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Most hospitals were found to be noncompliant with federal and state regulations when completing patient medical records requests, according to a study published in JAMA Network Open.

Through a simulated patient experience, researchers analyzed 83 U.S. hospitals across 29 states that maintained independent medical records request processes and medical records departments reachable by telephone. The hospitals were among the top 20 hospitals for each of the 16 adult specialties in the 2016-17 U.S. News & World Report Best Hospitals National Rankings.

Under HIPAA, patients have a right to access their protected health information. Federal law requires medical record requests must be fulfilled within 30 days of receipt, in the format the patient requests and for a fair cost to the patient.

Information on records request authorization forms differed from that obtained from patient telephone calls in terms of requestable information, formats of release and costs, according to the researchers. Additionally, 8 percent of hospitals were noncompliant with state requirements for processing times.

On telephone calls, all 83 hospitals said they were able to release entire medical records to patients, but on the forms, fewer than 9 hospitals (11 percent) provided the option of selecting one of the categories of requestable information, such as laboratory test results, medical history and discharge summaries, and only 44 hospitals’ forms (53 percent) gave patients the option to acquire the entire medical record.

There were also differences between the formats hospitals said they could use to release information. On telephone calls, 83 percent of hospitals stated they would allow the patient to pick up their records in person, compared with 48 percent of forms listing this option. Forty-seven percent of hospitals indicated they could email patients their records when patients asked on the telephone calls, while only 33 percent of hospitals’ forms listed email as an option.

The researchers also identified 48 hospitals that charged well above the federal government’s recommendation of $6.50 for electronic records — charging as much as $541.50 for a 200-page record.

“Requesting medical records remains a complicated and burdensome process for patients despite policy efforts and regulation to make medical records more readily available to patients,” the study reads. “As legislation, including the recent 21st Century Cures Act, and government-wide initiatives like MyHealthEData continue to stipulate improvements in patient access to medical records, attention to the most obvious barriers should be paramount.”












