A new proposed rule from the U.S. Department of Veterans Affairs (VA) seeks to streamline health data exchange of veterans’ medical records by enabling health information exchanges (HIEs) to more easily obtain patient consent.
The proposed rule would allow VA to amend current consent regulations so that partnering HIEs can obtain permission to share EHRs without a hardcopy of a patient’s written consent form. HIEs will have the option to electronically attest that a patient has granted them legally sufficient consent.
The VA states that the proposed rule would be a “reinterpretation of an existing, long-standing regulation and is necessary to facilitate modern requirements for the sharing of patient records with community health care providers, health plans, governmental agencies and other entities participating in electronic HIEs.”
According to the VA, under 38 U.S.C.7332, VA must keep confidential all records of identity, diagnosis, prognosis, or treatment of a patient in connection with any program or activity carried out by VA related to drug abuse, alcoholism or alcohol abuse, infection with human immunodeficiency virus, or sickle cell anemia, and must obtain patients’ written consent before VA may disclose the protected information unless authorized by the statute.
In the proposed rule, VA notes that the ability to quickly release section 7332-protected information has become increasingly important as VA strives to support veterans’ choice to seek care in the community and create innovative ways to provide effective and timely care to veterans. “In this regard, VA has entered into an agreement to participate in an HIE to help facilitate the transfer of information between different organizations. An HIE is the electronic transfer of health information among organizations according to nationally recognized standards,” the VA states.
The organizations that participate (HIE community partners) range from community health care providers and health plans to governmental agencies providing benefits, such as the Social Security Administration(SSA).
Historically, the VA’s interpretation that valid consent may be established only by VA’s physical possession of the written consent has left many HIE community partners unable to access veterans’ VA medical records at the point of care. While an estimated three out of four veterans enrolled in VA’s health care system also seek medical care in the community, HIE community partners’ requests for their VA health records must frequently be denied because VA does not have a consent on file, and many HIE community partners therefore, must either delay care to veterans or provide treatment to veterans without having the benefit of reviewing the veterans’ full medical history, according to the VA.
By allowing HIE community partners to attest that they have, in fact, obtained a valid consent, VA would be able to collect consent in a broader array of circumstances, the VA states. And, this would allow VA to release a veteran’s medical records to an HIE community partner, once the partner attests that they have collected valid consent, without VA having to wait for the document to be furnished. This would allow for HIE community partners to provide veterans with the most informed care, would allow VA to more expediently provide veterans’ records for the adjudication of their SSA disability claims, and would also allow for VA to continue innovating and creating new ways for veterans to receive timely and high-quality health care, the VA states in the proposed rule.