MediConnect, a health care IT software developer, has introduced a cloud platform that allows health insurers to manage workflows regarding reviews of health records, both remotely and on site.
The company specializes in medical record retrieval and health information exchange (HIE) applications.
Announced on Oct. 11, RapidRequest enables health plans to meet government deadlines on the review of health records and evaluations on quality of care, according to Amy Rees Anderson, CEO of MediConnect. "They only have a very limited time to do it," Anderson told eWEEK. "It's quite a process to get these records in and get them on time."
Health plans send nurses and coders to inspect physicians' health records so they can back up data on claims paid.
Through its Web dashboard, RapidRequest can schedule and track appointments to retrieve and review paper health records at doctor's offices. Health plan nurses can view Master Record Locations (MRL), or a list of physician sites where they'll need to examine health records. Patient records are grouped according to MRLs.
In addition, nurses and certified medical coders can view record-reviewing assignments from supervisors in Web-based calendars. Assignments may consist of picking up multiple records from a certain clinic, Anderson said.
Meanwhile, supervisors can track productivity and assign follow-up tasks. Workers can input end-of-day reports with the amount of miles they've traveled. RapidRequest also pulls driving directions from Google Maps.
RapidRequest integrates with the company's RapidReview proprietary and customizable workflow system. RapidReview features a Risk Adjustment Data Validation (RADV) module and compatibility with the Healthcare Effectiveness Data and Information Set (HEDIS), a tool health plans use to measure quality of care.
With just 12 to 15 percent of health records stored in electronic formats, medical records are primarily viewed on paper formats, Anderson said. They're often scanned or copied for the health plan's purposes, she said. Some are transcribed in Word documents, she said.
"The hope would be that as more doctors go on electronic systems, they can spit [data] out of an EHR system, but today where so many of these records are not electronic, they need people to read charts," Anderson said.
Before cloud services such as RapidRequest existed, nurses and coders would track health record reviews in Excel spreadsheets, Anderson said, a practice that brought penalties due to privacy and security problems. The Web-based cloud infrastructure of RapidRequest is more secure, she noted.
"Spreadsheets don't work so well when you're talking hundreds of thousands [of records]," Anderson said.
Because many physicians lack Internet access, nurses often enter data from health records into RapidRequest when they get back to the office, Anderson said. "If a doctor has Internet, they can go in to RapidReview for coding or abstraction," she said.
Health plans will often review records to see when the last time a patient was diagnosed with high blood pressure, or if the plan is tracking the care of pregnant women, it will pull records to see how doctors are treating women that are expecting, Anderson said.