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Copy fees limit patient access to medical data, doctors argue

By Lisa Rapaport

(Reuters Health) – Even although U.S. sufferers are supposed to have straightforward access to digital copies of their medical data, copy fees can forestall individuals from getting this info once they want it, some doctors argue.

Under federal tips issued final yr, health suppliers are permitted to cost fees for labor, prices of making digital or paper copies of data and postage, Dr. Harlan Krumholz of Yale School of Medicine in New Haven, Connecticut, and colleagues write in JAMA Internal Medicine.

Even although these tips recommend a most flat payment of $6.50 for digital copies of digital data, most state legal guidelines and healthcare suppliers nonetheless set per-page copy fees that may add up to a lot larger prices for sufferers, the doctors word of their “Viewpoint” article.

“Higher costs are a higher barrier for people to get their own information,” Krumholz informed Reuters Health by e-mail.

“Without that information it is not possible to correct errors in the record, get informed second opinions, donate your data to research – or share with others what is happening with your care,” Krumholz added.

The tips have been issued to assist implement the Health Insurance Portability and Accountability Act (HIPAA) of 1996, which was designed partially to usher in a brand new period of digital health data to substitute older, paper-based techniques.

Some healthcare suppliers, just like the Veterans Health Administration, make it straightforward for sufferers to go browsing and obtain their medical data with just some mouse clicks, and no fees, Krumholz and colleagues notice.

But prices can far exceed that, based mostly on researchers’ estimates of fees in 42 states with legal guidelines on the books detailing how a lot sufferers ought to pay for these data.

In Texas, for instance, a patient may pay as a lot as $53.60 for 15 pages of data, not together with postage or pictures, in accordance to researchers’ evaluation of 2015 knowledge.

Patients’ copy fees may attain as excessive as $218.70 for 150 pages of data in Minnesota, or $687.70 for 500 pages, researchers estimated.

Only in Kentucky does state regulation require health care suppliers to give sufferers the primary copy of their medical data freed from cost.

Kentucky ought to be a mannequin for different states to comply with, the researchers argue.

Krumholz is the founding father of Hugo, a software program platform designed to assist sufferers simply and freely get hold of and share copies of their medical data. He additionally has grant funding from Johnson and Johnson and Medtronic, and has served as an advisor to UnitedHealth and IBM Watson.

Easy and reasonably priced access to medical data may also help sufferers take cost of their very own health and make smarter decisions about their care, stated Daniel Walker, a researcher at Ohio State University in Columbus who wasn’t concerned within the opinion piece.

“Costs to access medical records prevent patient access to their health information,” Walker stated by e-mail.

“Preventing this access restricts patient choice about where they seek their medical care, and ultimately undermines patient empowerment and patient centered care – both of which result in better care satisfaction and outcomes,” Walker added.

When fees are too steep, sufferers ought to talk about it with their physician immediately, stated Dr. Bryan Lee, an ophthalmologist at Stanford University and Altos Eye Physicians in Los Altos, California.

“I would recommend being up front and saying that the cost is a barrier to obtaining a full copy of your records,” Lee, who wasn’t concerned within the paper, stated by e-mail.

“If the office staff is giving you a hard time, then discuss it directly with your doctor,” Lee added. “It’s hard for me to imagine that a doctor wouldn’t make an accommodation for a patient in that situation.”

SOURCE: JAMA Internal Medicine, on-line January 30, 2017.

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