Health Information Technologies and Processes

centralized medical records/HIM dept

  • 1.  centralized medical records/HIM dept

    Posted 10-31-2019 11:14
    Hello everyone,

    I was hoping to obtain some feedback regarding the centralizing of the medical records/HIM dept - especially in an ambulatory care setting.

    We are a Federally Qualified Health Center with 7 clinics and an administration office. A little over 1 year ago, I opted to centralize the dept at the administration location. This has created a large amount of challenges and victories. Our patient population is 30,000 patients across those 7 clinics and we are supporting 25 medical providers across those 7 clinics.

    I was wondering if others have feedback regarding decisions to centralize, maybe decentralize, or remain in each clinic continuously.

    I am struggling to find a way to provide excellent customer service to our providers and patients while maintaining consistency in task execution and workload.

    I appreciate any and all feedback/advice you can share!

    Thank you,

    Sabrina Brasuell
    Health Information and Compliance Manager
    Community Health Alliance Reno, NV

  • 2.  RE: centralized medical records/HIM dept

    Posted 11-01-2019 09:56

    This is a great question... to centralize or not to centralize.


    In my experience there as many ways to approach this as there healthcare organizations, meaning that each organization will have different needs and challenges. I don't think there is a one-size-fits all approach, rather a change management approach that incorporates an appreciation for the HIM department staff skill set and expertise aligned with the organization's needs. A hybrid model seems to work for those who are spread out, such as you've described below and similar to my organization.


    As an example in practice, what we've done is identify the areas that our team should own (100%) and keep those work flows local/in the department (indexing, ROI, eMPI, etc..).  Other workflows that can and should be de-centralized are kept to a minimum and are closely monitored and audited by our team (using system generated reports, etc.).  This helps to support our goal of HIMs as the subject matter experts, and data collection for performance improvement across the health system. 


    There are two areas that are decentralized (in a limited way), release of information and scanning.  Since we use Epic, the ROI functionality (Quick Release) is appropriate; some very large clinics (more than 10-providers) use the ROI application, and their releases are patient and payer only. Scanning and indexing (limited though it is) is a requirement, simply because of the geographical reach of the health system.


    Hope this helps, happy to chat off line (direct email is listed below).




    Maria C. Alizondo, MOL, MLC, RHIT, FAHIMA

    Director | Health Information Management Services

    ISS | Information Services & Solutions 

    Office: 310-267-7603 | Cell: 818-590-7504


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  • 3.  RE: centralized medical records/HIM dept

    Posted 11-04-2019 13:55
    Hi Sabrina:  We centralized our provider based clinics approximately 2 years ago.  It was a challenge for us too!  We have centralized release of information, scanning/indexing, provider incomplete note monitoring and notification. There have been challenges with staffing to meet the demands, however, overall we have had success with consistency in processes that in turn has produced improved quality and timeliness.  We have had to work very closely with the practice managers and are continually providing feedback on ways we can work together to improve processes for the good of the patient and the providers.

    Marcia Matthias
    Corporate Director Health Information/Privacy Officer
    Southern Illinois Healthcare