Posted on: December 6, 2017

Obtaining patient consent: Why is it necessary to ask every patient to sign a consent form in order to look at that patient’s complete medical history?

After all, the patient has probably signed the same consent form at a hospital or other provider’s office. You may wonder why a patient can’t sign a single consent form that lets every healthcare provider see their medical records.

In some states, like Rhode Island and other regions of New York, that is exactly what happens. In this context, patients sign a single consent form that lets every provider in the state access their health records.

It may appear that a single form makes more sense and that it would be easier for all involved. In our region, however, patients must sign a consent form for every healthcare provider they see. The reason is that it gives patients greater control over who has access to their medical information.

How Patient Information is Shared Between Providers

Health information exchanges (HIEs) compile medical information about patients who have been treated at participating providers. The HIE makes that information easily accessible to healthcare providers in a safe, secure environment so that whenever you see a patient, the provider will be able to easily see their patient’s complete medical history. Hixny is the HIE that covers the Capital District, northern New York, and the Mohawk Valley.

All HIEs in every state require some type of patient consent before they can access medical information with providers. But different states use different consent models . Some states use an opt-out model that automatically assumes patients have given consent unless they take specific action to withdraw that consent.

Other states use the community-wide consent model, which allows HIEs to collect a patient’s health information but not share it until the patient signs a single consent form. That form gives the HIE permission to share their information with every provider in the state.

The consent-to-share model is similar but requires that the HIE get a patient’s consent before it can begin to collect their medical information. When they get permission to collect a patient’s medical records, HIEs can share that information with every provider in the state.

New York State Prioritizes Patient Privacy

The fourth model, the consent-to-access model, is used by Hixny and other HIEs in New York state. The consent-to-access model allows HIEs to collect medical information about patients, but they cannot share that information with providers until a patient gives their consent.

Unlike other states, New York allows its HIEs to share medical information only with providers who have a consent form signed by the patient. The patient is in control of which of their treating physicians they grant access to their medical history.

The consent-to-access model used in New York state may seem burdensome at times. From a provider standpoint, obtaining patient consent can present workflow challenges. However, the consent-to-access model provides patients the most control over who can see their private medical records.

Different Requirements for Substance Abuse Issues

While the consent-to-access model used in New York state requires that each provider obtain a signed consent form from a patient, federal law also prohibits providers from seeing certain types of medical records without a patient’s specific consent. The federal Confidentiality of Substance Use Disorder Patients Records, also known as 42 CFR Part 2, governs access to medical records that cover treatment for substance abuse disorders. This means that certain types of medical information can come with challenging restrictions when provider access is needed.

Hixny has a number of participants who already contribute 42 CFR Part 2 data to the HIE. In other regions and states, more than one consent form would be required for a provider to access this type of data.

It can be tedious for providers to address the restrictions this type of data imposes—which is why Hixny made the choice to address multiple circumstances with one consent form that encompasses 42 CFR Part 2 data.

The all-inclusive consent form is designed for both the standard flow of data as well as 42 CFR Part 2 data and is a much more simplistic way for participants to access all of a patient’s medical history.

Putting Consent in Perspective

Consent requirements can seem like a hassle. But New York state has chosen this model because it’s the one that best serves patients and providers. It strikes a balance between two key healthcare goals: facilitating the sharing of clinical information and protecting patient privacy.

Hixny will be performing extended maintenance beginning Thursday, December 31 through Friday, January 1. During this time, all services
will be impacted and unavailable—including access to the provider portal.
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