WITH THE direction in which health and technology are going, it would be prudent for the issue of ownership and access to medical records to be worked out once and for all. With pertinent restrictions of course, access to medical records needs to be less prohibitive to the patient.
This year, I attended the Health Information Management Systems Society’s (HIMSS) 19th conference. This conference is hailed as the top event for providers of and others involved in some way in the provision of health technologies and supplementary systems and services. The problem of access to records was raised there and so we know it is not just a Jamaican issue.
I can think of India as one of the few countries which have clearly declared that the health record is wholly owned by the patient to the extent that after a doctor’s visit a patient is handed his/her file to take away. Apart from this, access in several countries across the world is on request, some free to the patient, some at a cost – as is the case in Jamaica, if access is actually granted at all. The most-held view is that the doctor or medical facility owns the records. In fact this is seen as a part of important assets if a monetary value is to be put on the practice. While I can understand this where a physician invests in putting together paper-based patient records, the associated storage space, time for filing and resources required to retrieve and copy to, at the end, hand over to patients, I do not see how we can still hold fast to this belief in this era of high technology. This needs to change. Patients must have easier access to their records and get it free of cost, depending on the method by which it is requested.
The National Coordinator for Health Information Technology in the United States instituted a new rule two weeks ago and the agency’s director of policy, Elise Sweeney Anthony made the announcement while addressing the HIMSS conference in Orlando, Florida. The rule requires that patients be in control of their health records. By this they mean that on request, patients should be able to access or given records electronically. Also, that healthcare providers share records as needed when it becomes relevant to continuity of care – without restrictions or unnecessary red tape.
This is an important policy change that is very much required if the health technology is to be used to its full potential and if the end user – the patient – is to benefit completely from what the technology offers. Shareable information and willingness to share through the technology is essential to interoperability, which is essential to healthcare linkages necessary for accurate investigation, diagnosis and continuity of care.
The important argument is that with Electronic Medical Records (EMR), there is no longer a reason to distrust the data and there is also little or no expense with respect to sharing information. EMR could, therefore, solve the problem of ownership of the patient record by changing the argument to access in that a presiding doctor will always have access to a patient’s record from instances with him/her – as they should. However, if you are talking about the overall health of the patient and patient rights it should not and does not have to preclude the patient’s access. Whereas, today this record is locked up in a file in the doctor’s office and would be costly to replicate, EMR facilitates quick and easy sharing and so resolves much of these difficulties. This becomes very relevant when the patient needs other medical opinion or a coordination of all the encounters for Artificial Intelligence (AI) intervention, genetic investigation and so on to get more precise and accurate diagnosis.
Access is just the beginning of showing how the technology can facilitate improvements to the care continuum, a more interoperable healthcare system, enhanced care coordination and more direct patient involvement in care coordination.
The University Hospital of the West Indies currently has this capability with the current digitisation and use of the Hospital Information Management System and their EMR can be used as the standard to guide other medical facilities.