Stream: patient empowerment
Topic: OCR ruling
Virginia Lorenzi (Feb 04 2020 at 02:24):
Some US regulatory tea that I am trying to comprehend that relates to patient access: https://healthitsecurity.com/news/judge-rules-against-hhs-over-hipaa-right-of-access-third-party-fees
Dave deBronkart (Feb 04 2020 at 02:28):
You’re not the only one. On Twitter last week someone tweeted it knowingly to their insider friends, and when I asked for a distillation of the double triple contradicted negatives, I got a quick “Don’t know - not in the habit of unpacking fifty page rulings on weekends”!
Dave deBronkart (Feb 04 2020 at 02:31):
No wait, this is different. It seems to be about the labor cost of delivering data, yes?
If so, wouldn’t FHIR nullify the issue, driving labor costs to zero? No? Maybe I’m misunderstanding.
Lloyd McKenzie (Feb 04 2020 at 03:31):
My read is: ONC gets to set rules on fees orgs can charge when giving access to the patient directly, but orgs can charge whatever unreasonable amount they want if there's a desire for the data to flow directly to someone other than the patient (e.g. their insurer, another healthcare provider). The end result seems to be to reinforce the need for the patient to act as data mule. (And for unreasonable costs to be imposed when the target recipient doesn't trust the patient as a data mule.)
Caveat - I'm a Canadian and not a lawyer, so my interpretation doesn't much count :>
Virginia Lorenzi (Feb 04 2020 at 05:34):
@k connor note this topic. I am thinking like Lloyd here. Also, a lot of this is copying costs of stuff not available on the API.
Ryan Howells (Feb 25 2020 at 22:27):
OCR recently posted the ruling should not affect patient access.
https://www.hhs.gov/hipaa/court-order-right-of-access/index.html
Dave deBronkart (Feb 26 2020 at 21:22):
From that OCR link, about that obnoxious court decision:
the fee limitation [on how much data holders can charge a patient] ... will apply only to an individual’s request for access to their own records, and does not apply to an individual’s request to transmit records to a third party.
That's just obnoxious. If I read that correctly, it allows pricey tolls on data transfer - is that what it says?
Does the proposed rule/s change that? I've heard vague things about the rule saying "API access must be free" or something.
Josh Mandel (Feb 26 2020 at 21:26):
https://www.healthit.gov/sites/default/files/nprm/ONCCuresNPRMAPIPermittedFees.pdf is ONC's summary of the proposal
Josh Mandel (Feb 26 2020 at 21:27):
The 2nd bullet is a proposed prohibition on fees "in connection with supporting the use of API technology that facilitates a patient's ability to access, exchange, or use their electronic health information".
Dave deBronkart (Feb 26 2020 at 21:28):
Glad to hear it. Let's hope.
Last updated: Apr 12 2022 at 19:14 UTC
