AMCNO Participates in Partnership Privacy Summit

Attendees of the summit were treated with an educational overview and demonstration of CliniSync. Representatives of Medicity (the vendor of CliniSync) and the Partnership fielded numerous questions from attendees regarding the infrastructure, mechanics and operation of CliniSync. Representatives also discussed the role and expectation of the participants (i.e., healthcare providers, hospitals, physicians, etc.) in establishing administrative access to CliniSync. As a brief overview, CliniSync is the electronic infrastructure (or software) that will enable the electronic exchange of health information between healthcare providers in Ohio. CliniSync is not a repository of health information. CliniSync is more akin to a records locator. Electronic health information is never transferred to CliniSync and will remain stored at the participant level. CliniSync is a portal that allows participants to access health information maintained by other participants.

The revised and final patient consent policy is the culmination of months of committee work and a public comment process. AMCNO and other healthcare stakeholders in Northern Ohio have been involved from the beginning providing detailed insight into the health information sharing practices in Northern Ohio and comments to the Partnership’s position regarding patient consent.

Throughout the process, AMCNO focused on two main areas. First, the desire for the Partnership not to take a legal position regarding the necessity under Ohio law of patient consent for the sharing of health information for treatment purposes. Second, the practical workflow barriers that exist with an opt-in model and the obligation to obtain express patient consent. The Partnership considered these two areas in great length and ultimately decided to finalize a patient consent policy that, while not exactly in line with the requested proposal from AMCNO and others in Northern Ohio, may provide a manageable framework without too many collateral consequences. The revised policy is guided by the Partnership’s interpretation of existing Ohio law regarding patient consent. The revised policy though is strictly policy based and risk management focused. The Partnership does not appear to take the position that Ohio law affirmatively requires express written consent from patients to share health information for treatment purposes. 

In addition, to reduce the burdens on operational workflows, the revised policy requires only a one-time patient consent. This consent is valid indefinitely until the patient revokes it. These aspects of the patient consent policy are critically important. By not taking a position on Ohio law, the Partnership implicitly recognizes that healthcare providers may elect not to participate in the CliniSync. While participating in CliniSync is encouraged, a healthcare provider may determine that the burden of obtaining patient consents for treatment purposes outweighs the operational efficiencies and other desires of current practice. That current practice being the permissible sharing of health information for treatment purposes among treatment providers without an express written consent from the patient.

Attendees at the summit also addressed the need for a legislative response. Since it appears as if this revised patient consent policy will be utilized by CliniSync and healthcare providers will be required to obtain affirmative consents from patients before sharing health information via CliniSync, a change to the revised patient consent policy may require legislative response. Several states have addressed this issue and have taken legislative action. For example, Nevada, Tennessee and Virginia each have enacted statutes that expressly permit the electronic sharing of health information for treatment purposes. In essence, these states have statutorily declared to follow an opt-out approach to HIE implementation. As for legislative changes, the partnership has invited those interested to participate in clarifying how this can/should be addressed by engaging with the committee in the future. Issues of physician liability, indemnity and auditing were of particular interest of those who attended. The AMCNO plans to participate in these discussions. More information on the partnership summit and on CliniSync will be included in the upcoming issue of the Northern Ohio Physician magazine.