Thread/ Our @JAMANetworkOpen paper is 1st to identify challenges & unmanageable variability in all aspects of medical records request process for patients. @hmkyale @thehowie @JodiDaniel @allenlh @MarilynMann @ePatientDave @HugoOC @YaleMed @HHSOCR jamanetwork.com/journals/jaman… (1/10) 
For 83 top US hospitals, we collected information about the medical records request process from request forms and from simulated patient telephone calls to medical records departments. (2/10)
There were stark differences between information stated on request forms vs during phone calls. And hospitals noncompliant with state requirements for processing times. (3/10)
There was high variability among the hospitals in selecting individual categories of medical information on the forms. Only 53% of hospitals provided option to request the entire medical record on the forms. (4/10)
Hospitals should fulfill medical records requests in whichever format requested by the patient. However, mail was the only format of release offered by all hospitals, while digital formats were not widely offered. (5/10)
There was even greater variability for costs of requests. Often costs on request forms were different from what hospitals stated during phone calls; 35 hospitals that did not acknowledge costs on forms, 18 of these did have costs when asked during phone calls. (6/10)
For a hypothetical 200-page record, costs ranged from $0.00 to $541.50. Even for this relatively small 200-page record, 59% of hospitals are already above the federal recommendation of a $6.50 flat fee. (7/10)
Processing times ranged from 0 to 60 days, with at least 7 hospitals verbally reporting ranges extending beyond the maximum time permitted by state law. (8/10)
Why do we find these results meaningful? The lack of uniformity in the request process creates a high degree of variability in what and how records can be requested, and patients are not presented with accurate, complete information about the request process. (9/10)
If you or somebody you know has experienced difficulty requesting records, our study corroborates your challenges. Stricter enforcement of policies focused on improving patient access is needed to make the request process more transparent and less burdensome for patients. (10/10)
