Release of information: are hospitals taking a hit?

Outsourcing release-of-information requests helps hospitals alleviate administrative and compliance burdens and expense. Recently, state lawmakers have begun to draft legislation reducing the maximum fee that may be charged for copies of electronically stored records. The reduced fees may not cover expenses. If such legislation makes it difficult for outsourcing companies to make a profit from this service, hospitals ultimately could bear the expense and risk.

HIPAA transition: challenges of a multisite medical records validation study of maternally linked birth records.

Numerous researchers have expressed concern over the impacts on medical records availability of the newly effective Medical Information Privacy rule, as authorized by the Health Insurance Portability and Accountability Act (HIPAA). The increased costs associated with compliance with the rule, and the increased potential for financial liability, raises the possibility that hospitals may be less likely to participate in such research, resulting in a decrease of the validity of multisite studies designed to represent an entire population. Our multisite medical record validation study, designed to assess the accuracy of maternally linked birth records, provides an overview of a number of HIPAA implementation challenges. We found that the new HIPAA rule presents new challenges for those who rely on the release of medical record information for epidemiologic research. At the very minimum, increased compliance costs associated with human subjects protection and increased administrative burden for researchers would seem to be inevitable as medical institutions address the requirements of the new HIPAA rule by instituting more complex and thus more cumbersome procedures. Researchers should anticipate increased costs and plan accordingly when budgeting for human subjects review processes.

The utility and cost effectiveness of voice recognition technology in surgical pathology.

Voice recognition (VR) technology in computer systems converts speech directly into electronic text. In pathology, VR holds promise to improve efficiency and to reduce transcription delays and costs. We investigated the utility and cost effectiveness of targeted VR deployment in surgical pathology. A VR system was deployed for entry of gross descriptions of biopsies and of low to moderate complexity specimens and for entry of final reports for specimens not requiring microscopic analysis. Templates for VR were developed for all reports. Free-text speech entry was used to enter information not covered by templates. Voice converted to text by VR crossed over an interface into the anatomic pathology laboratory information system. Tallies were kept of whether individual specimens were entered by VR or by conventional dictation. A computer program was written to analyze the number of lines of text entered through VR. Cost savings were calculated based on per-line transcription costs from an outside agency. Over 18 months, gross descriptions for an average of 5617 specimens per month were entered via VR, corresponding to 70% of all gross specimens processed by the laboratory. A mean of 106 gross-only final reports per month was entered through VR. VR facilitated same-day processing of specimens received after the previous day processing cutoff time (average 35 specimens per day). VR generated an average of 23,864 lines of text per month, translating to $2625 savings per month. Estimated payback period for VRT as implemented is 1.9 years. The use of VR for gross descriptions of biopsies and low to moderate complexity specimens and for gross-only final reports in surgical pathology facilitates data entry, reduces transcription costs, and contributes to improved turnaround time. Development of templates is important to successful implementation of VR in surgical pathology.

When health information and fiscal management meet.

HIM professionals have skills that can allow them to contribute to the bottom line in many ways. The author describes areas where HIM expertise can make a difference in evaluating an organization's fiscal performance through analysis of services driven by health information.

Ten steps to successful chargemaster reviews.

Is your chargemaster current, compliant, and comprehensive? In the age of APCs, healthcare facilities would do well to answer these questions regularly. Here's how an HIM professional can help.

A new approach to chargemaster management.

After examining their charge description master management processes, HIM professionals, in conjunction with clinical and support departments, redesigned and automated several practice aspects. Turnaround times were reduced and end users are happier. Here's how they did it.

Value measurement in health care: a new perspective.

Vital to the success of any healthcare organization is the ability to obtain useful information and feedback about its performance. In particular, healthcare organizations need to begin to understand how non-value-adding work activities detract from their bottom lines. Additionally, financial managers and information systems need to provide data and reports throughout the continuum of care. Overall, healthcare organizations must align the management information and control systems with the planning and decision-making processes. The horizontal information system is a tool to manage three common problems facing today's healthcare managers: (1) the use of existing information to focus on control rather than improve business, (2) failure to focus on satisfying the customer, and (3) failure to combine their efforts with those of the employees by developing trust and a common focus.

Internal benchmarking paves way for medical transcription improvements.

Accurate, detailed data collection is essential to improving productivity in medical transcription departments. Transcription staff are best positioned to identify nonvalue-added duties and processes and should be involved in improvement planning. Even a small percentage of improvement in productivity can translate into huge dollar and time savings.

The outsource contract.

Outsourcing business functions has become part of the US corporate culture in the 1990s. The general concept of outsourcing is that a company, which historically has performed its own services in a given area using in-house employees, transfers these services to an outside vendor. Many companies in a variety of industries have found the economics and the flexibility that outsourcing can offer to be attractive; healthcare is no exception. Whether the entity that outsources an internal function is a hospital, health insurer, or another entity involved in the delivery of services, outsourcing is now a viable alternative in healthcare. This is particularly true with respect to hospital support services, such as accounts receivable collection and processing, medical records, laboratory testing, and dietary. While outsourcing can be highly beneficial, several issues exist that could create pitfalls for the uninitiated. Wary outsourcers should consider the following issues to reap maximum benefits from the outsourcing experience.