Interoperability troubles highlighted in delay of presidential candidates' medical record release

As questions regarding the release of the presidential candidates' medical records persist, a larger issue of the feasibility of compiling and releasing the records in full has come to light. Given the state of connectivity — or lack thereof — today, could anyone access and curate their full medical record if they wanted to?

In recent days, Republican presidential nominee Donald Trump has pressed Democratic presidential nominee Hillary Clinton to release her health records. This request, according to a report in The New York Times, poses a significant challenge.

"Assume that Mrs. Clinton wished to take Mr. Trump's request seriously, and release full and detailed medical records. It would not be easy, even for a VIP with an army of staffers," according to the report. "Mrs. Clinton is 68 years old, has lived in multiple states and has been treated by many doctors and hospitals over the years. The notion of a single file, containing 'medical records' is a fiction. Her medical records are in bits and pieces, in doctors' filing cabinets, hospital records departments, and in hard-to-access computers."

If this is a problem for somebody in contention for the highest office in the country who has entire teams working with and for her, it paints a bleak picture for everyday citizens trying to obtain their own medical records, suggests the report. 

While patients may not always be seeking their medical records in full, even accessing parts of records can be daunting. The NYT report mentions providers' reluctance to provide patients information out of fear of inadvertently violating privacy laws, even though part of HIPAA requires covered entities to provide individuals access to designated record sets when requested. Or, providers give records to patients on CD-ROMs, or as illegible handwritten notes, or via fax.

Interoperability and health information exchanges are billed as the requisite next step in health IT, making patient data available no matter where the patient seeks treatment. But, as NYT suggests, the country is still far from achieving this ideal.

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