| Page # |
Line # |
Comments/Criticisms |
Suggested Alternatives |
| 23 |
22-24 |
This recommendation for a single consent form for all health information does not simplify information exchange. Sensitive health information, by law, requires affirmative consent. By combining all health informatin together in one form this adds an affirmative consent requirement that is not necessary by law to the great volume of health information that is not considered sensitive or protected. This will impede RHIO development and usage, and limit the reach and utility of the systems. There is no sound rationale to restricting "general" health information in the same way sensitive health information needs to be limited. On a practical matter, the vast majority of clinical information, which is everything other than the defined "sensitive" areas, would provide almost all if not all of the benefits the position paper describes on page 4. We feel it is open to further discussion whether all sensitive information needs to be included in the RHIO's at all. The significant benefits that EDI will accrue will be |
Eliminate recommendation # 5 requiring a single consent form for all health information including all specially protected health information. A single statewide consent form should be developed for sensitive health information. Sensitive health information may or may not be available through RHIOs. For RHIOs that include this option and for patients who wish this information to be made available over the RHIO, affirmative consent will be required as specified by law. For all other health information, patients will be able to "opt out" of the system if they do not want their information to be accessible through the RHIO networks. |
| 20 |
29-32 |
Extraordinary burden is placed on providers as well as RHIO's if they become saddled with this vast administrative burden. The process of educating patients with respect to the consent policies that are outlined, keeping track and maintaining the records of such consents, and appropriately sorting and selecting patients in these different consent categories is a huge task that will reach all aspects of the New York health care system, adding tremendous administrative load and expense throughout healthcare in our state. By definition, the activities undertaken by each provider to educate patients will soon become redundant and duplicate work that has been done by others before. The very sophisticated and subtle nature of the high degree of patient understanding implied in this white paper would be especially challenging to achieve, and would commensurately increase cost and complexity further, and disenfranchise some of the neediest and sickest members of our population. |
Eliminate recommendation # 2 requiring affirmative consent for all patients, instead limiting affirmative consent to the sensitive health information for which it is legally required. |
| 19 |
4 thru 19 |
We strongly agree that high liquidity is needed for the system to be utilized by providers and to be effective in improving patient care and improving patient outcomes, as well as avoiding duplicative and unnecessary testing. By requiring affirmative consent, this system becomes illiquid and all those benefits are lost. A system of affirmative consent would by definition exclude a large (but not measurable) portion of our NYS population. It would effectively discourage providers from participating fully in utilizing these systems, because the fewer patients enrolled the less utility this will provide in the office where care is delivered. The patient care benefits for everyone drop off rapidly the greater the number of patients and providers who do not participate. |
Eliminate recommendation # 2 requiring affirmative consent for all patients, instead limiting affirmative consent to the sensitive health information for which it is legally required. |
| 7 |
13 |
The document refers to consumer trust and consumer confidence. It is our position that consumer trust and consumer confidence is enhanced and assured by building the system with the proper guidelines, requirements, audit features and review policies and not by building a "better consent form". The trust of the consumers will be responsibly and convincingly addressed when operational effectiveness and appropriate safeguards are in place -- not by a new and better form. |
Eliminate recommendation # 2 requiring affirmative consent for all patients, instead limiting affirmative consent to the sensitive health information for which it is legally required. |
| 20 |
29-32 |
Instead of the "opt-in" methodology, treating providers should access the RHIO information in the method described on page 19, lines 28-38 for "one-to-one" information transfers.Since most, if not all, provider interactions with the RHIO information databases will be "one-to-one" transactions, then the methodology of acess descibed on this page should be the basic working model of how the system operates. If not, the system will lose the liquidity described on page 19, lines 4-19. In this arrangement, patients will be able to "opt out" of the system if they do not want their information to be accessible through the RHIO networks. |
Use the process described on page 18, lines 28-38, as a model for the operational process of information exchange of non-protected medical information for the RHIOs in New York State. |
