If you’re evaluating ROI vendors for your orthopedic practice, this guide covers the five non-negotiable requirements that separate platforms built for orthopedic workflows from generic medical records systems. Use this framework to validate vendor capabilities before signing a contract.
Orthopedic practices face distinct ROI challenges: mixed packets with 500MB-2GB of imaging per request, 60-70% workers’ comp and legal volume, and outside imaging exceptions that create workflow bottlenecks. Generic medical records platforms treat imaging as an edge case. You need a platform purpose-built for orthopedic release of information.
This reflects our perspective after implementing ROI solutions for orthopedic practices nationwide.
Why Do Orthopedic Practices Need ROI Software?
In orthopedics, a typical release request includes 20-50 pages of clinical documentation and 500MB-2GB of imaging files. MRI series, X-rays, and CT scans aren’t occasional attachments; they’re core deliverables.
Workers’ comp and legal requests, which drive 60-70% of total volume in most orthopedic practices, almost always require both clinical records and imaging.
Traditional manual methods of records release force staff to burn CDs, track imaging delivery in email, or maintain separate workflows outside the platform. This creates three operational failures:
- Audit gaps where clinical records are tracked, but imaging delivery isn’t
- Access permission sprawl to keep releases moving
- Exception tracking that moves to email and spreadsheets with no visibility or accountability
The question is whether imaging retrieval, packaging, and delivery occur within the same workflow as clinical records, with the same audit trail, access controls, and exception handling. If staff have to leave the platform to complete imaging fulfillment, your ROI software isn’t actually solving the workflow.
The IBM Cost of a Data Breach Report (2024) found that healthcare breaches average $9.77 million per incident and take 279 days to identify and contain. Widening access permissions to make things work increases your exposure in ways that are hard to quantify until you’re responding to an investigation.
Why a Live Demo Is the Standard
ROI software is easy to describe and harder to prove. Most vendors can claim audit trails, access controls, and imaging support. The question is whether those controls hold up when a real orthopedic request includes both clinical records and imaging, and exceptions start to pile up.
A live demo is the standard because it shows how the workflow behaves in practice. You can see whether permissions stay scoped, whether evidence is captured end-to-end, and whether exceptions remain visible in the workflow rather than drifting into email and spreadsheets.
Essential Requirements to Validate in Your Demo
These five requirements help you identify the right system for orthopedic practices where imaging is a core deliverable, and releases must stay controlled end-to-end. If a vendor can’t demonstrate these cleanly during a live demo, validate the capabilities through detailed technical discussions.
1. Access Controls and User Administration That Enforce Least Privilege
Multi-site orthopedic groups need site-level permission scoping and immediate user lifecycle management. Without both, you face a choice: widen access so staff can cover multiple locations, or force them to work around the system. Either outcome creates risk.
Site-Level Permission Scoping
Role sprawl happens gradually. A fulfillment specialist needs access to Site B for coverage during vacation. The system only supports coarse roles, so you grant broader permissions temporarily. Six months later, that temporary exception is still active, and you’ve repeated the pattern with five other users. What started as a reasonable workaround becomes permanent exposure.
This pattern of expanding access beyond the minimum necessary is one of the most common compliance gaps in orthopedic ROI workflows.
The platform needs to support roles separated by function: intake, fulfillment, QA, approval, and admin at a minimum, with site-level boundaries that prevent cross-site access by default.
Immediate User Lifecycle Management
User provisioning, role updates, and deprovisioning must be immediate and auditable without requiring vendor assistance. According to AHIMA’s 2023 workforce survey, 66% of health information professionals experienced persistent staffing shortages over the past two years.
Administrative overhead becomes a challenge when you’re managing multiple locations with limited IT staff. Deprovisioning needs to be immediate. This means no end-of-day batch processing and no ticket-dependent processing.
When someone leaves or changes roles, their access should be revoked immediately with verification that it’s actually blocked.
