Tuesday, October 31, 2017
Ohio House Bill 172: Modify Law Governing Access to Patient Medical Records
UPDATE: The organizations in support of HB 172 (Ohio Hospital Association, Ohio State Medical Association) decided to pull this bill in May 2018. If they re-introduce a similar bill, they have said they will involve OHIMA in that process.
Ohio House Bill 172, sponsored by Representative Kirk Schuring, had its second hearing in the House Health Committee on October 18th. OHIMA’s Executive Director, Lauren Manson, has been in contact with Representative Schuring regarding this bill. After analysis, OHIMA does not currently support nor oppose this bill. The bill was reviewed and HIPAA already defines the “designated record set” and in its current state, HB 172 does not appear to add anything more than what HIPAA already requires.
HB 172 came about in response to Griffith v. Aultman Hospital where the Ohio Supreme Court decision interpreted Ohio's definition of "medical record." In this case, the daughter of a patient sued the hospital alleging that it did not provide her with all of the medical record as she had requested. Missing from the record were cardiac monitoring strips printed after the patient's discharge from the hospital and maintained by the hospital's risk management division, rather than its medical records department.
The trial court ruled in favor of the hospital, concluding that it had produced the medical record as defined by state law. The appeals court agreed, noting that only records that a hospital determines need to be maintained in the process of caring for a patient and not everything having to do with the patient must be disclosed. It held that a patient's medical record consists of what is maintained by the medical records department; any information the health care provider decides not to maintain is not part of that record.
In a 5-2 decision, the Ohio Supreme Court reversed the appeals court, holding that the physical location of data is not relevant to determining whether it qualifies as a medical record. Instead, the issue is whether a health care provider decides to keep data that is generated in the process of a patient's treatment and that pertains to the patient's medical history, diagnosis, prognosis, or medical condition. The Supreme Court concluded that for purposes of the medical record definition, whether data is "maintained" by a healthcare provider (and therefore must be provided) is determined by whether the provider made a decision to keep or preserve the data. Basically stating that “if it exists, it could be considered part of the medical record.” Ohio HIM professionals have expressed that, logistically, this is near impossible to put into practice.
HB 172 was developed in response to Griffith v. Aultman Hospital and is meant to limit the definition of "medical record" for purposes of the law governing access to patient medical records. For more information on this bill and to follow its progression in the House, see The Ohio Legislature website.