With the pervasive use of electronic records in medical practice, most office-based clinicians now have an EHR. However, many first-time patients don’t understand why their doctors are still requesting their medical history. They expect everything to be available on their doctor’s screen.
This may be easy to achieve for healthcare providers that are part of an integrated health system that uses the same EHR system. The physician can easily read and interpret lab results, view imaging tests and read the patient’s complete medical history on the same screen.
When patients must move from one state to another or visit a smaller practice that doesn’t have a direct link with their physician at home, interoperability becomes difficult or virtually impossible. While a lot of work has been done to ensure interoperability between different healthcare organizations through state and regional health information exchange networks, the focus has been on institutions instead of patients.
However, interoperability will be greatly enhanced when we empower patients to be stewards of their health records. This will enable them to access and use their records during different doctor’s office visits and while receiving retail services like flu shots. Presently, the HIPAA Privacy Rule states that providers should give individuals access to their health data when they request it.
Here are some of the initiatives that will enhance interoperability through active patient participation.
Regulatory incentives have motivated the improvement of patients’ access to their clinical data. For instance, the Center for Medicare and Medicaid Services (CMS) program tagged “Promoting Interoperability” requires providers to give patients greater access to their clinical data in the form of electronic copies like PDF documents.
Patients should have the right to view, download or send this data to another provider or healthcare organization. CMS has also permitted patients to use third-party apps to view their medical records through an API. This allows applications to connect directly with their provider’s EHR.
Development of Open APIs
Major EHR developers have been promoting the HL7’s Fast Healthcare Interoperability Resources (FHIR) standard. This API can be used by any application developer or EHR vendor to connect and retrieve data from an EHR. Similarly, the Apple Health Records API offers developers the opportunity to develop patient-facing apps that pull records from an EHR and make them available to patients using Apple iOS devices.
Automated Patient Consent
When a patient’s medical records aren’t accessible through a health information exchange or integrated health records system, they need to be transmitted through other forms of electronic or paper documentation. This usually involves sending emails, making phone calls or faxes, which are cumbersome and time-consuming.
However, this bottleneck could be overcome by using an automated consent application. This application will help clinicians receive consent to access the records electronically without the need to send faxes back and forth. The patient can select the data they want to share, thereby protecting the physicians from violating patient privacy protection laws.
Increasing patient access to clinical data not only enhances interoperability, but it also makes it easy for such data to be used in scientific surveys and for managing population health.