‘En­raged’ by 30-day win­dow

Groups call AHA out of touch with pa­tients over med­i­cal-data de­lay

Modern Healthcare - - THE WEEK IN HEALTHCARE - Ashok Sel­vam

The Amer­i­can Hospi­tal As­so­ci­a­tion’s in­sis­tence on a 30day win­dow to pro­vide pa­tients with their med­i­cal data cat­alyzed In­ter­net crit­ics with pa­tient ad­vo­cates say­ing the group was out of touch with pa­tient needs. The on­line dis­cus­sion grew so heated that the AHA on the af­ter­noon of May 2 re­leased a state­ment via Twit­ter call­ing crit­i­cisms “in­ac­cu­rate.”

The AHA sub­mit­ted its public com­ment to the CMS re­gard­ing Stage 2 mean­ing­ful-use rules via a 68-page let­ter signed by AHA Ex­ec­u­tive Vice Pres­i­dent Richard Pol­lack, dated April 30.

The com­ment let­ter drew fire for a sug­ges­tion that hos­pi­tals be re­quired to re­lease dig­i­tal pa­tient records “with­out un­rea­son­able de­lay and no later than 30 days fol­low­ing the re­quest” rather than within 36 hours of dis­charge, as the CMS pro­posed.

The AHA rea­soned that hos­pi­tals didn’t have the proper tech­nol­ogy to share in­for­ma­tion any faster and that 80% of hos­pi­tals have failed to meet Stage 1 re­quire­ments. The group also men­tioned the se­cu­rity con­cerns and the Health In­sur­ance Porta­bil­ity and Ac­count­abil­ity Act as an ob­sta­cle in re­leas­ing data.

Chris­tine Bech­tel, vice pres­i­dent of the Na­tional Part­ner­ship for Women & Fam­i­lies, took to her blog on the morn­ing of May 2 and wrote that the AHA “has lit­tle in­ter­est in ad­vanc­ing mean­ing­ful-use cri­te­ria that would re­sult in tan­gi­ble ben­e­fits for pa­tients.” Bech­tel, who serves on the fed­eral gov­ern­ment’s Health IT Pol­icy Com­mit­tee,

called the AHA’S re­luc­tance to share data dig­i­tally a “cul­ture is­sue.” She called for her readers to sub­mit com­ments to HHS, and as of late last week, more than 4,500 had done so, she said.

Oth­ers quickly joined Bech­tel in rip­ping the re­quest for the 30day limit and us­ing HIPAA as a rea­son: “The ar­gu­ment that the ex­is­tence of these HIPAA pro­vi­sions pre­vents CMS from im­pos­ing more mean­ing­ful ac­cess to pa­tient data as a con­di­tion of re­ceiv­ing sub­stan­tial tax­payer sub­si­dies is the le­gal equiv­a­lent of a ‘Hail Mary pass,’” wrote Deven Mcgraw, di­rec­tor of the Health Privacy Project at the Cen­ter for Democ­racy and Tech­nol­ogy based in Washington.

AHA Di­rec­tor of Pol­icy Chan­tal Worzala de­fended the AHA’S po­si­tion, say­ing the in­tent is to com­ply with pa­tient re­quest faster than 30 days, but that the 36-hour win­dow is un­re­al­is­tic. “The re­al­ity is that we have to work with the tech­nol­ogy that’s avail­able to­day, which many have la­beled ma­tur­ing,” she said. “And we have IT sys­tems that right now can’t talk to each other, so you do need some time to get the in­for­ma­tion to­gether.”

Worzala’s ex­pla­na­tion wasn’t enough for Bech­tel, who said she and “those who un­der­stand the pa­tient view” con­tin­ued to be “en­raged” by the no­tion of wait­ing 30 days for their records.

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