its ROI environment such as year-over-year volumes and productivity variation. VanEimeren notes, “Before Verisma, we had no control and no insight into our release processes at all. Today, it’s at our fingertips and we have it in seconds. It allows us to run a more cost efficient, effective process.”

Partnering For The Future

With Verisma’s team of ROI experts and advanced technology solutions, PCH has transformed its third party ROI process from a disconnected manual process to a compliant process capable of adapting to the changing requestor needs and the ever-challenging regulatory environment.

“Verisma works hard to understand our changing needs and we look forward to continuing to innovate through our partnership.”

Robin Furlong, MS, RHIA, Director, Health Information Management

About PHOENIX CHILDREN’S HOSPITAL

Phoenix Children’s Hospital provides world-class inpatient, outpatient, trauma, emergency, and urgent care to children and families in Arizona and throughout the Southwest. As one of the largest children’s hospitals in the country, Phoenix Children’s provides care across more than 75 pediatric specialties. The Hospital is poised for continued growth in quality patient care, research and medical education. Visit us at www.phoenixchildrens.org.

ABOUT VERISMA SYSTEMS, INC.

Verisma is a health information technology provider focused on delivering unparalleled Release of Information (ROI) solutions to the healthcare industry. The company’s flagship ROI Automation System, Verisma® Release Manager (VRM), is utilized by well-known health care organizations nationwide. It is the only release technology with integrated HIPAA guidance and compliance review support.

Visit www.verisma.com, call 866-390-7404, email solutions@verisma.com or follow us on Twitter @verisma