Compromise On Health Data Access May Be Ugly
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In addition to the AHA's complaint, the American Medical Association, which represents physicians, isn't happy with the Stage 2 proposal that at least half of patients be given clinical summaries within 24 hours of an office visit. In its comments, AMA recommends that the turnaround be three business days, and the threshold be only 20% of patients, rather than 50%. The AMA suggested some other tweaks to the rule.
"The measure should also be based on unique patients seen during the EHR reporting period, and not based on every office visit to minimize reporting burdens. In addition, a physician should have the flexibility to include only the information that the physician believes to be relevant for the summary," said AMA in comments submitted to CMS.
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"We do not want to turn patient visits into typing sessions where physicians are keying information into the EHR just so they can print a clinical summary after every visit rather than spending time communicating with their patients regarding their care."
The AMA bid to provide clinical summaries to patients three days after an office visit instead of CMS' 24-hour proposal isn't as extreme as AHA's request to release patient info up to a month after discharge from a hospital instead of CMS' 36-hour proposal.
Then again, hospitalizations are generally a lot more complex and generate a lot more data from multiple departments than most doctor office visits.
On the other end of the battle over patient access to info is the Consumer Partnership for eHealth and the Campaign for Better Care. The consumer group represents two dozen patient and consumer advocacy groups, including AARP, National Partnership for Women and Families, and Advocacy for Patients with Chronic Illness. The group advocates patients having access to their information within 24 hours of an office visit and discharge from a hospital.
"We take issue with the proposed timeframes for when the patient's information must become available to the patient, because the proposed approach is not consistent with the patient's workflow during transitions of care, and does not ensure information availability to patients and their caregivers when they need it most and are most motivated to follow through with self-care instructions: immediately following an encounter or admission," wrote the Consumer Partnership for eHealth and the Campaign for Better Care in comments sent to CMS.
The group also makes an important point that should remind AHA of something that will soon pinch the pocketbooks of hospitals: Financial penalties and reduced reimbursements from CMS for care of patients readmitted within 30 days.
"The shorter timeframe [to provide discharged patients with their information] will also help address cost issues, considering the impact patient non-adherence has on readmission and the penalties hospitals will incur for avoidable re-hospitalizations starting in October 2012," wrote the consumer group to CMS.