I strongly support broad access by patients to their medical records and EHR interoperability and have blogged frequently about both topics (see, for example: Patients Often Lukewarm about Patient Portals; Problems with Training?; NYT Op-Ed on EHR Interoperability Blames Vendors and Greedy Hospitals). A recent article discussed Judy Faulkner of Epic and her questioning of former VP Joe Biden about the need for patients' access to their medical records. The article also touched on the topic of EHR interoperability (see: Cancer moonshot head recounts exchange with Epic’s Faulkner). Below is an excerpt from the article:
Former Vice President Joe Biden took to task an Epic executive who questioned during a January [2017] meeting of the Cancer Moonshot why patients should have their full medical record....Epic CEO Judy Faulkner asked Biden during ...[a] private meeting between EHR executives and administration officials, “Why do you want your medical records? They’re a thousand pages of which you understand 10,”....Biden responded, “None of your business,”....“If I need to, I’ll find someone to explain them to me and, by the way, I will understand a lot more than you think I do,”.....
....[A source close to Biden says the] account of the event offers a glimpse at the frustration the Obama White House faced in getting EHR companies to share patient records, despite giving billions in incentives for doctors and hospitals to buy systems. The software wasn’t reaching its potential despite years of investments. “We’ve made billionaires of the executives of these companies,” ...[he] said of EHR vendors. “They’ve had fun. Now, it’s our turn. Let’s get this thing changed.”
A perspective shared by many hospital executives, EHR vendors, and HIMMS representatives is that patient access to medical records and EHR interoperability is over-hyped. Hospital execs take this position, in my opinion, because they want to protect their market share and don't want patient records sufficiently portable such that patients can easily "doctor and hospital shop." EHR executives support their hospital clients in this regard and also favor the position because their systems are monolithic and not easy to change (see: How EMRs Will Change in the Near Future; Avoidance of Monolithic Systems; Why Is It So Hard to Promote Meaningful Changes in EHRs?). HIMMS clings closely to the hospital and vendor party line because it depends on them for the revenue generated by its annual conference and other activities.
There are two reasons why I think that patients need to have broad access to their medical records: price transparency and patient education. We always insist on appropriate and relevant documentation for any business that we transact: buying gasoline, buying a book on the web, or paying for any professional service. If the cost or quality of the goods and services we receive is unacceptable, we then turn to these records for proof. For the most part, patients don't have good access to their clinical record and the hospital billing is a disaster (see: Price Transparency In Medicine Faces Stiff Opposition — From Hospitals And Doctors; Coding for Hospital Services; One Reason for the High Cost of Healthcare; Two Reasons Why Medical and Hospital Bills Are Such a Mess; Those IndecipherableMedical Bills? They’re One Reason HealthCare Costs So Much). Also, patient education would be greatly improved by access to clinical records. Appropriately, Epic is now saying publicly that it absolutely supports patient access to medical records (see: Epic says it absolutely supports patient access to medical records despite reports of tense chat with Biden).
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