Patient records: The struggle for ownership

Patient medical records are undergoing a seismic shift. The transition from paper to electronic records has created new opportunities for sharing information among healthcare providers, between physicians and patients, and with third parties. The mobile revolution, meanwhile, has heightened consumers’ expectations about data sharing with physicians, including data generated by mobile health apps.

But this shift is happening quickly, in many ways too quickly for either physicians or the laws and regulations pertaining to medical records to keep up.

“We’re struggling with this in part because of the transitional nature of the technology that we’re using,” says Ira Nash, MD, a Manhattan cardiologist and executive director of the North Shore-LIJ Medical Group. “We have rules that were developed when none of this kind of wide-scale data sharing was possible. And I don’t think the regulatory environment or the general understanding about this has kept pace with the technical capacity to collect huge amounts of data and share it.”

How are these changes in the data environment affecting physicians’ relationships with patients, other healthcare providers, and the many other entities that seek access to healthcare data? Here is how some of your colleagues, healthcare attorneys, and consultants are thinking about these issues.

Who owns the records?

There is no consensus on who owns medical records. The Health Insurance Portability and Accountability Act (HIPAA) does not specify ownership, and state laws are inconsistent. Only New Hampshire has a law stating that patients own their medical records. In 20 other states, providers own them. The rest of the states have no legislation addressing the matter, according to an analysis of state laws by Health Information & The Law, a project of the George Washington University’s Hirsh Health Law and Policy Program and the Robert Wood Johnson Foundation.

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