Initiatives such as the “meaningful use” EHR Incentive Program, HITECH-HIPAA, and other patient-centered care efforts, were intended, in part, to help patients gain access to their own health information. The patient portal component of an EHR, where patients can view and request their files is growing, and these programs aim to keep the cost burdens of doing so low. But due to a patchwork of state statutes, facility-by-facility policies, and federal laws, the cost of requesting documents—even factoring in patient portals—is not consistent nationwide, according to a research study published in Perspectives in Health Information Management, and authored by Kim Murphy-Abdouch, MPH, RHIA, FACHE.
State of the Union
To get a handle on how individual organizations are responding to competing requirements, Murphy and the AHIMA Foundation conducted an anonymous survey of AHIMA members. The 313 respondents were asked about EHR utilization, patient portal availability and utilization, provision of paper and/or electronic copies of records, charges for providing paper and electronic copies, use of software for the release-of-information function, and contracts with vendors for the release-of-information function. They found that:
- 52.6% of respondents charge patients for electronic copies of their medical records, while 64.7% reported that they charge patients for paper copies of their medical records
- Fees for electronic copies ranged from a flat fee for a device to per-page fees or some combination of the two. 23.6% of respondents said they follow their state’s rates, which is out of compliance with HIPAA-HITECH, which says patients can only be charged a “reasonable cost-based fee” for copies of their medical records.
The survey saw the highest response rates from acute care settings, integrated delivery systems, and clinics. The survey was sent to people with HIM-related job titles including HIM director and privacy officer.
The “meaningful use” EHR Incentive Program pushes participants to create online portals where patients can access their information online. And with the adoption of portals, the rate of requests for information is expected to drop. But even with wide portal adoption, patient utilization rates are low. Almost 50% of the healthcare organizations with a patient portal reported that less than 5% of their patients use the portal, according to the survey.
More Work To Do
Not only is there variation in how patients are charged for their information, there also is variation in how long they have to wait after a request. Meaningful use criteria requires healthcare organizations to offer patients ready access to their information via a portal and within four days of a request for information. HIPAA allows up to 30 days to respond to a patient’s request, and state statutes vary from 15 to 30 days.
The Role of HIM
Murphy-Abdouch and her investigators concluded that health information management (HIM) professionals are well-positioned to break down barriers to patient information. They can help by:
- Discussing with patients the benefits of portal use
- Authenticating a patient’s identity
- Teaching patients how to use a portal to access secure information
- For patients who choose not to use an online portal, HIM can supply them with a pertinent record set to give patients upon request. This pertinent record set could include summaries of care, laboratory tests, and radiology results and could serve as the starting point for giving patients access to their personal health information, the study explains.
Healthcare at a Crossroads
AHIMA has long advocated that healthcare organizations and their release of information vendors remove or reduce costs associated with obtaining health information. “The healthcare industry is at a crossroad of converging technology and regulations influencing patients’ access to their personal health information…The time is opportune for HIM professionals to evaluate their policies and procedures to ensure that patient access is provided in secure and patient-friendly ways,” Murphy-Abdouch concluded.
Click here to read the full report in Perspectives in Health Information Management.