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Patient Access To Electronic Medical Records Strengthened By New HHS Rules
dstates writes "The Department of Health and Human Services has released newly revised rules for the Health Information Privacy and Accountability Act (HIPAA) to ensure patient access to electronic copies of their electronic medical records. Several years ago, there was a great deal of excitement about personalized health information management (e.g. Microsoft HealthVault and Google Health). Unfortunately, patients found it difficult to obtain their medical records from providers in formats that could easily be imported. Personalized health records were time consuming and difficult to maintain, so these initiatives have not lived up to their expectations (e.g. Google Health has been discontinued). The new rules should address this directly and hopefully will revitalize interest in personal health information management. The new HIPAA rules also greatly strengthen patient privacy, the ability of patients to control who sees their medical information, and increases the penalties for leaking medical records information. 'Much has changed in health care since HIPAA was enacted over fifteen years ago,' said HHS Secretary Kathleen Sebelius. 'The new rule will help protect patient privacy and safeguard patients' health information in an ever expanding digital age.'"
A recent experience in my family made me fully aware of how important immediate access to personal medical records can be and how difficult they can be to obtain at times.
A family member had been hospitalized and surgery was indicated. However, the current CT image showed something that may contraindicate surgery if it was new, but would not do so if it was an artifact of a previous surgery many years before. The only way they could tell was to compare the current image with an image several years old, but after the prior surgery. There was such imaging done at a different hospital about 20 miles away about eight years prior and the doctor learned that they did have the image archived. However, the only way to get the image to him was for someone to drive to the hospital and bring a copy of it back on a CD. I made that trip and the CD showed that the suspicious object on the CT scan was an artifact from a surgery over a decade prior.
This made me realize how important having one's own copy of complete medical records could be. It would be so easy to have them on even a small thumb drive and they could be encrypted for security. The real problem is getting the medical community to give the patient those records in electronic format, and that format should be an open and published format and not in any way proprietary.
One thing it misses - the "Final Rule" part of it implies that this is it. It's not.
The requirements from HITECH come in three stages - and this is the final rule for stage 2. There's an entire additional stage coming to further enhance what hospitals are doing to improve the quality of health care with technology.
Of note, too, hospitals who meet these requirements get additional reimbursement from Medicare (Beaucoup bucks). Those that don't get reduced reimbursement from Medicare. So a lot of these rules aren't entirely mandates, but close enough.
A year or so ago our doctor switched over to electronic records. Now they want $75 per person for us to get a copy of our records as an administrative fee. All they need to do is print the records off of the computer. Minimal labor, minimal cost, not even very many pages. They're just using the fact that they're now electronic records as a means to collect more fees. It is greed on the doctor's part, plain and simple.
One of the things that the UK does right is to allow 'subject access' to all forms of computer held data, with remarkably few 'national security / crime control' cop outs. The fee for the access is £10 - less than US$18 for EVERYTHING they've got on you. Facebook even succumbs - providing a CD when such a request is submitted. This certainly included your records with the National Health Service. It was passed nearly 30 years ago in 1984 http://en.wikipedia.org/wiki/Data_protection_act for the history and later extended to ALL data, not just computer held, when some organisations tried to avoid the issue by NOT computerising the data they were embarrassed to have.
Already accomplishing the task.
Why? Because the French aren't stupid about doing things. Except language. And wines. And cheese.
It's about government access to patient information. Everything else is a sideshow.
"Eve of Destruction", it's not just for old hippies anymore...
"Google Health has been discontinued"
2012 was the Year of the Cloud Going Away. Several major service vendors bailed completely. GoDaddy dropped their cloud service last October, Dell discontinued their Quest Cloud Automation Platform and Harris dropped theirs last February.
On the consumer side, where the contracts are heavily biased towards the vendor, it's worse. Apple dropped MobileMe, and Google dropped a long list of products. Windows Live Mesh shuts down February 13, 2013.
When cloud services die, they tend to die fast. A business which relied on a "cloud" service can be in big trouble. The best case is a frantic effort to get the data off and move to some alternative. Worst case is the data gets lost.
You want to make electronic health records easier for consumers?
1. Set up a standard XML format for records and mandate that all providers must give consumers access to the data in that standard format (other formats are allowed, but the standard format's required). That'd give services and software at least one format they can target for import/export that the patient's guaranteed to be able to get. Make sure the format inclues a "Notes" element that's free-form text, so providers can include stuff that won't fit anywhere else, but require that if the format provides an element for the information that element must be populated with that information (ie. no putting everything in the "Notes" element and leaving the actual XML unpopulated).
2. Mandate that the patient's record be complete. When I go to get my electronic records from my doctor's office, there's two major problems. First, they only include so many records and then cut the record off. I want a copy of all my records that they have, not just the last year's. Second, they don't include certain "sensitive" records. Again, I want a copy of all my records. I'm the patient, by definition I know or should have been told everything in that file. If there's anything in that record that it'd be a problem for me to see, then the problem is that the provider is concealing information from me. If it'd be confusing, the provider should have already discussed it with me so I won't be confused. Omitting sensitive or irrelevant records from a copy sent to another party would be OK but the patient's copy should have complete information for every record the provider has for the patient, without exception or limitation.
Frankly as a patient I'd love a single standard format I could get and maintain myself, so when I went to a new doctor I could just hand them a USB drive or SD card with my complete record on it. It'd make it easier for me too, no more struggling to remember phone numbers of doctors I saw years ago and no more dealing with a doctor I saw ages ago having moved his office and my new doctor can't reach him to get the records.
You'd think /. would be able to get HIPAA right, given they also link to the description of the abbreviation. "Health Insurance Portability and Accountability Act", folks.
The cost has to be the actual cost of making the copy and delivering it to you(postage, for instance) They cannot charge for search, retrieve, or things like transportation from an offsite location. Basically, they can charge for the labor and materials to burn a CDROM or make photocopies.
The sad thing is that those who follow the rules keep the information safe. Hospitals are in the game for the money, just like the pharmaceutical companies. Nothing is free, nothing is sacred, just show me the money. Anything that can benefit the patient is secondary unless some medical graduate can get a grant to further the exploration. If a substance cannot be patented, regardless of the lives saved or at least relieved, it has no merit.
The mind conceives, the body achieves, the spirit manifests.
fuck obamacare
fuck hospitals
fuck big pharma
fuck psychiatrists
fuck your lists
It's an Electronic Civil War
just last week I hear a Kaiser laptop went out unencrypted.
FUCK YOU!