Advocates Criticize AHA's Stance on Patient Access to Health Data

Patient advocates have criticized the American Hospital Association for recommending that CMS loosen its proposed patient access requirements for Stage 2 of the meaningful use program, Health Data Management reports (Goedert, Health Data Management, 5/2).

Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of certified electronic health record systems can qualify for Medicaid and Medicare incentive payments.

Background on the Letter

On Monday, AHA sent a letter to CMS stating that the Stage 2 meaningful use requirements "raise the bar too high and are not feasible for the majority of hospitals to achieve" (iHealthBeat, 5/1).

The letter noted that hospitals are particularly concerned about a requirement that they allow patients to view or download their health information within 36 hours of discharge (Monegain, Healthcare IT News, 5/3). The letter stated that the requirement "is at best premature given that no final rule has been issued to implement HITECH's specific mandate for a right of patients to obtain electronic copies of their protected health information when that information is part of an EHR."

Instead, AHA said it supports a 30-day window for giving patients access to their health data. The organization said that such a timeframe is necessary to determine how to respond to a patient's information request.  

Response From the National Partnership for Women & Families

In a blog post for the National Partnership for Women & Families, Christine Bechtel -- vice president of NPWF and member of the Health IT Policy Committee -- wrote that AHA "has little interest in advancing meaningful use criteria that would result in tangible benefits to patients" (Health Data Management, 5/2).

She added, "Objecting to the proposed 36-hour timeframe for patient access to information after discharge, the AHA instead advocates a 30-day timeframe for access to such basic, crucial and highly time-sensitive information as discharge instructions, medication lists, lab test results and care transition summaries."

Bechtel wrote, "This is the very information that can help keep patients from being readmitted unnecessarily" (Bechtel, "From the Desk of…," NPWF, 5/2).

Response From the Center for Democracy & Technology

In a blog post for the Center for Democracy & Technology, Deven McGraw -- director of CDT's Health Privacy Project and member of the Health IT Policy Committee -- criticizes AHA's recommended 30-day window for providing patients with access to their health data.

She wrote, "Patients should expect hospitals to be their partners in health care -- but in no partnership that I’m aware of does one side get to hoard all of the relevant information."

McGraw added, "CMS is on firm ground in its decision to encourage patients to take an active role in their care by creating an innovative program that provides immediate access to health information useful to their continued care and recovery. If only the hospitals would agree" (McGraw, CDT Blog, CDT, 5/2).

Response From Patient Advocate

In a blog post, patient advocate Regina Holliday also criticized AHA's recommended 30-day window for patient access to data. She wrote that AHA's "insistence of a return to the rules of yesteryear demonstrates the dangerous path of habit itself," adding, "Once you begin to design systems without patient inclusion it becomes habit to leave us out."

Holliday added, "I urge those who are in a position to create the final rule of Stage 2 meaningful use to be brave and leap beyond a past care model that left patients out and embrace a new tomorrow of patient inclusion" (Holliday, Medical Advocacy Blog, 5/2).


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