Hospitals make it challenging for patients to access medical records

Under HIPAA, patients have the right to obtain a copy of their medical records. However, hospitals are making it difficult for them.

That’s the conclusion of a research team led by the Yale University School of Medicine that evaluated the current state of medical records request processes at 83 top-ranked U.S. hospitals located in 29 states.

Their study, published on Friday in JAMA Network Open, showed “discrepancies” in the information provided to patients regarding hospitals’ respective medical records release processes as well as noncompliance with federal regulations.

Yale School of Medicine-CROP.jpg
Yale University School of Medicine

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HIPAA guarantees patient access to protected health information in a timely manner, in a patient's preferred format, and at a reasonably low processing fee.

Nonetheless, the study found that just 53 percent of the hospitals indicated an option for patients to acquire their entire medical record. There were also discrepancies between the information hospitals provided over the phone versus on their request forms about the possible formats in which patients could request their records to be released.

In addition, 58 percent of the hospitals had costs for releasing the records above the federal recommendation of $6.50 for medical records housed electronically, with one hospital charging as much as $541.50 for a 200-page record.

“There were overwhelming inconsistencies in information relayed to patients regarding the personal health information they are allowed to request, as well as the formats and costs of release, both within institutions and across institutions,” says Carolyn Lye, the study’s first author and a student at the Yale School of Medicine. “We also found considerable noncompliance with state and federal regulations and recommendations with respect to the costs and processing times associated with providing access to medical records.”

Co-author Harlan Krumholz, MD, a healthcare researcher at Yale and a member of the JAMA Network Open editorial board, says the study involved scripted phone interviews with the hospitals’ medical records departments in a simulated patient experience.

“In three hospitals, it was not even possible to get a hold of any person,” notes Krumholz.

“Discrepancies in information provided to patients regarding medical records request processes and noncompliance with regulations appear to indicate the need for stricter enforcement of policies relating to patients’ access to their protected health information,” conclude researchers.

“We are a long way from reaching the aspiration of the laws,” comments Krumholz. “If we really want to move to a healthcare system where patients are at the center, then we need to find ways to ensure that they have agency over their own data. We're far from that right now."

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