Wait time: 30 days or 36 hours?

By Bernie Monegain
01:52 PM

It’s near the end of May, and any organization that had something to say about the government’s proposed rules for meaningful use of electronic health records, Stage 2, has said it.

Now it’s time for CMS and ONC officials to weigh those comments and adjust the rules to make them user-friendly, while still effecting transformation.

The final rule is due this summer – no firm date yet.

Here at Healthcare IT News, we read comments from several professional organizations, representing CIOs, hospitals, doctors, health information managers, consumers and more, and we read a few from individual hospitals and physician groups, too. Each of them was extensive, several pages of detailed and sometimes complex comments – understandable, since they are providing insight on sweeping changes.

None struck us as much as the letter from the American Hospital Association that represents, as it notes to CMS, 5,000 hospitals across the country.

On the meaningful use requirement to provide patients who have been admitted to hospitals electronic health information about their stay within 36 hours after discharge, the AHA responded with an assertion that it just was not feasible.

We don’t buy it.

The AHA would maintain the status quo, it seems, at least on this aspect of the rule – and that is no way to manage change. It’s not that there is no room for comment or for disagreement. There is. Many hospital executives, for example, are worried about the piece of the rule that requires the hospital not only to make discharge information available to their patients, but also for the hospital to show that 10 percent of their patients have engaged by having either viewed, downloaded or transmitted their healthcare information.

They are nervous about being responsible for the actions – or rather non-action – of their patients. One hospital CIO told us that even with a portal in place for patients to view and download their information, less than 5 percent use it. However, the practice manager at one small physician group we visited, told us about 15 percent of their patients use the portal.

Each entity will have a different experience and will manage it in the way that is best for it. Many individual hospitals and health systems have weighed in on this and other details of the proposed rule. They have offered suggestions for amendment to the rule – perhaps a better or easier way of accomplishing the same thing, which is – lest we forget – engaging patients in their own care and moving the paper-mired healthcare system to the digital world.

In its comments to CMS, the AHA does not offer an alternative. Instead, it calls for removing this part of the rule altogether, and it asserts that CMS has no regulatory authority over patient access to electronic health information.

Moreover, AHA insists 30 days (not the three days called for in the proposed rule) is the necessary response time.

“While providing an electronic copy of protected health information maintained in an EHR eventually may be facilitated more easily by technology, the process of determining which records are relevant and appropriate takes the same amount of time as it does for evaluating paper records,” AHA writes in its comments.

So if the AHA had its way, patients would have to wait a month to access their own health information?


It’s not what today’s patients, who are used to instant-everything, expect or want. What about immediacy? What about relevance? A 30-day wait? It’s just not feasible.