Transparent Electronic Health Records and Lagging Laws
Authors: Bryan S. Lee, Jan Walker, Tom Delbanco, Joann G. Elmore
Journal: Annals of Internal Medicine (2016)

Ideas and Opinions2 August 2016Transparent Electronic Health Records and Lagging LawsBryan S. Lee, MD, JD, Jan Walker, RN, MBA, Tom Delbanco, MD, and Joann G. Elmore, MD, MPHBryan S. Lee, MD, JDFrom the University of Washington School of Medicine, Seattle, Washington; Altos Eye Physicians, Los Altos, California; and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts., Jan Walker, RN, MBAFrom the University of Washington School of Medicine, Seattle, Washington; Altos Eye Physicians, Los Altos, California; and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts., Tom Delbanco, MDFrom the University of Washington School of Medicine, Seattle, Washington; Altos Eye Physicians, Los Altos, California; and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts., and Joann G. Elmore, MD, MPHFrom the University of Washington School of Medicine, Seattle, Washington; Altos Eye Physicians, Los Altos, California; and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-2827 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Millions of patients are accessing their medical records online via secure electronic patient portals. They are also increasingly uploading data directly into their records, and many clinicians now offer patients ready and ongoing access to the notes that document encounters. In response, patients report improved understanding of their care, better recall, enhanced adherence to care plans, and an increased sense of control over their health (1).Although these changes hold promise for improving the value and safety of health care, some opportunities are hindered by legal constraints dating back to when patients rarely saw their physical charts. To reflect new ...References1. Delbanco T, Walker J, Bell SK, Darer JD, Elmore JG, Farag N, et al. Inviting patients to read their doctors' notes: a quasi-experimental study and a look ahead. Ann Intern Med. 2012;157:461-70. [PMID: 23027317]. doi:10.7326/0003-4819-157-7-201210020-00002 LinkGoogle Scholar2. HIPAA, Pub. L. No. 104-191 (1996); Privacy Rule, 45 C.F.R. § 160, 45 C.F.R. § 164 (2002). Google Scholar3. Hickson GB, Clayton EW, Githens PB, Sloan FA. Factors that prompted families to file medical malpractice claims following perinatal injuries. JAMA. 1992;267:1359-63. [PMID: 1740858] CrossrefMedlineGoogle Scholar4. Huycke LI, Huycke MM. Characteristics of potential plaintiffs in malpractice litigation. Ann Intern Med. 1994;120:792-8. [PMID: 8147552] LinkGoogle Scholar5. Bell SK, Folcarelli PH, Anselmo MK, Crotty BH, Flier LA, Walker J. Connecting patients and clinicians: the anticipated effects of open notes on patient safety and quality of care. Jt Comm J Qual Patient Saf. 2015;41:378-84. [PMID: 26215527] CrossrefMedlineGoogle Scholar6. Coleman DL, Rosoff PM. The legal authority of mature minors to consent to general medical treatment. Pediatrics. 2013;131:786-93. [PMID: 23530175] doi:10.1542/peds.2012-2470 CrossrefMedlineGoogle Scholar7. Hickey K. Minors' rights in medical decision making. JONAS Healthc Law Ethics Regul. 2007;9:100-4. [PMID: 17728582] CrossrefMedlineGoogle Scholar8. Bourgeois FC, Taylor PL, Emans SJ, Nigrin DJ, Mandl KD. Whose personal control? Creating private, personally controlled health records for pediatric and adolescent patients. J Am Med Inform Assoc. 2008;15:737-43. [PMID: 18755989] doi:10.1197/jamia.M2865 CrossrefMedlineGoogle Scholar9. Kahn MW, Bell SK, Walker J, Delbanco T. A piece of my mind. Let's show patients their mental health records. JAMA. 2014;311:1291-2. [PMID: 24691603] doi:10.1001/jama.2014.1824 CrossrefMedlineGoogle Scholar10. 47 U.S.C. § 230(c)(1) (2015). Google Scholar Author, Article, and Disclosure InformationAffiliations: From the University of Washington School of Medicine, Seattle, Washington; Altos Eye Physicians, Los Altos, California; and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.Acknowledgment: James Ralston, MD, MPH, and Benjamin W. Moulton, JD, MPH, reviewed an early version of the manuscript.Grant Support: By the Robert Wood Johnson Foundation, National Cancer Institute K05 CA 104699, and a department of ophthalmology grant from Research to Prevent Blindness.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-2827.Corresponding Author: Bryan S. Lee, MD, JD, Altos Eye Physicians, 762 Altos Oaks Drive #1, Los Altos, CA 94024; e-mail, [email protected]pro.Current Author Addresses: Dr. Lee: Altos Eye Physicians, 762 Altos Oaks Drive #1, Los Altos, CA 94024.Ms. Walker and Dr. Delbanco: Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215.Dr. Elmore: Department of Internal Medicine, University of Washington, Harborview Medical Center, Box 359780, 325 Ninth Avenue, Seattle, WA 98104.Author Contributions: Conception and design: B.S. Lee, J. Walker, T. Delbanco, J.G. Elmore.Analysis and interpretation of the data: B.S. Lee, J. Walker, T. Delbanco.Drafting of the article: B.S. Lee, T. Delbanco.Critical revision of the article for important intellectual content: B.S. Lee, J. Walker, T. Delbanco, J.G. Elmore.Final approval of the article: B.S. Lee, J. Walker, T. Delbanco, J.G. Elmore.Obtaining of funding: J. Walker, T. Delbanco.Administrative, technical, or logistic support: T. Delbanco.Collection and assembly of data: B.S. Lee, T. Delbanco.This article was published at www.annals.org on 24 May 2016. 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