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.

New feature: Advanced EHR Day Sheets

We now have a more advanced day sheet. What is a day sheet? It is a report of procedures, payments and adjustments for insurance and patients. At the end of the day, a doctor and his staff can use this for accounting purposes.

Easily scan to find a procedure and the price with an elegant interface.

You can find them under the billing section, then select day sheets.

HIPAA 4010 to 5010 migration? Is your EHR Ready?

HIPAA 4010 to 5010 migration, is your EHR and practice management software ready?

The 5010 standards replace the existing 4010/4010A1 version of HIPAA transactions, which go back nearly a decade—an eternity in the tech world and address many of the shortcomings in the current version, including the fact that 4010 does not support ICD-10 coding.

Make sure that your EHR and practice management software has made the move to 5010.

As of this month the drchrono platform has been moved over to 5010, so when the medical industry is ready to move from ICD-9 to ICD-10 we are ready.

(The ICD-9 codes have ~16,000 diagnosis codes and ICD-10 has ~64,000 diagnosis codes.)

CMS will be forcing the US healthcare system to fully move over to ICD-10 October 2013.

The switch to ICD-10 and 5010 facilitates more accurate coding, billing, and reimbursement.

Eric Schmidt of Google on Healthcare Pandemic Flu Trends

Eric Schmidt of Google talks about cloud computing and how Google can help in healthcare through search analysis trending.

In Eric’s examples in this video he talks about rises in anonymous query trends alerting google about potential Pandemic, e.g.: Flu Trend queries. In these situations Google alerts the healthcare professionals when these query rises happen. This alert system within Google saves 10 to 30 thousand lives a year.