Electronic Health Records

Adoption & Implementation News

Fees for Medical Records Inhibit Patient Access to Data

By Vera Gruessner

Within the healthcare sector, computerized health records are pivotal for improving the quality of patient care, reducing healthcare costs and redundant testing, and boosting population health outcomes. With the push toward patient engagement and implementation of patient portals, it would seem that patient access to their medical records would be vital for healthcare providers. However, medical records are still technically owned by the physician and not the patient.

If it wasn’t for a privacy rule passed in 2000, patients wouldn’t be able to get a copy of their own healthcare records. Even so, providers are only required to give patients this information if they pay a fee, The Brookings Institution reports. The rule explains that this fee is meant to help providers recoup their costs of copying protected medical data.

Past studies have illustrated that, when patients have access to their medical records, they are more engaged with their care and their health outcomes are often improved. The case of Steven Keatings, a doctoral student at the Massachusetts Institute of Technology’s Media Lab, tracking his own patient data and asking for an MRI that found a brain tumor shows that patient engagement with their own medical information is key for improved health outcomes.

Currently, the lack of EHR interoperability poses issues for the exchange of data among healthcare systems as well as the difficulty for patients to access their own medical records. By increasing patient access to their data, providers may be able to support interoperability among different physician practices or hospitals, as the patients themselves could share their health records directly with a new clinician.

This would reduce test redundancy, help physicians make clinical decisions in less time and thereby improve the quality of care. In this way, providing patients access to their own data can actually reduce healthcare costs.

Unfortunately for patients, there is a competitive environment among providers that causes them to strive to have a greater patient load than other healthcare entities. No physician likes to lose their consumer base to other providers. By creating more hurdles for patients to access their data, it may be easier for doctors to keep their patient load, according to the Brookings Institution.

One study from Standford University shows that there is a rise in patients switching over to other providers in states where it is easier and cheaper to access one’s own medical record. Separate states have different standards regarding a reasonable cost for copying patient records with many placing a cap while others allow the costs to rise with inflation.

The Brooking Institution took a look at more than 30 states and compared their average costs of having 75 pages of medical records copied. The highest caps on these costs came from Georgia ($101), Pennsylvania ($95), Indiana ($93), and Mississippi ($90). The lowest were seen in Tennessee ($29), Wisconsin ($23), and California ($19).

Patient Medical Records

Essentially, the Brookings Institution calls for new legislation that abolishes these fees and allows patients to access their medical records for free. Despite Stage 2 Meaningful Use requirements calling for patients to have access to their data, many providers have not adopted the portals necessary to meet this standard.

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