The American Health Information Management Association supports many of the provisions in the HHS Office for Civil Rights' proposed rule governing accounting of disclosures under the HIPAA privacy rule and applauds OCR for "an excellent job updating this rule." But the association has serious concerns about provisions that give patients the right to an access report about who has accessed their electronic health records.

AHIMA does not believe there has been enough time for the industry to work with OCR to development a set of access requirements that satisfy the needs of individuals or acquire the resources needed to collect and create the reports, according to a comment letter to OCR Director Georgina Verdugo.

"We have received comments from our members that access reports are voluminous and contain hundreds of pages," according to the letter. "Our HIM professionals believe that individuals will not understand how long these reports can be, and we are concerned about the impact this volume will have both on the individual and the covered entity. Education to individuals is necessary prior to implementation of the rule to ensure that individuals fully understand the various types of accesses that can be listed in an access report. AHIMA fully supports the individual's right to understand what to expect when he or she receives an access report."

HIM professionals indicate that they have been able to respond to queries for access reports and satisfy individuals without providing the details that OCR proposes to be in the access report. "Accordingly, AHIMA suggests it would make more sense to require covered entities and business associates to respond to these requests on an ad hoc basis rather than require significant systems and process changes that will raise the cost of healthcare for what appears to be a very limited number of requests."

The complete comment letter is available at, under Comments and Analyses. While it may be marked as a "Draft," it is the final letter.


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