Confidentiality, Privacy and Security

Reduction of ROI at windows/portal use

  • 1.  Reduction of ROI at windows/portal use

    Posted 08-18-2020 10:22
    Sorry if this comes across twice.  I had an error the first time.  We had closed our window for a few months and encouraged patients to view their records through our portal or they could obtain copies by email.  We are Meditech.  We went live with this portal over a year ago. We do not hold anything.  Everything has to be at final status before it goes to the portal. We cannot set it where inpatient and outpatient records go to the portal on different days. My quandary is that we have a Hospitalist that is on a mission to change the time frame things go to the portal.  He wants them to wait 3 days or more because "one" patient questioned him about a test that he had not had not seen before the patient did.  I feel like this is going backward.  We want the patients to access their records and take ownership in their care.  We would prefer they use the portal and not come into the building any more than necessary.  I have told them that I would not have staff hold records for 3 days if the patient comes to our window requesting them.  The same provider also doesn't care for the fact that the patient reads their progress notes.  This will be addressed at a meeting in Sept.  I was wondering what others are doing.  Thanks in advance for any advice/processes anyone would be willing to share.

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    Pamela Gonterman
    Director of His/Coding
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  • 2.  RE: Reduction of ROI at windows/portal use

    Posted 08-19-2020 08:51
    Hi Pamela,
    We are also a Meditech hospital and we have seen our portal use grow as well. Unfortunately, we did have a case a few years ago where a patient's imaging results were available late on a Friday evening, because the radiologist was signing reports later in the evening. It told her that her cancer had spread substantially. What a horrible situation. We had discussions at that time about re-instituting a "hold" period. We decided against it. It was unfortunate for the patient to find out that way, but she has every right to that information, and she signed up for the portal so that she could get her results when she wanted them, not when she could get to the office to pick them up. Your argument about not holding in person requests for a specific period of time is on point, and one that we used in our discussion as well. Ultimately our CEO decided that we will not even put a one hour hold on results, the information belongs to the patient and if we want them to be engaged in their care, we have to be as open as possible and be their partner in their care. We do send progress notes as well as other HIM reports done through either transcription or pDoc. I hope this helps to support you.

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    Kathryn Wood, RHIA
    Assist Dir of Information Systems/Privacy Officer
    War Memorial Hospital
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  • 3.  RE: Reduction of ROI at windows/portal use

    Posted 08-19-2020 09:35
    Edited by Frank Ruelas 08-19-2020 09:35
    This reminds me of some of the discussions that occurred when the Final Rule on completed lab reports was announced.  One of the major concerns was that patients had the right to access completed lab results, including those where for whatever reasons a physician may not have discussed the nature of the results with the patient.

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    Frank Ruelas
    Compliance Professional
    Arizona
    Posted: 6:35 AM AZ time
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  • 4.  RE: Reduction of ROI at windows/portal use

    Posted 08-19-2020 19:08
    My facility is on Epic and we are encouraging patients to use the portal to view information, send record requests via email and obtain records via email. We also closed for a while at the beginning of this but now  have our window open with safety precautions for in person pick up.  A patient can also complete an electronic request form within their portal that will route to an in-basket in Epic ,that is monitored and my team can process  and send records back to the portal in a PDF format or the delivery method requested.

    We currently do not have everything available in our portal. The information that auto releases to our  portal are labs, diagnostic reports, orders, after visit summaries and most scanned documents.  The labs and other reports that auto release has a 48hr hold after final resulted. Most information that does not auto release to the portal can be pushed to the portal in a PDF format upon request.  Due to the volume of requests for COVID-19 results, and to allow patients to obtain their results  in real time after final resulted,  HIM recommended  to disable the 48hr hold for COVID results . HIM is also working to have this for all results, as we to are leveraging the information blocking rule and working with IT and physician leadership. I directly work in HIM with release of information and patients have rights of access to their information. Like others have mentioned here , patients need access to be involved  and engaged in their care.  Physicians and executive leadership will need to understand that blocking and holding information can go against this right and will be costly to organizations who do not comply with the rules.

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    [Lisa ] [Hunter], RHIT, CHPS
    [HIM Operations Manager ]
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  • 5.  RE: Reduction of ROI at windows/portal use

    Posted 08-20-2020 10:04

    We are a Meditech shop too.  We allow 3 days so the provider would have an opportunity to contact the patient. 

    Kenneth






  • 6.  RE: Reduction of ROI at windows/portal use

    Posted 08-20-2020 10:27

    I believe the standard states that we are only allowed to hold results from the portal for 36 hours. We used to have a 34 hour hold in place, so that we knew were inside that 36 hour time limit. However, when we went Live with 6.15 we decided to just send them when available. HIM won't hold results for 36 hours after they are requested, they would fulfill a request as soon as they were able to do so.

     

    Katie Wood, RHIA

    Assistant Director of Information Systems/Privacy Officer

    War Memorial Hospital

    500 Osborn Blvd

    Sault Ste. Marie, MI  47983

    p: 906-635-4663   khwood@wmhos.org

     


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  • 7.  RE: Reduction of ROI at windows/portal use

    Posted 08-20-2020 10:51
    If a patient does not see their labs or what they are needing in the portal and decides to come in person to request, if available we are not holding and providing the records.

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    [Lisa ] [Hunter], RHIT, CHPS
    [HIM Operations Manager ]
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  • 8.  RE: Reduction of ROI at windows/portal use

    Posted 08-20-2020 11:21

    We too are Meditech 6.15.  We also don't hold the results.  They are fulfilled as soon as they are requested. 

    Kenneth

     






  • 9.  RE: Reduction of ROI at windows/portal use

    Posted 08-21-2020 07:47

    When we first implemented a patient portal, we had push-back from our Medical Staff – some wanted a 7 day delay!  I recall presenting stats at a medical staff meeting of how many patients come to HIM or Lab and get copies of their results, plus how quickly they do so – I think it was eye-opening for a lot of the physicians......I remember our CMO at the time, telling the other physicians that they needed to change their conversation somewhat with their patients in the office – tell them "If you have access to our new patient portal, you may see your results before I do, but I will be reviewing them and contact you to discuss results, as needed, just as I have always done."  He also told them that he foresees the time when results will go in immediately because that is what our patients want.  They started out holding test results for 48 hours, now they are going in as soon as they are resulted! 

     

    Wendy Mangin, MS, RHIA

    Director of Corporate Compliance

     

    Good Samaritan 

    520 S. Seventh St. | Vincennes, Indiana | 47591

    Hospital: 812.882.5220 | Direct: 812.885.3487 

    Fax: 812.885.3912 | wmangin@gshvin.org 

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  • 10.  RE: Reduction of ROI at windows/portal use

    Posted 08-21-2020 08:30
    Hi Pamela,

    We also have some delays on certain types of information that flow to our portal depending on the type of information. We also have information that flows over as soon as it is completed. With that said, I would encourage you to look into the new Information Blocking rules that have come out. The delayed release of lab results is listed as an example of Information Blocking. The guidance was clear that delaying the release of records to the patient in order for the provider to see prior was not a valid reason for the delay. Obviously Information Blocking is very complex and there are exceptions, but this topic is definitely a big one for organizations to address.


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    Nyssa Fuhreck, MA, RHIA
    Manager, eHIM Disclosure Management (ROI)
    Allina Health
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