As patient engagement gains momentum, and technology enables easier access to personal health information, many providers still charge patients for copies of their records. That's allowed under HIPAA and HITECH. But is it wise?
At the recent AHIMA convention in Atlanta, Kim Murphy-Abdouch, clinical assistant professor at Texas State University, said it might be time to rethink policies and procedures related to patient access that may be holdovers from a paper-based way of thinking.
Even as "patients are becoming much more aware of their own healthcare, and much more savvy" about managing their health data, "cost could be a barrier to patient access," said Murphy-Abdouch.
Especially, she said, it's important to make a distinction between who is requesting to get ahold of this data – the patients themselves, or third parties such as payers and lawyers?
While it may be perfectly defensible to charge the latter for access, she said, it goes against the spirit of meaningful use to place cost burdens on patients who are seeking to be better engaged in their care.
As it stands today, "what organizations charge patients for their healthcare information is all over the board," said Murphy-Abdouch. "There's a lack of consistency in what patients are charged – from free, to hundreds of dollars."
Under HIPAA, of course, patients have a right to see and obtain their medical records. And the law allows that providers can charge a "reasonable, cost-based fee" for providing either paper or electronic copies of patient records.
And effective this past Sept. 23, patients also have a right to request their information in an electronic form.
As Murphy-Abdouch pointed out, "the fees that can be charged cannot be any greater than the actual cost of labor and supplies to provide the information."
When considering the difference between the labor and supplies needed to print out reams of paper records, and the process of supplying the information online, that would suggest a different cost calculus is needed.
Not only is it the right thing to do to comply with HIPAA and HITECH, she said, but it's the right way to help improve health outcomes by driving engagement.
"As we transition to electronic health records, existing health information management policies and practices must be evaluated to ensure patients are supported in their efforts to access and manage their own information."