Study: Barriers Remain Between Patients and Copies of their Medical Records

While healthcare providers and health information management (HIM) professionals work diligently to comply with HIPAA and respond fully when patients request copies of their medical records, patients are still experiencing barriers to accessing their records, a new study finds. The study, from researchers at Yale University, was published last week in the Journal of the American Medical Association Network Open.

The objective of the study was to evaluate the current state of medical records request processes of US hospitals in terms of compliance with federal and state regulations and ease of patient access. To do this, the Yale researchers reached out to 83 top-ranked hospitals in the US with independent medical records request processes and medical records departments reachable by telephone. Then, researchers collected medical records release authorization forms and subsequently telephoned each hospital’s medical records department to collect data on requestable information, formats of release, costs, and processing times.

According to the findings, 53 percent of hospitals offered the option of giving patients their entire record. They also found discrepancies between the information hospitals were able to provide over the phone, compared with what their release forms said in terms of the possible format in which patients could request their records be released.

What’s more, 58 percent of the hospitals surveyed had fees above the federally recommended $6.50 for medical records stored in digital formats. For example, for a 200-page record the cost of release as communicated in telephone calls ranged from $0 to $541.50. Of the 82 hospitals that disclosed costs, 48 hospitals stated costs of release above the federal recommendation of a $6.50 flat fee for electronically maintained records. Of the 29 hospitals that disclosed costs of release on their authorization form, nine hospitals (31 percent) had the same fee schedule as that disclosed in the telephone calls, 10 (34 percent) had a less expensive fee schedule, three (10 percent) had a more expensive fee schedule, and seven (24 percent) released records free of charge.

“Our results revealed inconsistencies in information provided by medical records authorization forms and by medical records departments in select US hospitals, as well as potentially unaffordable costs and processing times that were not compliant with federal regulations,” investigators wrote. “As legislation, including the recent 21st Century Cures Act, and government-wide initiatives like MyHealthEData continue to stipulate improvements in patient access to medical records, attention to the most obvious barriers should be paramount.”

AHIMA has worked to help providers streamline their release of information (ROI) processes with the development last year of its Patient Request for Health Information form. The AHIMA-developed form is meant to be used as a template that providers can tweak to meet their needs, and then given to patients or their designated personal representative when they’ve requested access to their health records. This fall, AHIMA also participated in the development of the Health Record Request Wizard prototype tool. This tool is a digital app that can be used by HIM professionals to change workflow processing for consumer-generated information requests. The Wizard app builds on the work AHIMA did with the model form and is also designed to help individuals obtain and organize electronic formats of their medical records in a secure location.

“The Wizard is a digital ‘smart form’ that uses branch logic and skip patterns to help consumers articulate what they need, in what format and by when,” a press release for the app states. “It results in a highly specific, HIPAA-compliant document delivered to the health care provider’s medical records specialist.”

Mary Butler is the associate editor at Journal of AHIMA.

2 Comments

  1. Mary, I suggest a deeper dive into what you refer to as “suggested rate.” I believe the rate of $6.50 refers to those hospitals that have not done a study to determine a cost-based charge. Those healthcare systems that have a cost-based charge can, under the law, charge that fee.

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    • I agree that providers have various charging methods available. The flat rate of $6.50 is one option. Providers can also charge actual costs or average costs. State laws also must be considered when determining the charging method.

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