Who Is Accessing Your EHR And From Where?

Why Healthcare Providers Are Taking a Closer Look at ROI Vendors

Healthcare organizations invest heavily in cybersecurity, HIPAA compliance, and patient privacy protections. But as vendor relationships continue to expand, many providers are asking a new question:

Who is actually accessing our EHR systems – and from where?

For hospitals, physician groups, and HIM departments, vendor oversight is no longer just about turnaround times. Increasingly, it is about workforce transparency, PHI access, and understanding where patient information is being handled.

This is especially important in Release of Information (ROI) workflows, where vendors may access highly sensitive protected health information (PHI), including behavioral health records, legal requests, disability forms, reproductive health information, and other confidential patient data.

Offshore Access Is Receiving More Attention

As healthcare outsourcing has expanded, offshore staffing has become more common across administrative support functions. In some cases, healthcare organizations may not realize portions of their EHR-related workflows are being accessed or supported outside the United States through vendors or subcontractors.

Even when these arrangements are technically permitted, many providers are taking a closer look at:

• Who has access to their EHR systems
• Whether subcontractors are involved
• If any PHI is accessed offshore
• How access is monitored and controlled

For healthcare organizations, visibility and transparency matter more than ever.

State Laws Are Beginning to Restrict Offshore Healthcare Data Access

Several states have already passed – or proposed – laws limiting where healthcare data can be stored or accessed.

• Florida Senate Bill 264 requires certain patient records to be stored within the continental U.S., U.S. territories, or Canada, while also restricting some offshore access arrangements.
• Texas Senate Bill 1188 includes healthcare data localization requirements that will require certain Texas patient records to remain physically stored within the United States beginning in 2026.
• Michigan House Bill 4242 proposes similar restrictions requiring electronic medical records to remain in the U.S. or Canada.

Industry guidance is also evolving. According to Medtrade, some states and healthcare contracts are increasingly restricting offshore subcontracting arrangements involving medical billing, claims processing, transcription, analytics, and other functions that may involve PHI access.

Why ROI Workflows Carry Higher Privacy Risk

ROI vendors often handle some of the most sensitive categories of patient information, including behavioral health records, substance use documentation, HIV/AIDS-related information, genetic testing results, and legal disclosures.

Because ROI professionals work directly with highly sensitive patient data, healthcare organizations are increasingly evaluating where that work is performed and who is performing it.

Why Many Providers Are Requiring U.S.-Based ROI Teams

For healthcare providers focused on compliance, privacy, and accountability, fully U.S.-based ROI teams can offer greater transparency and operational control.

Domestic staffing models can provide clearer visibility into:

• Who is accessing records
• Where work is being performed
• How employees are trained and supervised
• How compliance standards are enforced

While offshore operations may be permissible under certain arrangements, many healthcare organizations still view international PHI access as an added risk factor due to concerns around cybersecurity, data governance, and regulatory complexity.

Transparency Matters

Today’s healthcare organizations need more than fast turnaround times from ROI vendors. They need confidence in how patient information is being managed.

• Healthcare providers should understand:
• Who has access to their EHR systems
• Where patient data is being handled
• Whether subcontractors are involved
• How PHI access is monitored and controlled

Because when it comes to protecting patient information, technology is only part of the equation.

Knowing who is accessing the records – and where they are accessing them from – matters too.

RecordQuest

At RecordQuest, we understand the growing pressure healthcare organizations face around compliance, privacy, and third-party risk management. That is why RecordQuest operates with a 100% U.S.-based workforce providing healthcare providers with greater transparency, accountability, and confidence in how sensitive patient information is handled. Our solutions help streamline secure medical record management while maintaining HIPAA compliance and protecting PHI. By partnering with RecordQuest, healthcare organizations can reduce operational complexity, strengthen oversight, and stay focused on what matters most – patient care.