Processes to Request Patient Medical Records

Oct 6, 2018
Study Examines Processes to Request Patient Medical Records in U.S. Hospitals

Bottom Line: Patients can face barriers when trying to obtain their medical records and a study of top-ranked U.S. hospitals suggests noncompliance with federal and state regulations regarding certain aspects of medical records request processes and discrepancies in information provided to patients may contribute.

Why The Research Is Interesting: A rule under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) gives patients the right to access their protected health information. A comprehensive review of the challenges patients experience when requesting the release of their medical records was needed.

What and When: 83 top-ranked U.S. hospitals (based on 2016-2017 U.S. News & World Report national rankings) in 29 states; researchers collected medical records release authorization forms from each hospital and telephoned each hospital’s medical records department to collect data on records release, processing times and cost to simulate a patient experience.

What (Study Measures and Outcomes): Scripted interview with medical records departments in a simulated patient experience (exposure); requested information, formats of release (pick up in person, mail, fax, email, CD and online patient portal), costs and request processing times that were identified on medical records release authorization forms and through telephone calls with medical records departments (outcomes)

How (Study Design): This was an observational study. Researchers were not intervening for purposes of the study and cannot control all the natural differences that could explain the study findings.

Authors: Harlan M. Krumholz, M.D., S.M., Yale School of Medicine, New Haven, Connecticut, and a member of the JAMA Network Open editorial board, and co-authors

Results:

This cross-sectional study of 83 US Hospitals revealed there was non-compliance with federal regulations for formats of release and state regulations for request processing times. In addition, there was discordance between information provided on medical records release authorization forms and that obtained directly from medical records departments regarding the medical records request processes.

Study Limitations: Only highly ranked hospitals were included and may not be representative of the medical request processes at all hospitals; telephone calls resulted in conversations with one person at each hospital and that person may disclose information not representative of the department or conflict with information others in the department might give

Study Conclusions:

The study revealed that there are discrepancies in the information provided to patients regarding the medical records release processes and non-compliance with federal and state regulations and recommendations. Policies focused on improving patient access may require stricter enforcement to ensure more transparent and less burdensome medical records request processes for patients.

To Learn More: The full study is available on the For The Media website.

(doi:10.1001/jamanetworkopen.2018.3014)