Limiting Access to Patient Records Hurts Care, Researchers Say

CMU team says sharing electronic records is as simple as choosing the right vendor

Accessing medical information can be difficult in America's health care system.

In a recent paper published in BMC Health Services Research, Carnegie Mellon University researcher Anabel F. Castillo, along with professors Marvin Sirbu and Alexander Davis, have looked into one major way that keeping information locked up is holding people back.

Traditionally, the health care industry has gone to great lengths to ensure that patients' medical records remain private and sealed. But as more hospitals adopt the use of electronic health records, more doctors are looking into ways that these records can be used to improve patient care.

Until now, when patients switch health care providers, getting health records transferred has been a long and involved process, incurring time and monetary costs. Without these records, patients' new providers are left without an accurate record of their medical history. With so many health care providers, and questions of in-network versus out-of-network treatment, there are many opportunities for error. While the introduction of electronic health recordss has the potential to make this sharing easier, the current system has problems.

"Without interoperable systems, the full potential benefits of adopting electronic health records cannot be achieved," said Castillo, a researcher in the Department of Engineering and Public Policy. "Patient-centered treatment requires collaboration, coordination, and accountability. This can only be accomplished when medical information is available for exchange."

The team's study looks at the factors that lead hospitals to adopt these electronic records and how their choice of vendor can affect how patient health information is shared. It turns out the answer to getting hospitals to share their information is as simple as choosing the right vendor.

"Our findings show that the likelihood of a hospital exchanging clinical summaries with hospitals outside its health system increases as the percentage of hospitals with the same EHR vendor in the region increases," the team wrote in the paper. In other words, hospitals are much more likely to share information if they are all using the same vendor, due to the ease with which systems can communicate, versus the difficulty of having one system communicate with another.

But hospitals aren't simply choosing vendors on a whim. Regulations govern how and why hospitals determine their preferred vendor. The Health Information Technology for Economic and Clinical Health (HITECH) Act and the associated State Health Information Exchange Cooperative Program, provide monetary incentives to providers and hospitals to support the exchange of information through electronic records. Because these regulations play such a big role in the adoption of these systems, new regulations could have a huge impact on making these exchanges more efficient.

"Identifying the barriers for information exchange," the team said, "is a necessary step to achieve the goals of the HITECH Act in creating a more efficient and effective health care system."