Electronic medical records legislation clears N.M. Senate

The state Senate voted 36-4 to pass legislation that would make electronic medical records the equivalent of paper records.

The chamber’s vote came after a short debate on the Senate floor in which some lawmakers wondered if placing medical records in a system would invade a patient’s privacy.

The legislation’s sponsor, Sen. Peter Wirth, D-Santa Fe, said that a patient would sign a release each year allowing the records to be kept in the system.

The New Mexico Legislature has debated this issue before and came close to passing a similar bill during last year’s special legislative session.

Like much of the nation, New Mexico is shifting in how medical records are stored, with the state estimating that 10 percent to 15 percent of the state’s 4,000 physicians already use electronic records. And in all likelihood the number will increase, particularly with President Barack Obama’s talk of codifying the trend, proponents say. Obama has tied the idea of electronic medical records to his economic recovery plan.

Opponents — including some physicians — have argued that the transition to electronic records would be costly, requiring physicians to spring for programs that run into the tens of thousands of dollars.

The bill that cleared the Senate on Tuesday would fill some gaps in coverage, supporters say.

Most medical records fall under the federal Health Insurance Portability and Accountability Act, a Clinton-era law outlining a consumer’s privacy rights in regard to medical information. It establishes who does and does not have access to your medical records.

But as more records are digitized in New Mexico and across the country, professionals and policy makers are debating whether HIPAA covers all the newly digitized information. For example, Mayer says, Microsoft stores protected medical information, and Microsoft is not a covered entity under HIPPA.

In addition to making electronic records as legally acceptable as paper records, the bill would accomplish other goals, according to a legislative report analyzing the legislation. The report says the bill would:

• recognize the legal equivalency of electronic records and signatures;
• provide for the accurate retention and accessibility of electronic medical records;
• limit disclosure of information in an electronic medical record unless the patient consents, it is required for emergency treatment, or it is otherwise permitted by state or federal law;
• require an audit log of persons obtaining access to an electronic medical record;
• require an audit log made available to an individual health care consumer to only contain information relating to that individual;
• provide a mechanism for an individual health care consumer to request a removal of private information from a health information exchange; however, the request to exclude information will not apply to a provider or health care institution that has provided health care to that individual;
• give providers, health care institutions or health information exchanges exclusion from liability for any harm caused by an individual’s exclusion of medical information;
• requires that providers or institutions warrant that a request for an individual’s electronic medical record has consent of the individual or is otherwise permitted by state or federal law;
• provide a mechanism for an individual health care consumer to secure a copy of the information contained in the individual’s medical record audit log;
• allows information in an individual’s electronic medical record to be used in aggregate form for research or public health purposes;
• provide for both in-state and out-of-state disclosure of information; and
• exclude property and casualty, workers’ compensation, life, long-term care and disability income insurers from the provisions in the Act.

The legislation now goes to the House.