The Future of ROI after COVID

By Lauren Forbes, RHIT

There were many adjustments made for processing ROI requests when COVID-19 appeared in 2020. Staff may have been moved partially or fully remote, patient requests became contactless and requesters were not at their physical location and needed records sent electronically instead of mailed.

So, there is a question of keeping the current changes made to the ROI workflow or changing them back to the previous ROI model your facility was using. Does it make sense to go back to the “old way” or is the new process working? There are a few things to consider with the new ROI process when reviewing what the future model should look like.

  • Having ROI staff work remotely.
    • If you moved part or all your staff remotely, review if there have been any delays or if there have been measurable improvements in productivity and efficiency. I have seen improvements in productivity and efficiency with the staff who moved remote.
    • If the remote process is working, evaluate if the efficiency and productivity slow down when brought on site.
    • Having staff work remotely has shown to reduce missed days. This results in steadier turn-around times and production for requests. Compare the attendance and turnaround times during periods of high missed attendance to the same period with remote staffing.
  • Contactless Patient Requests.
    • With the threat of Covid transmission, a lot of facilities have moved to a way of a contactless patient requests for medical records.
    • Verbal requests- Patients can call and verbally request their medical records.
    • Email requests- An email inbox can be set up so patients can send an email to request their records from.
    • Patient portal- Depending on the patient portal set up, patients can request medical records through a patient portal.
    • Website- A list of the various ways patients can request their records without entering a facility should be posted with links and downloadable documents if available.
  • Remote 3rd Party Requesters.
    • The ROI/HIM team are not the only ones who may be remote. A lot of attorneys and insurance companies have moved remote as well. This can pose challenges as well as advantages regarding the release of medical records.
    • If a requester was getting records mailed on paper or CD to their physical location and now they are remote, there can be a few options.
      • Have the requester sign up for electronic delivery portal through ROI vendor if available.
      • Have the requester send an email address to send records via encrypted email.
      • Verify if the requester has electronic fax set up or has been provided information on getting this set up.
    • If the above listed delivery methods are not available, that may fall back on ROI/HIM or the requester. If the requester is unable to set up an alternative delivery method, the records will most likely continue to be mailed as they previously have been. The requester may need to schedule time on site to retrieve the records.
    • Having electronic delivery methods even when/if the requester is back at the physical location has some benefits.
      • Records are received quicker.
      • Records may be able to be downloaded in a searchable PDF format.
      • Reduced costs as shipping costs are removed.

As we reflect on the sudden workflow changes of 2020, we are now able to look back and see that, despite the many challenges, we have also had great successes. When we look to the future of a postCovid world, we are now able to weigh the pros versus cons of remote work and better understand what is best for our teams when handling patient requests.


About the Author

Lauren Forbes, RHIT is the Senior Health Information Operations Manager at Ciox Health. She is an active volunteer on the WHIMA Membership Engagement Team. Lauren can be reached at: