Health Care Record Hell Is Still a Problem: GAO

The U.S. Department of Health and Human Services tried to impose strict patient record access rules on health care providers back in January 2016, but, for many patients, actually getting the records is still a hellish process.

Carolyn Yocum, a director at the U.S. Government Accountability Office, describes how hellish in a new report prepared for the Senate Health, Education, Labor and Pensions Committee and the House Energy and Commerce Committee.

Patients may not always know enough about their records access rights to file complaints with HHS when they have problems, Yocum writes.

When patients do file complaints with HHS, the HHS Office for Civil Rights (OCR) usually takes months to get the requested records, according to GAO data.

The GAO reviewed records for 583 patient record access complaints that OCR received between February 2016 and June 2017.

• The GAO closed 437 of the cases, or 75% of the total.
• The GAO closed just seven of the cases, or 1.2% of the total, in 50 or fewer days.
• The GAO needed 251 or more days to close 90 of the cases, or about 15% of the total.
• Closing one case took at least 451 days.

(Related: Maybe Medicare Providers Should Meet Data-Sharing Standards: CMS Chief)

A copy of the GAO report is available here.

Back in January 2016, HHS OCR said that patients should be able to get copies of most personal health information from providers or other holders of health data, such as health insurers, within 60 days, and that they should be able to get most records in a convenient electronic format.

But Seema Verma, the administrator in charge of the Centers for Medicaid and Medicare Services, a major HHS agency, has said in two major speeches this spring that she was unable to get the records she wanted for her own husband after he suffered from heart problems, even though she is a longtime health program administrator.

GAO investigators found many reasons for problems with compliance, Yocum writes in a summary of the investigators’ work.

HHS OCR has received complaints about providers continuing to charge excessive record access fees, providers failing to respond to requests for records, and providers refusing to respond to requests for records from children’s parents.

One obstacle is conflicts between electronic health record (EHR) systems, another is that exporting data from EHR systems can be difficult, and a third is that many providers still have a mix of paper and electronic records, Yocum writes.

Yocum notes that HHS OCR has recently audited 103 covered entities’ compliance with patient record access rules.

OCR will release a final report on its audit findings later this year, Yocum writes.

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