A legislative measure that redefines more precisely what a medical record is and eases healthcare facilities’ burdensome task of compiling complete medical histories was reported out of committee by lawmakers in the final weeks of 2017.
House Bill 172 limits a medical record’s definition for purposes of the law governing access to patient medical records. It achieves that end by the purposeful exclusion of additional medical data, such as superfluous data generated in the electronic medical record, or EMR, that is not relevant to the decision-making process of providers during the clinical treatment of a patient or a patient’s medical history.
The bill does not preclude a healthcare facility from including the additional details in a records request.
Additionally, it explicitly provides for the right of a patient to examine and obtain copies of additional medical data that is not included in his medical record under the new definition.
“When a patient requests a copy of their medical record, this request is made more onerous by our current definition of ‘medical record’ in statute,” Ohio State Medical Association Senior Director Tim Maglione said during testimony before members of the House Health Committee last month. “Current law was written before the EMR existed, and as applied to the EMR, dictates that even extraneous data generated in the duration of the patient’s treatment be included in the ‘medical record.’
“This means the EMR even includes volumes of records created by monitoring equipment, and coding data. The increased breadth of information and length of a medical record means a request takes longer to process, and it can be difficult for patients and providers alike to sift through and find the relevant information they need.”
HB 172 sponsor, Rep. Kirk Schuring, R-Canton, proposed the measure at the urging of associations representing physicians and hospitals.
“Consider a typical patient request: a patient requests a copy of her medical record to take with her as she moves across the country to a new job,” Jennifer Nelson Carney spoke on behalf of the Ohio Hospital Association. “That patient believes this to be a relatively simple request — not a request that will take days, weeks or even likely, months — to fulfill, nor a request that will result in 10 boxes of paper or multiple disks of large electronic files that are too big to electronically transfer and are difficult to decipher.
“Inclusion of this extraneous data is not helpful to the patient.”
She state further that the extraneous information is no benefit to the patient’s medical care.
“A bloated medical record makes it difficult for physicians and other clinicians to find the information they need,” she said. “The medical record is first and foremost a clinical tool to enable clinicians to provide appropriate care to a patient.
“Note, the medical record has never been as a repository of all information concerning a patient; clinicians, by virtue of their training and experience, have always been in the best position to determine the clinically relevant information to be included in the medical record.”
Inclusion of such irrelevant data in the record results in the counterproductive effect of physicians wasting precious time sorting through the enormous amounts of information or worse: Clinicians missing vital data buried within the mass of information included, Carney added.
HB 172 additionally clarifies that an authorized person — one who is authorized to act on a patient’s behalf regarding medical records or additional medical data — includes the patient’s attorney.
A pair of fellow House members cosponsored the bill.