“I did it myself first and I’m in the [Washington] DC area, not
dealing with rural hospitals, but major hospitals. I called four of the
many [hospitals] I’ve interacted with and got four sets of answers.
Some departments charged a quarter a page [for health record cop-ies], or 50 cents per page, or $1.43 per page. I get that there’s a cost
to this. My father was a physician. I understand that in small pediatrics practices that someone has to stop working at the front desk
to make copies. I just don’t think that the costs should fall on the
patient or caregiver who’s already paid their insurance premium
and paid their copays. It’s like going back to the same well three
times,” O’Boyle says.
Complicating matters, there was no uniformity in providers’
procedures for obtaining health records, or simply how they referred to their health information management (HIM) departments. “Generally, the staff in the medical records departments
are polite and informative. Unfortunately, they do not create
the policies for the retrieval of medical records or determine the
cost that goes along with it, so I imagine that they hear the frustrations of the patients and caregivers,” O’Boyle says.
She notes that this time-consuming process is especially
fraught for parents of children whose care is an all-consuming
task in its own right. “Truly our families have a hard time getting a shower. You cannot leave your child in front of a television. Somebody has to be watching them. It’s just not feasible
for them to give up hours to chase down records,” O’Boyle says.
Fortunately, the Phelan-McDermid Syndrome Foundation
received funding in 2013 through an award from the Patient-
Centered Outcomes Research Institute (PCORI) to collect
patient medical records and incorporate them with existing
parent-reported data from the registry as part of the Phelan-
McDermid Syndrome Data Network. This allowed the foun-
dation to outsource the collection of medical records to a
third-party organization. That organization would request
all the records, track all the consents, and then upload the
records to a database. This help came after the Phelan-Mc-
Dermid Syndrome Foundation had some families do a beta
test of sorts by trying to get all the needed documentation
from patient portals.
While the portals should have simplified things, this also
turned out to be far more complicated than they first thought,
especially since parents were requesting information for children who were over the age of 12 or 13—the age at which, in
some practices, the portals are turned over to the patient’s
control. Teenagers with Phelan-McDermid Syndrome, however, are unable to provide verbal or written consent allowing
their parents to see everything in their portal. So in addition
to requesting records, the parents were also asked to provide
documentation of their child’s intellectual disability before
they could acquire the records they needed. Even without this
barrier, portals generally do not provide the data that families
and researchers truly need in rare diseases. They need access
to the actual notes, the “story,” not just the vital signs and labs.
4-Part Packaged Program
Clinical Data Quality Continuum of Services
Promotes and improves clinical documentation
Yields correct and accurate coding,
aligned with CDI
Ensures that respective cases are clean
and billed timely
Defends and reduces third party denials from
a coding and clinical perspective
Ramon J. Rodriguez, President & CEO, Wyckoff Heights Medical Center
Pena4’s team provided Clinical Documentation Improvement services that included staffing,
management, education, and analytics that yielded improved physician documentation,
quality and ultimately revenue for Wyckoff Heights Medical Center.
www.pena4.com l firstname.lastname@example.org