Officials debate content in digital health records
Fred Schulte
Issue date: 2/5/10 Section: News
When Kaiser Permanente started giving patients online access to their medical records nearly five years ago, it offered the same lab reports doctors saw-complete with warning flags highlighting any abnormal results.
The capital letters - such as "H" for "high" -- alarmed many patients. So now the giant health plan has modified the policy for most of its members. It displays lab results in a more neutral way, showing patients how they compare to normal ranges and advising them to contact their health practitioner with any questions.
The experience at Kaiser reflects the sensitivities that can arise over how much medical data patients should be entitled to view and how quickly-a debate that's intensifying as medicine enters the digital era.
Federal officials hope to create a digital medical record for every American within the next five years and are set to use from $14 billion to $27 billion in stimulus money to help doctors and hospitals adopt the systems. One goal is to "provide patients and their families with timely access to data, knowledge and tools to make informed decisions and to manage their health."
To that end, doctors receiving stimulus money starting next year must be able to give patients electronic copies of their "health information" in as little as 48 hours after an office visit, according to draft regulations issued in late December.
But the proposed rules don't specify precisely how much detail doctors and medical systems are obliged to report. Lack of agreement on this issue, and others, suggests a bumpy road ahead as patients begin to assert control over records that thus far have remained almost exclusively in the custody of medical providers.
Many health analysts and physicians say the new regulations are open to interpretation, even the term "health information" itself. "There's no definition of what a medical record is," said Steven E. Waldren, a doctor who specializes in health information technology issues for the American Academy of Family Physicians.
The capital letters - such as "H" for "high" -- alarmed many patients. So now the giant health plan has modified the policy for most of its members. It displays lab results in a more neutral way, showing patients how they compare to normal ranges and advising them to contact their health practitioner with any questions.
The experience at Kaiser reflects the sensitivities that can arise over how much medical data patients should be entitled to view and how quickly-a debate that's intensifying as medicine enters the digital era.
Federal officials hope to create a digital medical record for every American within the next five years and are set to use from $14 billion to $27 billion in stimulus money to help doctors and hospitals adopt the systems. One goal is to "provide patients and their families with timely access to data, knowledge and tools to make informed decisions and to manage their health."
To that end, doctors receiving stimulus money starting next year must be able to give patients electronic copies of their "health information" in as little as 48 hours after an office visit, according to draft regulations issued in late December.
But the proposed rules don't specify precisely how much detail doctors and medical systems are obliged to report. Lack of agreement on this issue, and others, suggests a bumpy road ahead as patients begin to assert control over records that thus far have remained almost exclusively in the custody of medical providers.
Many health analysts and physicians say the new regulations are open to interpretation, even the term "health information" itself. "There's no definition of what a medical record is," said Steven E. Waldren, a doctor who specializes in health information technology issues for the American Academy of Family Physicians.
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