Providers Prep for a New Age of Patient Record Access

HIStalk follows up its coverage of OCR’s new HIPAA guidance with a look at provider reaction and preparation.
By @JennHIStalk

OCR’s new HIPAA guidance has the industry on high alert. The office’s clarifications on reasonable fees, timeliness, and a patient’s right to electronically transmit their health data to third parties have many providers and their release of information (ROI) vendors rethinking workflows and technology needs – all in the name of ensuring that patient medical records requests are handled in a timely and cost-effective manner.

As OCR Deputy Director for Health Information Privacy Deven McGraw explained in a previous HIStalk article, “People shouldn’t put their heads in the sand about this. We’re quite serious.”

OCR has made its case clearly and is making an effort to help providers understand their role in helping to empower patients with the ability to access their health data in a non-burdensome manner. But are providers listening? Are they – and their ROI vendors – ready for this new age of patient medical-record access?

Huge Culture Change

HIM leaders at Oakland Regional Hospital (MI) and Piedmont Healthcare (GA) have been keeping a close eye on OCR’s HIPAA updates, working in tandem with their ROI vendors to ensure compliance with minimum disruption to patient care.

“Some providers are a bit skeptical with the move towards more patient involvement and control over their health record,” says Stephanie Tatum, director of health information and informatics management at Oakland Regional, a multi-site health system that focuses on hand, joint, orthopedic, and sports medicine. “I believe it’s a huge culture change that providers are having to adapt to. The younger generation of providers view this movement as a positive for the patients because it allows them to feel more involved. On the other hand, other providers believe patients will become overwhelmed with the amount of information that is available to them.”

Oakland Regional’s ROI vendor, Bactes, has already made changes to its records request process to maintain compliance with the updated guidance. “Our facility follows the guidelines of our ROI vendor, so our workflows will remain the same at this time. [Bactes] does a really good job of processing the requests in a timely manner, and they also provide great statistical reports that allow us to track the number of requests as well as the type of requests processed over time.”

Tatum adds that while Bactes — a Sharecare subsidiary that made news a few years ago for overcharging patients for copies of their medical records — is working to bring its clients up to speed with HIPAA, the ROI vendor community as a whole is not necessarily ecstatic about the changes, especially with regard to the transition to more reasonable fees. “I have heard that the updated OCR guidance will cause some vendors to lose money on processing requests, so it’s being viewed as a negative.”

Gaining Clarity into New Fees

Piedmont’s ROI vendor, Healthport, also made similar news several years ago for overcharging. The Atlanta-based company, which acquired medical record retrieval company ECS last September, is working diligently with Piedmont to ensure its compliance as the health system begins to roll out patient medical record access through its Epic MyChart patient portal.

Pamella Marshall, senior director of HIM at Piedmont, did a little digging into the difference between the state of Georgia’s take on record access fees and OCR’s guidance, ultimately contacting Healthport for clarification. “They came back and had actually reduced their per-page fee and eliminated the retrieval fee that was allowed by the state. They also eliminated the certification fee.”

Marshall isn’t so sure that reducing or eliminating fees will empower patients to go after their records more than they already are, given that requests are “usually made as a follow-up to care. But I do know that the change in copy fees will make a difference for everybody.”

Satisfaction Scores will Benefit

Piedmont has been working on making medical records access easier even before OCR released its latest clarifications. Access via patient portal will be key. “I suspect we’ll probably have the complete patient medical record access feature up and running by the end of this fiscal year … maybe by the end of the third quarter. We are about to upgrade to the 2015 version of Epic, and so everyone is tied up with that.”

Marshall adds that the patient portal strategy will be a win not only for patients, but for Piedmont’s patient satisfaction scores, too. “One of the things I’m looking at is adding not only the ability to release the entire record through MyChart, but also to give patients the ability to request their records through MyChart,” she says. “For those patients who are computer savvy – and not all patients are – this is a really good patient satisfier. Our goal is to make a complete, downloadable, and shareable copy available to the patient – all free of charge. Those are a couple of things we have to work on over the next several months.”

Marshall believes that giving patients easier, less burdensome access to their complete medical record will be a win for population health in the long run. “We as a population of people are becoming more health conscious, looking at things like genetics and our ancestry.” As the momentum behind this trend escalates, she adds, especially in light of the 1 million patient Precision Medicine Initiative, “people may be more inclined to get copies of their records so they can compare them and make sure they are leading a healthy lifestyle.”