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.'"

Comments

About time but is it enough

[Gim Tom]

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.

Re:About time but is it enough

[Anonymous Coward]

As someone who develops medical records, let me tell you "good luck with that".

As a newcomer to the field (with hundreds of competitors) fighting to carve a space for ourselves we're all for it, after all if you don't like your current system, an open record format makes it easy to import it into our system.

Obviously, the established players aren't so happy with it, but there's one more party who's against it too: the doctors themselves. They don't realize it, but their own actions are fighting this tooth and nail. "Why can't I just dictate everything in a box?" "Why can't i just write it down and scan it in" "I don't want my chart to say Weight can't it just say W"?

TL;DR: the format already exists, it's called PDF.

Re:About time but is it enough

[ColdWetDog]

As a physician involved in this mess (and it's a mess), let me chime in and say that you're partially right and partially wrong (TL;DR - it's complicated).

Yes, lots of health care providers (doctors, nurses and ancillary personell) absolutely hate change. There are doctors who are perfectly happy scribbling down a paragraph of acronyms and abbreviations and calling it a day. Then they get mad at the nurse because she can't figure out just what the hell the doc meant.

Those people need to get put in a closet and only used in emergencies (fat chance). Then there are EHR providers that can't program anything harder than "hello world" without six months of testing. It should be fairly easy, for example, to input weights in pounds and convert it on the fly to kg (or stones or troy ounces for that matter). Instead you have input fields that are rigidly structured, and worse, fail in unspecified ways requiring you to re input the data. Those programmers need to be put in a closet an left there.

The problem with patient data is that you don't know the level of understanding that you are shooting for. Do you dump everything out in Doctor Babble? Do you try to make it read at a 5th grade level? Do both? Something else?

PDF is fine for data output that would be static - not so good if the patient wants the new provider to input it into another system. That's a difficult problem to solve. HL7 was supposed to be the standard that offered a solution to that, but, like most standards, it suffers from implementation problems.

And the new gem:

When individuals pay by cash they can instruct their provider not to share information about their treatment with their health plan.

is going to really jam things up. Now you have to sort data on a whole new metric - who can see it. I predict this isn't going to work out well, although I understand the rationale behind it. I also understand how this is going to be abused - your doctor / healthplan doesn't see the fact that you paid for a script for 150 Vicodan. You'd like some more.... Whatcouldpossiblygowrong.

What's not in the article

[somarilnos]

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.