Thread by @JoelGWakefield

Because I think it is important that those of us working in healthcare remember the practical consequences of the regs we advise clients on, I am going to live tweet my own attempt to obtain a copy of the record of a single clinic visit a few months ago . . . #HIPAA #Really?

Clinic visit happened in January, and now I have a need for a copy of the record. Doctor was at a clinic that isn't convenient to walk into personally, so I called and asked the process. Told that I need to access the patient portal to get the authorization form. So far so good.

Need to set up a patient account to get into the portal. There's another password to remember, of course, but I can deal with that.

Once an account is established I find the Authorization Form, anticipating that now that I am inside the patient portal I should be able to fill out the form, electronically sign it, and download the record, or at least submit the request from there. But nope.

First, the Authorization Form is not set up as a fillable form (Pro tip to the clinic - that's not very hard to do). Instead, I have to print the form to fill it out. Ok, there's another unnecessary step, but if that's what they have decided I have to do, so be it.

There are 19 different boxes to consider when saying which records I want. None of them are "all records." I hope I cover everything when I check the separate boxes for "Progress Notes," "Outpatient Clinic Records," "History & Physical Exams," and "Consultations/Evaluations."

So now I have a piece of paper which I have to get to the clinic. Of course as we all know, HIPAA was drafted in a time of technological flux, giving rise to the cementing of fax technology in place, so the only way I can transmit this to the clinic is by fax. Or I could mail it.

I don't have access to an old time fax machine of course, no one does. Except health care providers. Rather than go to a nearby doctor's office and ask to borrow their fax I use our online fax system-which we only maintain because our healthcare clients need to fax us things

Of course, I now need to scan the paper authorization, which converts it back into an electronic document (which it was about 20 minutes ago, remember). It is in its electronic form only so I can upload it to our fax service.

At this point (and I must confess I am not sure about this part and am not going to spend the time to verify), I believe the fax service then converts the electronic version of my authorization to an analog form so it can be received in fax form by the clinic.

And I am pretty sure the clinic will now take that Authorization (which likely is back in paper form) and digitize it again so it can be easily accessed in its electronic health record.

And then the clinic will mail me a photocopy of the 2 pages of notes from the original visit (I asked for paper copy rather than the only other option - a CD). Probably a couple of weeks for that to get here, I set the over/under at May 1.

I know that this is a process people go through all the time and it isn't new and HIPAA supposedly requires all of this (though not really), and I am just being old and crotchety (though don't old and crotchety people tend to complain about new technology, not old processes?).

I just thought it would be amusing to document this little corner of the healthcare world we have created at this point in the year 2019.