LAWTECH GURU BLOG by Jeff Beard

Legal EHR Summit: Thoughts & Impressions

From the many presentations and discussions at the AHIMA sponsored Legal EHR Summit in Chicago, it's clear that healthcare records and records management in the U.S. are changing.  (In case you were wondering, "EHR" = Electronic Health Record).  In George Paul's (Lewis & Roca) keynote, he shared how the U.S. government is pouring money into healthcare records via incentives in the ARRA and HITECH acts.  Several presenters referred to these changes as the biggest change to healthcare privacy and security rules since HIPAA was enacted.  Indeed, even as we discussed these developments, new security breach notification rules were due out yesterday.  Also discussed in several sessions, these new laws will likely require many business associate contracts to be renegotiated.

It's also interesting to note that as much as some think of U.S. healthcare as high-quality and high-tech, the underlying HIT and records management systems and professionals are struggling with addressing these new changes, challenges, and ramifications, especially with respect to the legal aspects.  For instance, many HIT systems are not geared toward the legal aspects of preservation (think dynamically changing databases on a daily basis) and production.  Not surprisingly, their focus is on enabling the healthcare professionals and organizations in the provision of their services.  Several cases were mentioned where the plaintiff's attorney wanted to see the data and screens of what the doctor saw when he/she was treating the patient.  The response I heard throughout was that this wasn't possible due to the constantly changing nature of the data in these systems.  It doesn't take much imagination to sense how well this goes over in litigation, and the need for creative solutions.  Much discussion also centered around records management and creating/refining document retention policies, and just as importantly, complying with them.

There were also some pretty scary stories relating to Iatrogenesis, or the patient harm caused by the use of computer systems, and the lack of transparency and sharing of those problems by the software vendors.

There's also the issue of creating the necessary interoperability and sharing of information across different HIE's (Health Information Exchanges) - from local to regional to state to national levels.  So there's a fair amount of catching up and transformation that needs to happen in this industry.  The good news is that these issues are being discussed in depth across multiple disciplines - IT (HIT), Records Management, Legal, Risk Management, and Compliance, just to name a few.

With respect to the summit itself, this was the first time I attended an AHIMA conference.  It's been well organized and everyone at AHIMA has been very helpful and friendly.  There is definitely a spirit of cooperation and collaboration among everyone here, including the attending HIT, records and risk managers, consultants, and attorneys.  Indeed, there is a high degree of interest in addressing and resolving these issues through better understanding of the legal issues by health information professionals, better definition of standards (for instance, what constitutes the "Legal Electronic Health Record"?), and transforming the records management systems and processes.