2. Audit Logging That’s Exportable Without Vendor Tickets
Audit controls only help if they’re operational. When you receive an access complaint, breach investigation, or regulatory inquiry, you need evidence quickly.
If log retrieval requires vendor support tickets, your response time becomes vendor-dependent. Fast access log retrieval is especially critical in orthopedics, where workers’ comp and legal requests create heightened scrutiny.
In urgent situations, waiting 3-5 business days for vendor support to run a report isn’t acceptable.
Self-service audit exports need to include user identity, timestamp, request ID, site context, and action type. At a minimum, this should include view, download, export, and print actions. Administrative actions matter as much as operational ones. Role changes, user creation and deletion, and permission updates all need to appear in the audit trail with full context.
When you’re asked, ‘Who had access to this patient’s imaging on this date?’ you should be able to answer immediately without vendor assistance.
3. Imaging Chain of Custody Inside the ROI Workflow
If imaging fulfillment lives outside your release of information platform, you create parallel workflows with weaker audit trails and higher exception volume.
Every time staff handle imaging through email, CD burning, or manual upload to a portal, you lose visibility and increase risk. Orthopedic practices handle imaging in nearly every request. Making imaging a separate process means your team manages two workflows for every release: one for clinical records (tracked in the platform) and one for imaging (tracked informally or not at all).
Imaging delivery needs to appear in the same request record as clinical documentation, with imaging access events logged alongside document access in the same audit trail.
Outside imaging exceptions (studies from referring providers that haven’t arrived yet) need to be structured work items with ownership assignment, aging visibility, and resolution tracking. If your team is tracking outside imaging in free-text notes or email threads, you have no way to measure exception volume, identify patterns, or hold anyone accountable for follow-up.
4. Ensure System Compatibility With Your EHR System
Start with a basic question: Does the platform work cleanly in your environment?
Validate which EHRs are supported, what the integration includes, and what still requires manual steps. In the demo, ask the vendor to show the full flow using realistic orthopedic scenarios, including duplicates, near-matches, missing identifiers, and multi-site patient records. Require them to show what the user sees when matching fails and how the request stays tracked.
Then, validate operational reliability. EHR upgrades, permission changes, and API issues will happen. Ask how failures are detected, who gets notified, what the alert looks like, and what the fallback process is while the issue is resolved.
ChartRequest can provide industry-leading turnaround times by enabling one-click records retrieval from an eligible EHR system based on the request details. This reduces manual steps during fulfillment and helps keep each release within a single controlled workflow, with clear visibility and accountability.
5. Implementation Plan That Defines IT Lift
Easy implementation must be defined in writing with milestones, RACI (responsible, accountable, consulted, informed), and post-go-live ownership spelled out. Otherwise, you accept hidden work that surfaces as tickets and escalations after launch.
The implementation timeline needs specific milestones and deliverables, not aspirational phases.
The RACI needs to be explicit about who:
- Configures roles
- Sets up site scoping
- Builds exception workflows
- Owns integration testing
- Monitors after go-live
Post-launch monitoring and failure handling determine whether IT becomes the permanent intermediary between users and the vendor. You need to know what IT owns versus what the vendor manages before you sign the contract.
Critical Questions to Ask Before It’s Too Late
Most vendor evaluations focus on features and functionality visible in demos. The questions below address what typically surfaces only after implementation. These aren’t deal breakers by themselves, but the vendor’s answers reveal how they’ll perform under real operational pressure.
Performance and Scalability Under Real Load
Demos run in sanitized environments with clean data and light loads. Your orthopedic practice might handle 200 requests per month today, but what happens when you grow to 500 or when workers’ comp deadline rushes bring 80 requests in one week?
Performance degradation doesn’t show up in demos with test data. It surfaces when your fulfillment team is packaging their tenth 2GB imaging study of the day.
Questions to ask:
- What’s your largest orthopedic customer’s monthly request volume, and what does performance look like at that scale?
- How long does it take to retrieve and package a 2GB imaging study during normal operations versus during peak load?
