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  1. FHIR Specification Feedback
  2. FHIR-37048

EHR's record of a prior patient visit is at odds with the patient's recollection. Again, how would this be adjudicated? Human-to-human interaction?

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Details

    • Icon: Change Request Change Request
    • Resolution: Persuasive with Modification
    • Icon: Highest Highest
    • Patient Corrections (FHIR)
    • 1.0.0-ballot
    • Patient Empowerment
    • Patient Correction Communication
    • Actors and Use Cases
    • 2.2.3
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      Add scope text to Section 1 as follows:

      Patients have more and more access to their medical records via technology such as patient portals and personal health records and can detect errors. HIPAA and GDPR provide patients with the right to request a correction/amendment to their health record. However, the current processes are manual, often paper-based, with little communication or status provided, and opaque. A majority of patients do not know how to make a request for a correction to their chart. Since FHIR is now being used to share information between provider organizations and patients millions of times a day, this presents a nice opportunity for creating a standard for patients to request a correction/amendment to their health record via FHIR.

      The scope of this IG is limited to the communication standards between a patient/caregiver and the fulfiller of the request (most likely a provider organization) to:

      communicate the correction request
      provide a mechanism for tracking the status of the request fulfilment
      support back and forth communication between patient and provider as needed in the evaluation and fulfillment of the request
      communicate about the outcome of the request fulfillment
      support communication of a disagreement statement from the patient if the request is denied.

      For this version of the guide, Process status and new communications from the fulfiller will be detected by the requester via polling. In future versions of the guide, we hope to add support for subscription based notifications.

      It is assumed that the fulfiller is able to process the correction request through to resolution. In most cases, this would be the organization which has the authority to directly correct the error (such as a provider that is the custodian of the record with the error). However, if an intermediary takes responsibility for shepherding the handling of a patient request with the custodial organization, the intermediatory could serve as a fulfiller (for example, a patient advocacy service). It is assumed that in most cases, an HIE or a payor would not serve as fulfillers of requests to correct information unless the error originated from their records, or they wanted to take on the responsibility of mediating.

      This IG does not attempt to speak to how a fulfiller organization fulfils a requested correction nor does it try to resolve conflicting opinions between a patient and their provider.

      The guide does not provide a way to automatically correct information on the fulfiller system. It is only about the communication and tracking of the request. Manual intervention to evaluate and fulfill the request is expected.

      Finally, the guide is not trying to standardize the requester application or the fulfiller application's user interface that would be used by a patient or caregiver to send their request or the user interface of the fulfilling system. It is limited to standardization of the interoperability between the systems.

      Show
      Add scope text to Section 1 as follows: Patients have more and more access to their medical records via technology such as patient portals and personal health records and can detect errors. HIPAA and GDPR provide patients with the right to request a correction/amendment to their health record. However, the current processes are manual, often paper-based, with little communication or status provided, and opaque. A majority of patients do not know how to make a request for a correction to their chart. Since FHIR is now being used to share information between provider organizations and patients millions of times a day, this presents a nice opportunity for creating a standard for patients to request a correction/amendment to their health record via FHIR. The scope of this IG is limited to the communication standards between a patient/caregiver and the fulfiller of the request (most likely a provider organization) to: communicate the correction request provide a mechanism for tracking the status of the request fulfilment support back and forth communication between patient and provider as needed in the evaluation and fulfillment of the request communicate about the outcome of the request fulfillment support communication of a disagreement statement from the patient if the request is denied. For this version of the guide, Process status and new communications from the fulfiller will be detected by the requester via polling. In future versions of the guide, we hope to add support for subscription based notifications. It is assumed that the fulfiller is able to process the correction request through to resolution. In most cases, this would be the organization which has the authority to directly correct the error (such as a provider that is the custodian of the record with the error). However, if an intermediary takes responsibility for shepherding the handling of a patient request with the custodial organization, the intermediatory could serve as a fulfiller (for example, a patient advocacy service). It is assumed that in most cases, an HIE or a payor would not serve as fulfillers of requests to correct information unless the error originated from their records, or they wanted to take on the responsibility of mediating. This IG does not attempt to speak to how a fulfiller organization fulfils a requested correction nor does it try to resolve conflicting opinions between a patient and their provider. The guide does not provide a way to automatically correct information on the fulfiller system. It is only about the communication and tracking of the request. Manual intervention to evaluate and fulfill the request is expected. Finally, the guide is not trying to standardize the requester application or the fulfiller application's user interface that would be used by a patient or caregiver to send their request or the user interface of the fulfilling system. It is limited to standardization of the interoperability between the systems.
    • Debi Willis / David Pyke : 6-0-1
    • Clarification
    • Non-substantive

    Description

      In this Use Case 3 it appears that EHR's record of a prior patient visit is at odds with the patient's recollection. Again, how would this be adjudicated? Sound like there would need to be a human-to-human interation

      Existing Wording:

      The provider determines that the chart is correct and is not swayed by the disagreement. The provider connects the disagreement to the patient’s electronic chart so that it can be referred to and sent along with the record. The provider also potentially provides a formal rebuttal.

      Proposed Wording:

      none

      (Comment 5 - imported by: Chris Shawn)

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            ginocanessa Gino Canessa
            chris Chris Shawn
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              Created:
              Updated:
              Resolved: