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The so-called "AHIMA paradox"
- To: firstname.lastname@example.org
- Subject: The so-called "AHIMA paradox"
- From: "Meg H. O'Donnell" <email@example.com>
- Date: Wed, 22 May 1996 11:30:25 EST
- Organization: Vermont Health Care Authority
- Priority: normal
- Return-receipt-to: "Meg H. O'Donnell" <firstname.lastname@example.org>
On Tuesday, May 21, Metra1001 (Al) wrote about what he perceived as
a paradox in that the American Health Information Management
Association (AHIMA) advises people not to sign general releases, but
general releases are often required by insurers before paying for any
health care treatments. He then recommended that we all " contact Ms.
Kathleen A. Frawley, JD, Director [of AHIMA]" to pursue this apparent
contradiction, saying "[y]ou will find she is very polite, very professional
and courteous, yet she can be somewhat evasive on occasion... particularly in
areas of contention such as this."
This is, in my opinion, exatcly the wrong thing to do. The
implication is that AHIMA, and/or Ms. Frawley, are somehow
responsible for the dilemma faced by persons who do not wish to share
their medical records for any purpose when they are confronted by the
realities of our health care system.
Reality #1: Insurance is not a "right" at this time. This means if I
want to participate in an insurance plan, I may have to give up some
things that are important to me -- like some expectations of
Reality #2: AHIMA is in the forefront of organizations seeking to
change state and federal laws to incorporate the excellent practices
its members use in dealing with identifiable medical records.
Perhaps that is why their brochures warn people as to the
consequences of signing general releases. This does *not* mean AHIMA
supports or condones how the insurance system works. See Reality #1.
Reality #3: It is exactly this kind of issue that motivates those of us in the
trenches who are trying to adopt statutory protections, on both the state
and federal levels. Vermont's proposed health care information law, which
was tabled at the end of our recent legislative session after having been
endorsed by three of the four committees working on it, and having passed
the House, included strong language to the effect that even if an insurer has
access to medical records with a patient's written consent, *access was
restricted only to the minimum amount necessary to accomplish the
purpose for which it was released.* This means an insurer who needs
to pay a claim *gets only what is necessary to pay that claim,* and
nothing more. This principle would have applied to *any* release of
information, and would penalize the release or use of information in
excess of that minimum. S. 1360 has similar provisions. These are
far more consumer-friendly than *anything* that exists in common law
Instead of personalizing these issues by bothering individuals, like
Ms. Frawley, the most constructive approach (IMHO) is to look at
proposed laws -- like S. 1360 -- and try to make them the bext possible
laws that they can be, given the political and economic realities of our
health care system. The result ain't gonna please everyone, but we'll
all be better off if we gain legal protections we do not have at
Meg H. O'Donnell
Vermont Health Care Authority