Texas legislators have made the state one of a handful offering physicians liability protection when using electronic health records and participating in a Health Information Exchange (HIE).
While the expanding role of health information technology brings value through increased sharing of patient data and better care coordination, its growth also brings liability concerns to providers as cyber criminals expand their activities by targeting sensitive patient information. According to the Identity Theft Resource Center (ITRC), more than 169 million personal records were compromised in 2015 as a result of reported data breaches. While the breaches occurred across a range of industries from financial to education and the government, the ITRC reports that more than 67 percent or 112,832,082 of the compromised records came from the medical and healthcare industry.
In response, legislators adopted House Bill 2641 during the 2015 legislative session providing protections for health care providers if they participate in an HIE. The new law, which received overwhelming bipartisan support in both the Texas House of Representatives and Senate, states that unless a health care provider acts with intent or gross negligence in providing patient information to a health information exchange or another provider, the provider is not liable for any damages, penalties, or other relief related to the obtainment, use, or disclosure of the patient information by a health information exchange, another health care provider, or any other person that is in violation of federal or state law.
The new law does not affect a provider’s responsibilities to comply with state and federal privacy laws nor does it relieve them of their notification requirements should they be involved in a data breach, but it does put in place strong protection for providers participating in an HIE.
The adoption of HB 2641 reinforces the state’s ongoing commitment to foster the use and exchange of electronic health records to improve the quality, efficiency and safety of health care in Texas. In 2011, legislation was adopted which resulted in the creation of the SECURETexas program which allows its certification to be used as a mitigating factor for any civil or administrative penalties resulting from violations of the Texas Medical Records Privacy Act by individuals or organizations that use, store and/or exchange patient health information. You can learn more about the SECURETexas program by visiting: http://securetexas.org/.
The Rio Grande Valley of Texas is known to have among the highest rates of Type II diabetes in the country. Research reported by The University of Texas Health Science Center of Houston estimates that as many as one-third of adults have diabetes, many of whom are undiagnosed or not receiving adequate treatment. With Hispanics twice as likely as non-Hispanics to be diagnosed with diabetes, the impact of the illness among the Rio Grande Valley’s largely Hispanic population is significant. Its causal effects on medical conditions including heart attacks, strokes, sepsis, leg ulcers, and eye and kidney diseases make the human and financial toll of the illness staggering.
While preventive measures and disease management programs can greatly reduce the impact of the disease, the low income of much of the region’s population, high uninsured rates and a large segment of medical underserved individuals present challenging barriers for effective treatment. These factors reduce a patient’s access to primary health care services, leading many to use emergency rooms for care, resulting in fragmented management of chronic conditions and increased chances for diabetes-related complications.
Recognizing the barriers to treatment, the Rio Grande Valley Health Information Exchange (RGVHIE) and The University of Texas Health Science Center are partnering to develop a diabetes registry that will give medical providers in the region a powerful tool to identify diabetic patients, track their progress and design customized treatment plans. By participating in the registry, physicians will be able to share notes, coordinate care, consider diagnostics and medication regimens, and access inpatient and emergency room records that could impact treatment. The data, its timeliness and availability will allow medical providers to make better treatment decisions based on a more comprehensive patient record while also avoiding duplicative testing. Patients will have the ability to authorize who is permitted to access the information.
The RGVHIE currently includes 26 hospitals, clinics and other organizations that provide primary care for the area’s 500,000 residents. The registry will integrate electronic medical records of diabetic patients from those institutions into the region’s growing RGVHIE, allowing the information to be shared among physicians and hospitals across the region.
Data such as disease status, hospital admission, co-morbidities and treatment recommendations will be included in the registry. Through the RGVHIE, physicians will be able to access the registry’s dashboards to view the data in order to enhance care coordination. The outcomes will not only mean improved quality of care for diabetic patients, but allow physicians to spend less time analyzing data and more time talking with the patient about managing the condition.
The diabetes registry was launched on October 2014 and is featured in a case study that is available on the HIETexas website. To view the case study, click here.
Many don’t understand or simply under estimate the importance of personal health records. Most people have their health information scattered amongst different providers, allowing for duplicate procedures and processes. This can be dangerous, financially and for your health. Without the most current and updated information available to the provider, it can affect the medical decisions one makes and in turn affect you.
Ideally, a personal health record or PHR is an internet based set of tools that allows people to access and coordinate their lifelong health information and make appropriate parts of it available to those who need it. It holds the potential of engaging patients in their own healthcare with the ultimate purpose of improving overall quality and health outcomes.
The PHR is a comprehensive health record, where all information from within comes from Electronic Health Records (EHR), Pharmacies, Authorized users, and Patient entered data, it is controlled by the patient. The PHR comes in different forms such as:
- Freestanding- Entirely owned by the patient and usually hosted through an internet-based platform, and is not “officially” associated with any record
- Tethered- A PHR that is hosted by a health care provider and is linked to his or her EHR.
- Sponsored- A PHR that is provided by a patient’s health insurance plan, or employer, and is populated with information based upon claims data.
The efforts to engage in Personal Health Records are driven by the belief that it holds value for patients, providers, and the communities in which they live to improve health care delivery. Consumers have the greatest opportunity to expand their role in their own healthcare. Its functions include, 24 hour access to health information, communication with providers, education regarding the patient health, and most importantly, privacy.
The Veterans Health Administration has seen great success with its Online PHR “My HealtheVet”, an award winning PHR that has occupied 35% of the veteran population. With integrated 24 hour secure messaging it has promoted the partnership between patients and providers while providing a safe alternative means of communication. A prime example to one of many solutions concerning quality care improvement.
Centers for Medicare and Medicaid Services recently released its proposed regulations for Stage 2 Meaningful Use. It includes numerous hospital and physician requirements such as secure messaging platforms by 2014. It will also emphasize provider accountability for 10 percent of its patients to have online access to patient health information via PHR or web portals to achieve Meaningful Use.
However, current awareness of the capability and benefits of PHR’s is low. The adoption and investment of PHR’s requires health providers and practices to actively promote its benefits, as most patients would prefer to have a PHR sponsored by their physician. The rapid use of Electronic Health Records adoption by physicians will accelerate deployment of Personal Health Records. Ideally Patient Health Records will serve a major role in this evolving health care system and engage consumers to aid in improving their own health goals.