As the volume of healthcare data grows, so does the need for HIPAA-compliant methods to protect sensitive information while maintaining accessibility at the point of need. To effectively manage healthcare processes and leverage resulting structured and unstructured data, hospitals need technology to facilitate the secure exchange of health information and communication among fellow providers, patients and insurers. Technology is needed to encompass all forms of data – voice, fax, image data and electronic documents – and provide seamless exchange while securing protected health information in the process.
Following are four keys for an effective platform to manage health data and communication.
1. Electronic import, delivery and tracking
Paper-based documentation processes are time-consuming and error prone, presenting risks for data loss and security breach. It also consumes resources with manual efforts to fax, print, route and scan paper records. Technology platforms that facilitate secure electronic exchange allow providers to share protected health data in a manner that saves time, reduces cost and eliminates waste.
In the area of medical claims documentation, health information exchange facilitates the secure electronic exchange of patient medical records between providers and health plans. Any documentation required by a payer to adjudicate a claim can be captured, indexed to the patient and securely transmitted to the requesting party. This gives hospitals the ability to respond more quickly to time-sensitive audit documentation requests, such as prior authorization reviews and pre- and post-payment claims audits.
Records are delivered and tracked through CONNECT gateway standards, the open source health information exchange software that serves as the electronic submission of medical documentation (esMD) transmission mode for the National Health Information Network (NwHIN). Delivery tracking ensures that records are received within specified time frames, improving the timeliness of responses to documentation requests for RAC and MAC claims and audit reviews.
With an electronic solution, providers can quickly transmit an unlimited number of records, delivering them in a secure encrypted format. Patient records can be captured from any source – paper, medical record, image, file import or mobile device – and placed in an electronic envelope for secure delivery. This allows providers to combine data such as x-rays, charts, EOBs and narratives from a variety of sources to support documentation requests. The health plan can then simultaneously review the electronic medical claim and supporting documentation in one location.
2. Comprehensive capture and management
A successful information and communication exchange platform must have the ability to capture and manage the full spectrum of available patient data. While a portion of patient data is documented in the electronic record, a significant amount resides in outside sources such as ancillary systems, paper files and verbal exchanges. The ability to capture and tie this information to the patient record closes gaps in documentation and provides a comprehensive view of processes across the continuum.
Software is now available to capture any type of exchange – be it voice, fax or electronic – and store it in a central location for immediate viewing, processing and retrieval. These solutions allow providers to document interactions, such as phone calls, faxes, Web visits – even face-to-face conversations – for a more complete picture of the patient’s path across the health system.
While a significant number of health systems already record phone calls with patients, the ability to integrate these recordings to the patient record is uncharted territory for many. Recordings of phone calls and face-to-face conversations can now be indexed to the patient account and combined with fax and electronic record for a more inclusive view of patient information exchanged across the continuum. This digital audit trail of the patient’s experience provides valuable intelligence to ensure accuracy and consistency across departments, promote quality assurance and improve performance for the health system.
3. Secure cloud storage and retrieval
HIPAA-compliant document and data storage is a must for an effective health information exchange platform. Hospitals need convenient access to data while ensuring that PHI is exchanged in a HIPAA-compliant manner.
With cloud-based storage, providers can remotely store patient health data, eliminating the need for paper files and on-site storage. A secure, encrypted connection ensures that PHI is protected while facilitating data access and exchange through any approved device.
Methods are also available to safely transmit sensitive documents through secure links. Links can be secured with passcodes and expiration time frames to limit data accessibility. These safeguards ensure that information is protected when sharing files with referring providers, payers or patients.
4. Single platform for data management
With technology now available to capture, store and exchange all sources of available patient data, providers are within reach of a patient record that is truly comprehensive and fully accessible across the enterprise. By combining disparate data sources into a single, secure and integrated repository, providers can close gaps in documentation for a complete view of information exchanged across the continuum.
The benefits of a single repository for patient data are far reaching. A central access point resolves countless workflow and care coordination challenges, ensuring that relevant patient information is immediately available at the point of need. Processes are supported with tools that automatically and securely share records between systems and team members, tracking access points along the way.
Technology that facilitates secure exchange and management of patient health data is critical for providers to effectively manage the volume and complexity of information now surrounding patient care. Real-time access to this information fosters a more efficient work environment, better collaboration among teams and improved service to the organization’s key stakeholders. The effort to capture and centralize data around the patient is one worth making as the industry moves closer toward a comprehensive and fully-accessible electronic patient record.
Lindy Benton is CEO and president of MEA | NEA | TWSG, which lead the industry in providing secure electronic healthcare communication and health information exchange solutions for payers, medical and dental providers and other agents.