Monday, April 29, 2019

Passion for Politics

by Clarice Warner, RHIA, CCS-P, CPC, CHC

Have you ever had a passion for something. Something totally unexpected. Well recently, I’ve had the passion for politics.  Yes, politics.  I guess it started with me becoming a delegate for OHIMA. This year, I was provided the opportunity to attend AHIMA’s Hill Day and it was a great experience.  On March 25th and 26th, delegates from all 50 states gathered in Washington D.C. to visit our respective elected officials. I had the opportunity to visit with a member of Senator Rob Portman’s staff, a member of Senator Sherrod Brown’s staff and almost everyone in representative Steve Chabot’s office.  I also got an opportunity to meet with him personally as well.  As you can see the the elected officials showcase their pride in their states and the communities that they represent.   It was great to see the mementos and keepsakes displayed in their offices.

There were several issues that we brought before the officials.  The first one is to encourage notes sharing with patients in real time.  Unfortunately, our pervasive culture in medicine has kept real-time access of notes from getting into the hands of patients despite the numerous benefits of sharing notes with patients in real time.  The vast majority of hospitals and physician offices do not engage in systematic note sharing so AHIMA’s recommendation to Congress using its oversight authority to promote efforts such as open notes, the Medicare and Medicaid payment programs including the promoting interoperability programs, the MIPS improvement activity performance category and other innovative payment models so that the practice of note sharing benefits patients nationwide.

Next is align HIPAA right of access with the ONC’s Health IT certification functionality with all of the laws that we have for access to patient information individuals ability to access and use their health information continues to be a challenge and AHIMA recommends law makers to revise the definition of the designated record set (DRS) and require certified Health IT to provide the amended DRS to patients electronically while maintaining computability.  Further, regulators should develop guidance and request regular feedback from stakeholders on continued barriers to delivering this right under HIPAA.  This revision will provide greater clarity and predictability of what constitutes the DRS to both providers and patients.

Next is patient matching.  Since 1999, Congress has prohibited the use of appropriations by the U.S. Department of Health and Human Services (HHS) to promulgate or adopt any standard for unique health identifier until legislation is enacted specifically approving the standard.  This limitation has been included in every subsequent appropriations bill since fiscal year 1999 and is often seen as a barrier to public private sector collaboration and accelerating and scaling effective patient identification and matching solutions and AHIMA’s request to Congress is to omit the 1999 language in the fiscal year 2020 appropriations legislation to empower HHS to work with industry to advance a nationwide patient matching strategy. 

And lastly, extending HIPAA’s individual right of access to non-covered entities.  With all the rules and laws the ability of individuals to access and use their health information continues to be a challenge.  This challenge has only compounded in recent years with the proliferation of mobile health and health social media applications which are typically not covered by HIPAA’s right of access.  Such technologies are examples of HIPPAs non-covered entities (NCEs).  While Congress has passed several policies with HHS and has implemented a host of programs to improve patient data access, patients find that they have little access to and control of their health information collected by most HIPAA NCEs such as Fitbit and health apps. AHIMA recommends that lawmakers develop or directs HHS to define HIPAA NCEs in law and at a minimal extend HIPAA’s right of access to NCEs.  The goal of such a policy is to create a uniform data access policy for individuals using technology developed by an entity that produces and or manages their individually identifiable health information regardless of commercial or legal status.  We presented these issues to our elected officials and had 15-20 minute conversations with them.  Most of them were really interested in the NCEs because that was relatable. Everyone could relate to that and how that could potentially affect their constituents.

Is this the kind of work that you would be interested in?  Do you also have a passion for politics?  If so, feel free to volunteer for OHIMA and/or local American Health Information Management Association organizations. 

About the Author

Clarice Warner, RHIA, CCS-P, CPC, CHC is the Corporate Director of Corporate Responsibility for the Mercy Health Corporate Office in Cincinnati, Ohio.  She is also the Founder and Education Director for the Professional Reimbursement Network.  Clarice serves as a 1st-year Director and Delegate on the OHIMA FY 2018-19 Board of Directors, overseeing the Public Good strategy and Advocacy Committee.   

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