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Can Outsourcing The Medical Information Management Function
Improve Your Client Service?

By Elizabeth B. Juliano and Dean F. Slejko

Your firm has been retained to handle litigation involving hundreds of cases in which medical issues are pivotal to the plaintiffs' allegations.As lead counsel in this multi-state litigation, you assemble a team from several of your firm's offices and begin work.

As the litigation progresses, you find that managing the medical information presents a number of challenges:

  • Boxes of records, in no apparent order or organization, are arriving daily.How should the records be organized so that they can be analyzed efficiently, even when additional records arrive three weeks later?

  • Many additional health care providers are identified in the records.Which providers have been contacted, which ones have responded, and how many records are still outstanding?

  • You and your client assign case priorities, with many of the highest priority cases having milestone dates near each other.How can progress be tracked across all cases so that milestones are met?

  • Your team begins to recognize recurring fact patterns among plaintiffs in the litigation.How can statistics across the entire plaintiff population be gathered to easily examine trends or anomalies?

  • Your client has to present a status report on the litigation to management later today and asks for your help.How quickly can meaningful information be gathered that will fulfill your client's request?

Your team meets all of these challenges, but you wonder if retaining a medical information management (MIM) service provider might be a better solution. If you outsource the MIM function, can the service provider help you better serve your client?

MIM Service Provider Essentials

A MIM service provider can help you with client service in three significant ways:

  • Handle the day-to-day challenges involved in the collection and analysis of medical records;
  • Provide tools that help you understand the medical issues of the litigation, prepare each plaintiff's case for discovery and trial, and communicate the medical picture throughout your firm, to your client, and to local counsel; and
  • Provide the ability to see the litigation as a whole in order to monitor trends, prioritize cases, and project costs.

Handling Day-to-Day Challenges

Your MIM service provider should have the organization, processes and procedures in place to:

  • Efficiently follow up with providers who don't respond to requests for records
  • Quickly track down new providers that were not previously identified and who may have critical information regarding the plaintiff
  • Deal with provider pre-payment or other special requirements to locate, copy, and mail records
  • Monitor which records have been received, those that are still outstanding, and receipt (or not) of "No Records Statements"
  • Keep the review process flowing, even though the records arrive in bunches over the course of weeks, and sometimes months
  • Update sections of the reports as new records arrive and identify those sections that have been updated so you don't waste time re-reading the report to learn what has changed
  • Automatically and continually communicate the record collection and analysis status of each case so that you are informed of progress

These are details that require significant follow-up and maintenance time and effort.When they are handled in a way that is transparent to you and your client, it allows you to focus on client service activities such as evaluating the medical record findings, monitoring trends, developing strategy and communicating this information to your client.

Tools That Improve Your Client Service

Not only should a MIM service provider relieve you of these detail-oriented tasks, but they should also give you the means for providing the advocacy that your client expects from outside counsel.Consider some of the other tools and services that a MIM service provider can offer and how they can help improve your client service:

  • A secure web site that gives you continuous access to all case-related information including scanned records, work products, status reports, and other litigation-related documents you wish to store.You and your partners access the same database of records and reports so that everyone sees the same information.Your client notices the excellent coordination among members of your team and attributes it to your leadership skills.

  • Customized types and styles of medical analysis work products that conform to the needs of the litigation as well as your personal preferences for information display.Members of your team can quickly familiarize themselves with a case since the reports all have the same format.Your client sees how quickly your team has moved up the learning curve regarding this litigation.

  • Chronological charts of pertinent key words or phrases identified in each plaintiff's records. Keywording facilitates use of the summary by promoting the ability to reference specific information quickly.You determine the type of information which is critical to the evaluation of the case, and by identifying these keywords, you can review the information at a glance to evaluate the relevance to the case.

  • Medical analysis work products that contain embedded hyperlinks that allow you to directly access and view imaged records as they are referenced in the report.You spend less time searching for the source documents and more time preparing the defense of cases.

  • On-line split-screen viewing capability that allows you to view medical analyses on the left side of your computer screen, and the records on the right side, a welcome change from balancing a report on one knee and a pile of records on the other.The combination of hyperlinked records and split-screen format makes your team more productive, enabling you to keep on top of the growing caseload.Your client sees that your team is meeting all deadlines.

  • The ability to easily download work products and the linked records to your laptop computer.Your team doesn't have to lug around file folders full of reports and records when conducting depositions in remote locations. Further, your team can work in various locations, i.e., on airplanes, without risking others viewing sensitive documents.

  • Case sorting functionality to quickly examine the litigation by parameters you select, such as plaintiff name, diagnosis, counsel, assigned priority, deadline date, or venue.Your client comes to realize that you have everything under control, and now calls mainly to discuss litigation strategy.

  • Communication through a single point of contact that keeps you apprised of all the medical-related activities in the litigation.Your client is confident of your grasp of the medical issues.

  • Established budgets for the services provided, helping you to manage litigation costs.You know there will be no surprises when the invoice for MIM services arrives.Your client's Legal Finance Department acknowledges that litigation expenses are at or below budgeted levels.

Providing a Global View of the Litigation Medically driven litigation can involve enormous amounts of information of various types including:

  • Pleadings
  • Medical records
  • Employment, social security, educational, and worksite records
  • Deposition transcripts (both historical and current)
  • Expert witness reports and CV's
  • Product or project files and related documents
  • Briefs, motions and court orders
  • Attorney work products

Since information developed early in the life of the litigation remains critical to the defense as the tort matures, you need to be able to easily access and analyze all of this historical data across all cases and throughout all phases of the litigation.

In addition to handling the medical information, your MIM service provider should offer the technology to conveniently store, view, and disseminate this critical information.The added capability to create your own custom compilation reports can help you examine statistics, monitor trends, prioritize cases, and project costs.Now, when your client calls requesting information, you can respond quickly with current information in the format your client requests.

Client Service from Behind The Scenes

There are obviously many attributes that go into providing top-notch client service, but the MIM service provider can play a critical behind-the-scenes role in medically driven litigation.The three critical items to expect from your MIM service provider are the handling of day-to-day challenges in the collection and analysis of medical records, the tools and services that help you understand and communicate the medical issues of the litigation to your client, and the technology to provide a global view of the litigation.

When your client calls with a new assignment, either mass tort litigation or a single case, consider the support a MIM service provider can offer.It may raise your client service, and your client's ultimate satisfaction, to an even higher level.

About the Authors

Elizabeth B. Juliano is the founder and President of Litigation Management, Inc.She may be contacted via email at ebj@medicineforthedefense.com or by telephone at 1.800.778.5424.

Dean F. Slejko is the Director of Business Development at LMI.He may be contacted via email at dfs@medicineforthedefense.com or by telephone at 1.800.778.5424.

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