Patients would be allowed direct access to lab results under a new rule proposed by the Obama administration that is part of a broader effort to nudge the health care industry away from paper-driven systems and toward technologies that make it easier to access and share records.
President Obama included in his 2009 stimulus bill a $20 billion package consisting mainly of incentives for doctors and hospitals to use electronic record-keeping systems. The aim is for patients to become more involved in their own health care through technology that helps them share records with providers and track symptoms.
"I know you have all experienced the same frustration I've certainly experienced," said Secretary of Health and Human Services Kathleen Sebelius, speaking at a health IT summit on Monday. "Going into a doctor's office and being presented with the blank clipboard as if you arrived from Mars once again and had to start all over once again introducing yourself."
Mrs. Sebelius was outlining frustrations patients commonly face in an industry where just roughly 20 percent of hospitals and 10 percent of doctors store records electronically, even though the first electronic models were developed in the 1960s.
"As time went on and industry after industry threw away their paper files and storage cabinets, health care continued to lag behind," she said. "Even after innovative hospitals around the country showed that electronic records reduce errors and improve communication between doctors, paper records stuck around."
Later this year, HHS will finalize the proposed rule requiring labs to give patients direct access to test results, after a 60-day public comment period. The federal government is allowed to regulate laboratories under the 1988 Clinical Laboratory Improvement Amendments.
Mrs. Sebelius, who announced the new rule at the summit, said patients will be more likely to ask the right questions, make better decisions and receive better care if they can access their results.
That's where the technology comes in. Officials highlighted players in the health care industry that have signed pledges committing to either implement or promote health IT — groups that include major insurers Aetna and United Health Group, along with large providers like Kaiser Permanente and the Cleveland Clinic.
Last year, the Department of Veterans Affairs launched a capability called Blue Button that allows patients to download their personal health records and is being adopted by Aetna and Walgreens, two of the largest storers of health records. Another innovation is electronic prescribing, where doctors can transmit prescriptions directly to pharmacies.
Some technologies are taking the form of applications for mobile devices. Nikolai Kirienko, afflicted with Crohn's disease, said he is developing an iPad application that helps other patients record and communicate their symptoms to their doctor. Mr. Kirienko shared stories of how his physicians chose procedures that later turned out to be harmful because they weren't familiar enough with his medical history.
Donald Berwick, administrator for the Centers for Medicare and Medicaid Services, shared a personal story of how health IT improves care.
About 15 years ago, a close friend began finding it difficult to walk and then started having severe pain around his midriff, Mr. Berwick said. After doctors guessed the pain was caused by multiple sclerosis and sent his friend home, the friend decided to take matters into his own hands and requested his complete medical records from the hospital.
"On the last page of the last portion of his record was a laboratory slip," Mr. Berwick said. "It had not arrived until he had been discharged home and had simply been inserted by a clerk into the record. It reported a vitamin B-12 level of zero — he had pernicious anemia, a totally curable, totally treatable cause for what otherwise would have led to a lethal outcome for my friend."
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