Personal Health Records
How are patients going to get “timely access” to their records?
By Brad Rourke, CPA
Last year, the Obama administration's stimulus plan legislation began fast-tracking initiatives and incentives for the adoption of electronic health records (EHRs) to reduce healthcare costs and improve coordination of care, among other objectives.
At the base of the subject is “meaningful use” and certification for same. Notes David Blumenthal, MD, MPP, former national coordinator for the Health Information Technology (HIT) Policy Committee, U.S. Department of Health and Human Services (HHS), “We will only compensate providers if they're using certified records in a meaningful way.”
Some people don't want to maintain a personal record of their health information and some wouldn't mind doing it, if it's relatively easy. One option is to register for a Microsoft HealthVault Account.
ARE THEY EASY?
Registration is easy. If you already have a Hotmail/Windows Live ID account, creating a HealthVault account is a snap. If you don't, just open one. Then, visit https://account.healthvault.com/, sign in, enter your hotmail account and password, and, voila, you'll have your own PHR—Personal Health Record—in a matter of seconds.
It will be a completely empty PHR, but nonetheless your own PHR, which you can share by selecting “share” and submitting an email address. That individual will be sent an email with an embedded link to your PHR profile. Microsoft keeps a log of who has accessed a PHR, so you can view those who have accessed the profile.
44,000 MEANINGFUL USE INCENTIVES
What does all this mean to you as a healthcare provider? The answer is simple: incentive money.
There are 25 Stage 1 Meaningful Use Standards that encompass the Health & Human Services Electronic Health Record Program whereby doctors can obtain up to $44,000 for adopting and using a certified EHR. One of the HHS 25 standards requires that doctors provide “timely patient access” to patient health information. Specifically, the meaningful use standard is: “Provide patients with an electronic copy of their health information (including diagnostics test results, problem list, medication lists, and medication allergies) upon request.”
TAXPAYER BENEFIT OBJECTIVES
The February 2009, $787 billion American Recovery & Reinvestment Act (ARRA) stimulus monies include $19 billion earmarked for incentivizing doctors to adopt Electronic Health Records. It set out two specific taxpayer benefit objectives for these EHR monies to reduce Medicare/Medicaid costs.
■ EFFICIENCY. Improve the efficiency of healthcare delivery.
■ HEALTH. Improve the health of all Americans.
This begs the question: Can the requirement of providing patients with their health information help meet these two objectives?
It's easy to see how they can. Faster and more convenient access to information will always improve the probability of better decision outcomes. And how can convenient access to health information hurt?
As evidenced in the sidebar above that features the example of Hurricane Katrina, the bottom-line benefit of PHRs is clear: A Personal Health Record preserves a patient's medical history online when the paper records are destroyed.
MY OWN PHR
I'm now in the process of populating my own Microsoft Healthvault PHR. I called my MD and asked if the clinic could upload my personal health information to my PHR, but they could not. Fortunately, Practice Director Version 4.0, which is ONC-ATCB Certified (and was created by Practice Director, the EHR vendor for whom I work), has the ability to upload patient clinical information to PHRs. I attached a copy of my latest chart and lab blood work to my PHR.
A few other features of my PHR include: sections for insurance information, /archive/2011/October/images/documents (max 10.0MB), contacts, immunizations, allergies, medications, and more.
I'm going to appreciate the value of being able to access, and provide others timely access, to my health information. Who knows, maybe someday it will save my life. EB
Brad Rourke is vice president of Practice Director, a division of Williams Group, Lincoln, Neb.
INFO: practicedirector.com
| DOCTOR Q & A |
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MY RESPONSIBILITYQ As a doctor using an EHR, am I required to send patient health information to my patients' PHR?A The following are the basic meaningful use rules: • ELECTRONIC … Providers must provide patients an electronic copy of their health information upon request (as stated to the right). • TIME LIMIT … The provision must be accomplished within three business days of the patient request. • FORMATS … Providers are expected to make reasonable accommodations for patient preference of the format in which they request to receive the health information. If a patient requests to have an electronic copy of their health information in a specified electronic media such as CD, USB thumb drive, or PHR, it would seem that the doctor is required to accommodate the patient requests in any of these formats. CHARGING PATIENTSQ Can doctors charge their patients for providing them with the health information?A Here's what the Final Rule on the Electronic Health Record Program has to say about this: “We do not have the authority under the ARRA HITECH Act to regulate fees in this manner. Rather, the charging of fees for this information is governed by the HIPAA Privacy Rule which only permits HIPAA-covered entities to charge an individual a reasonable cost-based fee for a copy of the individual's health information.” So the upshot is that you can charge a fee, but it better not be too much. |
| HURRICANE KATRINA |
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| Physician leader Archelle Georgiou, MD, states on the Healthcare Leadership Forum that “Personal healthcare records save time and lives.” She went on to write, “ … In the aftermath of Hurricane Katrina, physicians like Doug Henly, MD, executive vice president of the American Academy of Physicians, reflected on how Personal Health Records could have helped victims who were injured or displaced.” According to Henley, “Then, whether they ended up in Houston or Baton Rouge or God knows where, they would have had that information with them, and any physician or hospital could have seen their past medical histories.” |
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