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The AHA’s Controversial Position Stirs Debate

May 4, 2012
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On the subject of patient portal access, AHA wants a longer window of time for hospitals

With the impending deadline for Stage 2 comments from the ONC,  there was bound to be some degree of controversy with the various associations submitting their proposals and comments, and thanks to the American Hospital Association (AHA) we got a good deal of disagreement this week. The AHA caused a stir when it released 68 pages of comments to the Centers for Medicare and Medicaid Services (CMS) over the proposed rule for Stage 2 of meaningful use, which generally said the requirements were too much for hospitals to bear.

Among the association’s many comments critiquing the rule was disapproval of a CMS requirement that forces hospitals to allow patients to view or download their health information within 36 hours of discharge. According to the AHA, this requirement “is at best premature given that no final rule has been issued to implement HITECH’s specific mandate for a right of patients to obtain electronic copies of their protected health information when that information is part of an EHR.” The AHA used the Health Insurance Portability and Accountability Act (HIPAA) to defend its position, saying the requirement goes against HIPAA privacy rules. The group instead supports a 30-day period for providing access.

Those comments were not taken lightly by multiple health IT advocates. Among those who criticized the AHA was Deven McGraw, director of the Health Privacy Project at the Center for Democracy and Technology (CDT). In a blog post, McGraw said that the AHA’s use of HIPAA to excuse hospitals from providing patients more meaningful access to their data is essentially the “legal equivalent of a ‘Hail Mary pass.’” She also said there is no basis for the argument that CMS can’t create conditions on meaningful use that gives patients greater rights.  

McGraw’s comments were supported by The National Partnership for Women and Families’ Christine Bechtel in a blog post. Bechtel says that, “No patient in this day and age should have to wait a full month for access to their own health information.” She says with this protest, the AHA has made it clear it doesn’t have the patients’ best interests in mind.

Naturally, the AHA has not taken these comments lying down. Yesterday, the organization released a statement on its website, clarifying its position. The AHA said, “while it strongly supports patients’ access to their medical information, we believe CMS’ plan is not supported by current technology, raises significant security issues, and goes beyond current technical capacity.”

We know the patient engagement/patient portal aspect of Stage 2 has been among its most controversial provisions. There were a lot of rumblings from the provider side about a requirement that 10 percent of patients must access, download, or view their health record as “completely unrealistic,” notes a blog post from HCI Contributing Editor David Raths back in February.  I’m intrigued to see what ends up staying in the final rule, and whether other associations representing the provider side, such as perhaps the American Medical Association, come out with comments on the side of the AHA.

What do you readers think? Is the AHA’s pushback justified or do you agree with Bechtel and McGraw? Leave your comments below and let us know.