When a patient moves between treatment facilities, there is often a need for their medical information and record to follow. Requests for records made by a covered entity to be delivered to another covered entity for care purposes are called “Continuity of Care” requests. Records necessary for care of the patient fall under the “treatment” provision on the HIPAA Privacy Rule and do not require an authorization from the patient. But when sharing records with another facility for treatment purposes, what and how much should you disclose?
What’s a Transfer of Care?
While a Continuity of Care request is often a patient travelling between providers, the patient remains actively involved with both providers. Consider a patient moving between a primary care physician and a cardiologist – it’s important for both providers to know what the other provider’s treatment of the patient entailed. Thus, they may submit a Continuity of Care request to obtain the records from the other provider.
A “Transfer of Care” request is slightly different. In a Transfer of Care, the patient is transferring who will provide his or her care from one provider to another, and there is no intent for the patient to return to the originating provider. Transfer of Care requests happen most often when the patient has moved and established care with a new provider.
The minimum necessary provision of the HIPAA Privacy Rule requires that the minimum amount of information be disclosed to accomplish the intended purpose of the records request. However, the minimum necessary rule is not required to apply on provider to provider requests for treatment purposes. Even though minimum necessary may not be required for Continuity of Care or Transfer of Care requests, it can serve as a best practice to get the most meaningful information to another provider.
When a provider receives hundreds of pages of medical records, there is a burden for the provider to sort through the information and determine what he or she needs. Much of the information is redundant and copied forward from previous visits. In the case of Continuity of Care, most providers only need the most recent records of a patient. Sending “any and all records” for Continuity of Care requests can be a waste of time and resources. Applying the minimum necessary standard to Continuity of Care and Transfer of Care requests allows for providers to receive the most pertinent information often on the first request. Of course, if the requesting provider needs more records, a second release of information can occur with the transfer of the additional records.
Creating a Continuity of Care Policy
It’s important for healthcare organizations to create policies and procedures to remain consistent when applying standards like the minimum necessary provision. If your organization implements the minimum necessary standard for Continuity of Care or Transfer of Care requests, you should outline what factors are considered to limit the number of pages or information initially disclosed.
These factors could include, but are not limited to:
- An established understanding with the receiving practice on what they want to receive
- Patient age
- Patient condition
- Size of the medical record
- Organization’s EHR product
- The specialty of the provider
Ultimately, if your organization decides to limit the information initially sent to the requesting provider, it is critical you make the receiving provider aware not all of the information has been sent. This can be incorporated through a cover letter indicated the most recent records have been sent and include instructions on how the provider may request the additional records if needed. As long as your organization does not refuse to provide the additional records, there is not a concern of violating HIPAA.
Release Records Requests to a Partner
If you find Continuity of Care, Transfer of Care, and all other records requests take too much of your staff’s valuable time, consider releasing this administrative burden to a partner. ScanSTAT Technologies processes hundreds of thousands of records requests annually and is an industry-leader with our 24-hour turnaround time and accuracy rate. If you are ready to return to patient care, request a demo today to see how we can help.