Getting Permission to Exchange EHRs
Report analyzes patient consent options
Researchers at George Washington University Medical Center prepared the report for the Office of the National Coordinator for Health Information Technology at the Department of Health and Human Services.
Carrying out a mandate in the HITECH Act, HHS recently issued grants to every state to help support HIEs.
The new report describes in great detail the options regarding patient consent for exchanging data among healthcare organizations. The options include:
- No consent: Automatically allowing the exchange of records without patient consent and without an opt-out clause;
- Opt-out: Offering patients only an all-inclusive opt-out option;
- Opt-out, with exceptions: Offering varying levels of opt-outs, such as allowing only selected data to be exchanged;
- Opt-in: Requiring that patients explicitly grant permission for the exchange of all of their information; and
- Opt-in, with restrictions: Enabling patients to grant permission for the exchange of specific subsets of their records.
The consent model chosen can directly affect the privacy and security of personal health information, the report acknowledges.
"While this document represents a starting point for discussion related to consent, it is imperative that future deliberations are informed by further research regarding the effectiveness and impact of various consent options, consideration of the broader policy landscape and assessment of the needs of those most affected by the consent decision," the report states.
"Until the time when we are confident that we can protect health information in a systematic and thorough way, prudent use of the mechanism of consent appears to be one of the most reliable ways to pursue that goal."
