It's Time To Stop Pretending Patients Don't Care About Their Medical Records

http://goo.gl/ovtYVw

Last week, I asked the Internet whether it was important for them to view their electronic medical records. Almost 1,000 people voted, with a resounding 77% responding that they wanted access to their record "like yesterday."

It might seem obvious that patients voted to view documents that contain information about medical histories, immunization reports, doctors' annotations, diagnoses, and prescriptions. In some cases, accessing records has resulted in patients stepping in to to correct important medical errors or oversight, or avoiding duplicate testing.

But the results were a surprise to me. For years, I've heard from prominent groups in health care that most patients are fairly indifferent to their medical records. That view has even informed important policy decisions: As an example, in part due to pressure from physician groups, Centers for Medicare and Medicaid Services (CMS) implemented a rule change that made providers responsible for just one patient viewing, transmitting, and downloading their digital medical record in 2015 and 2016, down from than the previous 5%. That's not one per person—that's one total.

"The biggest issue in the pushback on CMS from groups like the American Medical Association and American Hospital Association was that providers shouldn’t be accountable to patient behavior, and that patients were often indifferent," says Arien Malec, a vice president at RelayHealth and former employee at ONC, the government agency responsible for coordinating the implementation of health IT. The AMA admits here that it urged CMS to make this "immediate improvement"; AHA has also pushed for a rollback of this rule on the grounds that physicians' performance shouldn't be "contingent on the actions of others."