Maintaining complete medical records is essential to coordinate patient care and most physicians rely on medical transcription services to ensure accurate and timely clinical reporting in electronic health records (EHRs). An accurate written record is also important because with digitization, physicians can share patient information with other health care providers involved in the patient’s care. Sharing patient data means two things: sharing this data across healthcare settings or EHR interoperability and giving patients access to their EHR. Federal law supports greater patient access to healthcare records and the sharing of such records across health networks. Communicating health care data can improve patient care but there are challenges to overcome. Importantly, physicians need to understand their obligations for patient record sharing.
The benefits of providing patients access to their own healthcare records are:
- Improves patient engagement and involvement in their own care, which enhances the overall health care experience
- Patients can use the patient portal to send and receive messages, get answers to questions, and fix appointments
- They can check prescription information and request refills online
- They can access their records from their devices any where and at any time
- Patients can fill out pre-visit forms on the system, making the process smoother and hassle free
- Being able to view their health summary before their visit will ensure that they are better prepared
- Appointment scheduling and follow-up are easy to manage through the portal.
A recent Pew Research survey found that patients do want access to their healthcare data. The survey found that Americans are aware about the importance of getting access to their own health data and sharing it with their clinicians. Some key findings of the survey:
- 61% of adults said they would be comfortable with downloading their records to applications on mobile devices to help them manage their own health.
- Up to 81% of adults said they would support allowing different health care providers to share their patients’ EHR data when they are providing care for the same patient.
- A majority expressed concerns about privacy when informed that when downloaded to an app, their health care data would not be protected by federal laws such as HIPAA.
So, what are the barriers associated with patient EHR access? The problems range from high fees to outdated formats for information and state regulations.
High fees are a barrier to patients’ access to their medical records. While HIPAA laws require healthcare organizations to allow patients to access their own healthcare records in a timely, affordable way, a report released by the U.S. Government Accountability Office (GAO) in 2018 found that costs and state regulations surrounding access pose formidable challenges to this. The report, which was based on interviews with patient advocates and other stakeholders, noted the following concerns relating to costs of accessing medical records in different states:
- Charges for per-page for records requests
- Additional rates for X-ray and MRI image requests
- Additional fees for third-party record requests, such as for a patient’s lawyer
- High fees when records are requested in a healthcare emergency
Some patients cancelled their requests for access to their records when they were informed about the potential costs associated it.
Other problems, according to a recent Healthcare IT include: records not sent within the required 30-day period, records not shared in the requested digital format, refusal to send images, and not accepting requests by email or fax (as required by HIPAA).
Many healthcare organizations not aware about federal transparency law, according to a study by Accenture. The study revealed that more than half of technology executives in leading healthcare organizations in the US are only “somewhat familiar” with the federal law that requires providing greater patient access to healthcare records and the sharing of these records across health networks.
“Our survey findings are a wake-up call for health organizations and agencies that remain relatively uninformed about the regulations, or who are not actively preparing. Complying with the regulations will provide them with a major opportunity to enhance the services they provide and to fundamentally improve consumer engagement in their healthcare,” says Andy Truscott, managing director and technology consulting lead in Accenture’s Health practice and a member of U.S. federal government advisory groups on health IT and Health Level Seven (www.managedhealthcareexecutive.com).
The American Medical Association (AMA) recognizes that physician offices can find it difficult to navigate complex federal and state laws on allowing patients the right to access their medical records electronically. The AMA’s new Patient Records Electronic Access Playbook is focused on easing these concerns. A recent article published by the AMA provides 10 things that practices need to know about patients access to their records:
- Patients have the authority to view/obtain a copy of their medical and billing information.
- There are HIPAA fee limitations for patient records requests.
- Patients can obtain copies of their medical information through means other than patient portals.
- Patients have to fill out a request form for a copy of medical information.
- A patient’s access cannot be denied on the grounds that the practice thinks it is not in their best interest.
- Medical records can be sent to patients through unencrypted email if they are warned of the risk of unauthorized access in transit.
- A HIPAA-compliant authorization form is required for a request comes from a third party and does not appear that it is at the patient’s direction. If the practice is unsure whether a third-party request is at the patient’s direction or not, the patient may be contacted to confirm the matter.
- The patient has the right to request the practice to provide a copy of their medical record to a third party.
When patients request their record, the practice should try to inform them and their caregivers when the record request was received and, if possible, provide an estimated timeline for when they can expect to receive the records. The AMA also recommends allowing patients to flag emergency requests.
- As patients who are sick may ask family/caregivers to help them access their records, practices should try to work with these caregivers to provide access in accordance with the patient’s wishes.
As health records are shared with patients and with their health care providers, US based medical transcription companies have a key role in ensuring that the records are completed accurately and in a timely manner.