- A review of 83 hospitals in 29 states found that patient access to medical records is still limited despite federal regulations that have promoted access, according to a recent study in JAMA.
- When researchers called the hospitals to ask about medical record release, there was conflict between the information relayed on the phone and that found in the release forms.
- Some hospitals were not in compliance when it came to the charges they required for the release of records, including requesting fees greater than the $6.50 recommended by the federal government. Also, some hospitals did not adhere to state requirements for processing times.
There has been an ongoing debate in the medical community about who really owns medical records. As patients are pushed to take more control over their health outcomes, lack of access to personal records has been a barrier. "The lack of a uniform procedure for requesting medical records across US hospitals highlights a systemic problem in complying with the right of access under HIPAA," the study authors wrote.
This study focused on traditional methods for obtaining the information, but the swing toward more access might come from a more electronic route. Digital and mobile health companies are working to make PHIs more accessible, including on smart phones. Apple, for example, is partnering with hundreds of hospitals to allow users to access their medical records on the iPhone Health app.
The JAMA study details the barriers patients continue to face when trying to obtain their own information. It also highlights the conflicting answers hospitals provide depending on whether patients are talking to officials on the phone or reading the forms provided to obtain records.
Only 44 of the 83 hospitals researched allowed patients the option to gain access to their entire medical record through forms provided. Yet, conflicting information was provided over the phone. All of the hospitals, when reached by phone, said they could release the entire patient medical record. As few as nine hospitals provided the option for patients to obtain physician orders via a form, while 73 hospitals allowed patients to select the option to obtain laboratory testing via the forms provided to patients.
Discrepancies continued when researchers asked about the format in which they could obtain the records. On the phone, some hospital representatives gave one answer, but the forms provided another. About 83% of the hospitals said on the phone that patients could pick up the records but only 48% of the forms allowed for that option.
When it came to disclosing the cost for records, only 35% of the hospitals provided the exact figure on the authorization forms. Costs for a 200-page record varied dramatically for hospitals that disclosed the cost in authorization forms, ranging from nothing to nearly $282. Those figures for the same 200-page report were different when speaking with the hospital representatives over the phone, ranging from nothing to nearly $542.
About 59% relayed costs to release records that were above the federal recommendations of a $6.50 flat fee for electronically maintained records.