Startup Seeks To Hold Doctors, Hospitals Accountable On Patient Record Requests

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When Kelly Shanahan had her OB-GYN follow in South Lake Tahoe, Calif., she was meticulous about offering medical information promptly to all sufferers who requested them, she stated.

But since being identified with metastatic breast most cancers in 2013, an occasion that compelled her into retirement, Shanahan has found that not all of her medical doctors are as attentive to such requests.

Getting copies of her information has been, as she places it, “a colossal pain.”

With few exceptions, federal legislation requires that well being care suppliers make copies of medical information accessible inside 30 days after sufferers request them and, when doable, within the format they want. Under California legislation, suppliers have 15 days at hand over the information if they’re being despatched on to the affected person.

But many sufferers, who could have information scattered throughout medical doctors’ places of work, labs, hospitals and clinics, say responses from well being care suppliers can vary from sluggish to churlish. Assembling the information may be onerous.

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Earlier this 12 months, Shanahan turned to a Silicon Valley startup referred to as Ciitizen, which requests medical information on behalf of most cancers sufferers and redacts them for readability and legibility.

Shanahan logged on to the corporate’s web site and signed an digital consent type, handing over to Ciitizen the duty of requesting her information from a number of suppliers. The firm emails her when a file is prepared for her to view.

Ciitizen doesn’t cost sufferers for gathering their medical info. Rather, it hopes to earn cash “in the near future” by taking a transaction payment for “matching third-party researchers with patients who wish to share their records,” stated Deven McGraw, Ciitizen’s chief regulatory officer and former head of well being care privateness coverage on the U.S. Department of Health and Human Services. She stated the corporate plans to supply its providers to individuals with different severe diseases sooner or later.

On Tuesday, Ciitizen, based mostly in Palo Alto, Calif., launched an replace to a report card it first revealed in August that makes use of a five-star system to fee how well being care suppliers adjust to federal guidelines governing file requests. The scorecard, which Ciitizen plans to refresh each few months, may be seen on-line at

It exhibits that of the 210 suppliers from whom Ciitizen has requested affected person information to date — together with hospitals, medical doctors and specialty clinics nationwide — 51% have just one or two stars, which means they had been noncompliant or required vital intervention by the corporate to conform.

Ciitizen additionally revealed a report, based mostly on the scores of these 210 suppliers plus phone surveys of almost three,000 well being care establishments, that discovered that greater than half of suppliers had been out of compliance with federal affected person knowledge entry guidelines.

That is in keeping with a study by Yale University researchers final 12 months displaying that many high U.S. hospitals weren’t in compliance with affected person information guidelines.

“Cancer patients do not have the time or energy to make two to three phone calls and argue with their providers,” McGraw stated. “We did a lot of arguing. We encountered so many roadblocks.”

In a speech in August, Seema Verma, administrator of the Centers for Medicare & Medicaid Services, referred to as the Ciitizen scorecard “a powerful tool for patients” that “will hopefully spur competition amongst providers to make patient data more readily accessible.”

Lois Richardson, vp and authorized counsel of the California Hospital Association, stated the scorecard is just too new to evaluate whether or not its findings are vital or only a assortment of anecdotes based mostly on a small variety of information requests. “It could be either; I just cannot tell,” she stated.

Some client advocates say enforcement of legal guidelines governing medical information accessibility is ineffectual.

“There have never been any cops who will go around and bust a hospital for failing to produce the data,” stated Dave deBronkart, a pioneer of the affected person entry motion.

DeBronkart, 69, beat the percentages after medical doctors gave him 24 weeks to reside following a prognosis of metastatic kidney most cancers 12 years in the past. Along the way in which, he has butted heads with the medical institution over his well being information.

When he was invited to talk at a medical convention in Toronto in 2009, the organizers requested him the title of his speech. He replied: “Just call it ‘Give Me My Damn Data.’”

That phrase rapidly grew to become a rallying cry, a hashtag, a meme, a espresso cup, a rock ’n’ roll song, and even a rap: “Give me my rattling knowledge/’trigger it’s my life to save lots of/give me my rattling knowledge /similar to e-patient Dave.”

DeBronkart and others within the medical knowledge entry motion applaud Ciitizen’s report card however imagine the actual sport changer might be a brand new federal rule that would ultimately permit sufferers to see their medical knowledge on their cellphones as simply as they will see their financial institution accounts.

“What we have been striving for is starting to happen,” deBronkart stated. “For the first time in 10 years of advocating for patient access to our medical information, I am excited and optimistic.”

The new rule is anticipated to start rolling out in 2020, a CMS spokeswoman stated. It would require well being care suppliers doing enterprise with Medicare and Medicaid, and within the federally run Affordable Care Act marketplaces, to share their sufferers’ knowledge by apps which are suitable with a world commonplace for sharing well being care info often called FHIR (Fast Healthcare Interoperability Resources).

Unlike present federal legislation governing information entry, the brand new rule may have some tooth, federal officers say. Just how it is going to be enforced remains to be being hammered out, however it would seemingly entail monetary penalties.

Some affected person advocates fear about customers’ privateness when their medical knowledge is shared so extensively on-line. “Of course we want consumers to be more empowered, but it does seem like we’re rushing into this idea,” stated Dena Mendelsohn, a senior lawyer within the San Francisco workplace of Consumer Reports, including that there should not but legal guidelines in place to guard affected person privateness.

But Shanahan, the breast most cancers affected person and former OB-GYN, stated it ought to be her choice.

“I’m the patient,” she stated. “I’m saying, share my freakin’ information.”

Use Our Content This story may be republished without spending a dime (details).

This KHN story first revealed on California Healthline, a service of the California Health Care Foundation.

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