All Over the Map: Patient Access to Clinical Lab Information

Last September, the Department of Health and Human Services introduced an amendment to the CLIA Program and HIPAA Privacy Rule: Patients’ Access to Test Reports. The rule proposes that patients have unfettered access to clinical lab test reports upon request. While hospitals, clinical labs, and clinicians say they support the proposal, implementation may have its share of problems. Added costs, new processes, privacy protections, and training of lab personnel would be required to comply with the rule.

If the federal rule is adopted, it would override the current model which provides authority to the state health information exchanges who determine accessibility rules. Today, patients’ access to clinical lab information is determined by the states. The rules are, literally, all over the map. I spent the afternoon building a US map in Powerpoint of patient lab data accessibility rules thinking that I would be able to find a rational pattern across the country.

I made a few guesses/presumptions.

• Do states with strong medical lobbies only allow reports to go the the medical provider?
• There are a cluster of states in the Mid-Atlantic (DC, DE, MD, NJ, WV) that already allow patients access to lab data. Has the “open health” movement in DC had any influence on policies in neighboring or nearby states?
• Do states that have large health systems (like Kaiser Permanente in CA, OR, WA, DC, MD, and VA ) with patient portals that share data with patients already have a consistency in policies across states?
• Is there an alignment of data accessibility policies between “blue” states and “red” states?
• Is limited accessibility by patients aligned with strong statewide tort reform and medical malpractice caps?

The answers, for the most part are, “not necessarily.” In politics, it is a mistake to look for rational patterns. Politics aside, looks like the same goes for health care.

Download the map in Powerpoint.

Prescribing eHealth for Your Patients

I recently attended the mHealth Summit in Washington D.C. and it was yet another example that physicians are still missing from key conversations. Last week it was New York eHealth Collaborative Conference, previously Connected Health Symposium in Boston … Health 2.0 in San Francisco. Why aren’t physicians attending these conferences?

The techies and start-up health company founders were discussing their plans for pilot programs where physicians become active prescribers of eHealth resources and mobile health applications for their patients. Why is that an important discussion physicians should be part of?

Think about the countless hours patients spend on managing their conditions outside of the doctors’ offices. In diabetes for example, we’re talking about an average of almost 8,000 hours that physicians can’t account for! Can doctors make an impact on what happens during that time? Yes. Some examples:

• Prescribe your website or blog where you write answers to most common questions that you repeat 20-30 times a day. The time savings alone justify having your own website. How many doctors have their own website?
• Prescribe online patient communities that you yourself reviewed and approve of. Patients will be spending hundreds if not thousands of hours online looking up their conditions, other patients’ experiences and advice on how to improve their quality of life. Why not become a trusted filter and help your patients find great information … rather than misinformation.
• Prescribe Mobile Health Applications for your patients. iPhone and Android applications are being created by the hundreds. You’re able to account for every adverse effect, every time a patient might not be feeling their best, and even accurately record ECG in real time via the iPhone that can be seemlessly transferred directly into the EHR. Do you treat migraines? What if you had the opportunity to monitor effects of treatment plans at the patient’s home, something that is never recorded in real time but rather at the next patient visit. Think of all the critical clinical data that is lost when it is not recorded and forgotten.

With so much stress on accountability, treatment compliance, cost-effectiveness and keeping patients healthy, physicians’ voices have never been more important than right now.

Start planning for 2012 to attend conferences and meetings on innovations in the medical practice. There are many conferences being planned that will not only unveil ways to keep your practice successful, but will earn you CME credits, uncover business opportunities, and earn you recognition for being an innovator when you bring your success stories to the panels.

Two upcoming conferences:

• February 19-21 Physician Strategies Summit
• March 29-30th in New York City – NextGenHealth - plug in code “simon12″ at checkout for a discount.

I’ll update this list of conferences for physicians as soon as I review what’s coming up. There are also conferences planned in each major specialty. Check in with your specialty’s association for details.

iPad EHR Presented at Health 2.0 Conference

Every year the drchrono team has presented at the health 2.0 conference. This year I was able to show off some of our cool new ideas just implemented.

• FreeDraw, drawing on images
• Macro buttons, adding new keys to the iPad keyboard
• Fast medical template input

We would just like to thank the health 2.0 team for always supporting us and our view in changing healthcare through technology.

Health 2.0 Conference iPad Winner

We had an interactive raffle at the Health 2.0 conference this Oct 2010 in San Francisco. Lots of people entered to win the free iPad 3G. It was amazing how much a fun game can take off and get people involved.

We gave out two cards with the same number to totally random people from our booth at the conference. The people with matching numbers had to find each other and then they both got to enter the raffle. This was a hard task since there were 1000′s of people at the conference.

A few hours after, Katelyn and Zsa Zsa gave away 100′s of raffle tickets, people started to tweet out their numbers, they then started to post up numbers on the walls and believe it or not someone created a website to post up the iPad raffle numbers to get matches.

This is the wall of number postings we found:

After the whole event, the conference founders Indu and Matthew drew the winner’s ticket from a bowl to see who got the free iPad 3G.

The lucky winner was a savvy Web 2.0 user who used the power of twitter to find his number match. Craig DeLarge tweeted out his number and found the person who had the same number as him. This is Craig’s twitter and his blog.