- How does system performance scale when request volume increases significantly?
Understanding Full Costs Beyond Base Pricing
Initial pricing quotes rarely reflect what you will actually spend over time. A vendor might quote a low per request rate, but that number often excludes implementation, training, integration work tied to your environment, and storage costs as imaging volume grows.
You are not just comparing platform fees. You are comparing the total cost of operating ROI, including staff time to retrieve records, fulfill imaging requests, handle exceptions, respond to follow-ups, and manage escalations. That is especially important when you are weighing self-service software against a full-service solution, because two vendors can look similar on pricing while creating very different workload and labor costs for your team.
Questions to ask:
- Beyond the platform fee, what other costs should I budget for? (Implementation, training, integration, storage overages, premium support)
- At our projected volume, what’s the all-in cost per request including platform, storage, and support?
- What’s included in base pricing versus what would incur additional fees?
- If we need to scale up capacity by 50% next year, how does pricing change?
If you want to avoid cost surprises entirely, it is worth evaluating a no cost model designed for orthopedic practices. ChartRequestSelect remains no cost as your practice grows, so higher request volume, new locations, and expanding imaging demand do not force a pricing reset or increase platform fees.
Ongoing Support and Customer Success
Understanding how vendors support customers throughout the relationship helps you set realistic expectations.
Every vendor is responsive during the sales process. The question is whether that continues six months after implementation. Support quality matters most when you actually need it, like when an integration stops working after your EHR upgrade or when imaging studies aren’t packaging correctly.
Response time commitments tell you when to expect an acknowledgment, but first-contact resolution rates tell you whether issues are actually fixed or just acknowledged and escalated.
Questions to ask:
- What’s your average support ticket response time by severity level? Show me data from the past six months.
- How many support tiers do you have, and which tier handles orthopedic-specific issues?
- If an integration requires updates after an EHR upgrade, how quickly can you implement them?
- What’s your first-contact resolution rate for support tickets?
- Do you have a customer success manager assigned to accounts our size, or is support ticket-only?
Ask for actual support metrics from the past six months, and validate the story against real customer feedback, including ChartRequest’s 4.9-star Google rating.
Choosing the Right Orthopedic Software for Release of Information
The right ROI software for orthopedic practices handles imaging requests inside the workflow, enforces least privilege across sites, provides self-service audit evidence, and has a proven implementation track record in orthopedic environments.
When evaluating vendors, remember that easy evaluation predicts easy implementation. If a vendor makes the evaluation process difficult with vague answers, deferred details, or an inability to demonstrate core functionality live, expect similar challenges during implementation.
Conversely, vendors who provide clear evidence upfront and confidently demonstrate their capabilities typically deliver on their promises.
How ChartRequestSelect Addresses Orthopedic ROI Requirements
Our platform was built specifically for release of information workflows in specialty environments like orthopedics, where mixed packets and imaging volume are the norm rather than the exception.
ChartRequestSelect is our no-cost partnership for orthopedic practices, where our ROI experts handle the end-to-end release process. This includes a 5-day turnaround time guarantee for medical, imaging, and billing record requests, double QA to ensure accuracy, and comprehensive compliance coverage for HIPAA, the Cures Act, state statutes, and more.
Here’s how ChartRequestSelect addresses core compliance requirements:
- Access controls: Role-based permissions with site-level scoping and immediate user lifecycle management
- Audit logging: Self-service audit exports with complete user, timestamp, and action data
- Imaging workflow: Clinical documentation and imaging handled in a single workflow with a unified audit trail
- Integration: Direct EHR and PACS integration with proven patient matching logic
- Implementation: Defined milestones, clear RACI, and dedicated support throughout go-live
For eligible orthopedic practices, ChartRequestSelect addresses staffing challenges by letting our team manage ROI while your staff focuses on patient care.
If you’d like to see how we address these requirements in a live orthopedic workflow or learn whether your practice is eligible for ChartRequestSelect, schedule a consultation to walk through it with our team.
