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Legal Task Force - Patient Consent Work Group Minutes - February 15 2011 

February 15, 2011

Attendees (phone and in-person):

  • Committee Members Who Attended in Person:
  • Mark Chudzinski, Office of Health Information Technology (OHIT)
  • Carolyn Metnick, Barnes & Thornburg
  • Julie Treumann, Ungaretti & Harris
  • Committee Members Who Attended by Phone:
  • Rob Connor, Department of Human Services
  • Bruce Lane, Barnes Jewish Christian Healthcare
  • April Schweitzer, OHIT
  • Marilyn Thomas, Department of Healthcare and Family Services
  • Mary Kay Furiasse, Attorney at Law
  • Crystal VanDeventer, Lincoln Land HIE (LL HIE)
  • Jay McCutcheon, LL HIE

Marilyn, as chair of the Patient Consent Work group, welcomed people to the call at 10:03 a.m., hosted by OHIT at the State of Illinois J.R. Thompson Center in Downtown Chicago, with a telephone conference call-in number. Notice of the meeting and the agenda were posted on the OHIT Web site and at the Chicago meeting location no later than 48 hours prior to the meeting. Roll was taken, and the ability of those attending by telephone to hear and participate was confirmed.

The group agreed to re-submit the minutes from the last meeting to be reviewed with Mark's additional comments.

Members of the work group were encouraged to read the report entitled Consumer Consent Options for Electronic Health Information Exchange: Policy Considerations and Analysis that was sent out prior to today's meeting. There is also an additional report by Professor Goldstein dealing with the segregation of data, which Mark will share with the group.

The group then discussed a letter sent to Secretary Sebelius by the National Committee on Vital and Health Statistics, which recommends including domestic violence as well as reproductive health information in sensitive information categories.

The consents developed by HISPIC do not address these categories. The group discussed whether or not to make recommendations regarding these categories and ultimately concluded that recommendations should be made in order to be as inclusive as possible. However, there are questions about whether statutory changes would need to be made in order to implement such recommendations.

One member of the group noted that legislation concerning genetic information would definitely need to be amended.

The group them began to look at the sample consents sent around prior to the meeting. One member commented that the Wellport example seemed the most patient friendly. Another member noted that the HISPIC consent is very bare bones and likely needs to provide additional context. One member asked whether the provider was going to hand out a document with information regarding the exchange. Another member suggested that perhaps the information about the exchange should be included on the consent. The MODEL RHIO example was discussed with regards to allowing access to information during an emergency.

The group briefly discussed the implications of the HITECH amendment. One group member suggested that the HIE also consider monitoring healthcare power of attorney forms. He suggested that this could be included in the record locator service of the state HIE at some point in the future.

Another group member mentioned the need to address parent/guardianship issues in modified consents. Additionally, the group discussed the need to keep the personal representative and identity verification on Illinois consent forms.

Mark informed the group that the new authority is going to have their first meeting in the next six to eight weeks. The authority will be discussing educational plans in the near future. The group discussed several educational options including a brochure, a video and/or an app that could be used on a Smart Phone. Mark suggested that these ideas be passed along to the communications advisory board.

The discussion then turned to how the technology actually works relative to coordination of care, specific carve outs and push technology with respect to consents.

The group also discussed a hypothetical about whether sensitive information would be sent to all doctors that have been previously designated to get a patient's information. Mark reported that the exchange is likely going to have some level of granularity, but whether it would be a specific doctor or a specific incident is an interesting question that has not been discussed.

The group also discussed how data was being entered into one specific HIE in the state, and how patients can make changes to their preferences concerning which physicians can see their data. The group also discussed the issues that arise when patients see physicians outside the HIE system. Ultimately, this would result in two records. This lead to a discussion of how the state HIE will function. Mark informed the group that the state had not yet developed the information that local/regional HIEs will need to report to the state HIE.

Marilyn informed the group that, before any recommendations can be written, the issue of research with regards to consent needs to be considered. Marilyn agreed to touch base with Maria Pekar regarding research and consents.

One member inquired about interstate issues. Mark suggested that Marilyn reach out to the interstate group.

Marilyn asked members to volunteer to assist with the drafting of the recommendations and thanked everyone for their time. Marilyn will send out potential dates for the next meeting.

Marilyn asked for comments. Hearing none; the meeting adjourned at 11:11 a.m.