Physicians, in most cases, should be responsible for educating patients about health information exchange and obtaining “meaningful choice”--a decision on consent--from the patient, according to recent guidance from the Office of the National Coordinator for HIT.

“Meaningful choice ensures patients understand how and with whom their provider can share their information and the impact of their choices,” notes the guidance on the ONC blog site.

While the most popular way to capture patient consent is on paper, it is not optimal as the nation moves toward electronic capture of health information. Use of electronic consent systems in the Veterans Administration, with the provider and patient sitting at a computer screen, shows it can facilitate patient understanding of the process and ease tracking of consents, with a high rate of patient satisfaction, according to ONC.

A notice published in March 2012 provides rules for obtaining patient choice for information exchange: The consent is made with advance knowledge, not used as a condition for receiving care or other discriminatory purposes, made with transparency and education, appropriate under the circumstances, consistent with patient expectations and revocable at any time. Patients also should be able to designate another individual to make information exchange decisions on their behalf.

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