Moving health information from paper files to electronic records has promised improvements in health care ranging from increased efficiency and accuracy to allowing information sharing. For example, a single electronic health information (EHI) record could help a physician treat a patient, provide public health officials information on potential threats or give researchers a way to evaluate treatment effectiveness. However, the health care industry has been slower to adopt these technologies than other fields. Medical practitioners cite the complex and confusing body of EHI-related laws as a major obstacle to using such tools, thus improving things will require a deeper understanding of the network of laws and regulations around the country.
A research team led by Mr. Cason Schmit, research assistant professor in the department of health policy and management at the Texas A&M School of Public Health dug into this complex legal environment to gain a better understanding of the laws and uncover how regulations affect various health care and public health goals such as patient care and public health reporting. The study, published in the journal Public Health Reports, searched legal databases to find laws in the 50 U.S. states, Guam, Puerto Rico, the U.S. Virgin Islands and the District of Columbia that were related to electronic information and individual health.
[Photo: Mr. Cason Schmit]
“Our research found over 2,300 EHI-related laws on the books as of January 2014,” said Mr. Schmit. “Of these, 145 laws were from Texas alone, the largest number from a single jurisdiction.”
Although the number of laws varied between jurisdictions, most were related to treatment, health care payers, health information exchange and oversight, and vital statistics. However, other laws covered a wide range of categories such as child welfare, disease reporting and health information in driver license records.
In addition to the sheer number of laws, many regulations overlap with each other, further complicating matters. This complexity affects more than health care providers, hospitals and public health departments, too.
“Health information software developers would need to analyze, understand and comply with regulations in each jurisdiction where their software would be used, said Mr. Schmit. “This serves as an obstacle to innovation in a field that would otherwise grow and adapt rapidly.”
The study authors also state that regulatory complexity and misconceptions about laws can lead to overly conservative policies that minimize legal risk but limit the usefulness of the technology.
Although consistent with other research in the area, the study was limited by only examining laws that specifically refer to EHI. Other laws and regulations that do not explicitly mention EHI could also affect the use of health information technology, which warrants further research. Additionally, future research will need to compare different laws, as some are more complex than others, and consider misconceptions that hamper proper use of existing laws and could affect future changes.
Despite the study’s limits, the findings help shed light on the complex nature of the EHI legal environment, serving as a starting point for understanding why information technology adoption has been slower in the health care arena than in other fields. Better understanding of regulations and their effects, intended and unintended, will be key to improved health care technology and more effective use of these helpful tools.