VA proposal tweaks confidentiality regulation to improve data sharing with community providers

Veterans affairs sign
A proposed rule issued by the VA would make it easier to share medical records with community providers. (JeffOnWire CC BY 2.0)

The Department of Veterans Affairs wants to revise a federal regulation that oversees medical records confidentiality to improve data sharing with community providers.

A proposed rule (PDF) scheduled for publication on Friday would revise a VA-specific privacy regulation to allow the release of veterans' medical records to “eligible community partners” even if the agency does not have a physical copy of the patient’s written consent. Instead, HIE community partners would attest that they have obtained consent from the patient to release their medical record.

That’s a shift from the agency’s prior interpretation that valid consent relied on the VA’s physical possession of the patient’s written consent. With an estimated 75% of veterans seeking care outside of the VA health system, requests from HIEs were frequently denied because there was no written consent on file.

Veterans are generally willing to authorize a release, the agency said. However, they frequently seek care from community providers before having an opportunity to provide a consent form to the VA, which—under the agency’s stringent interpretation of the law—was a significant obstacle to transferring medical records to community partners.

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As a result, community providers have been forced to delay care or provide treatment to veterans without access to their full medical history.

“This revision would ensure that more community health care providers and other HIE community partners can deliver informed medical care to patients by having access to the patient’s VA medical records at the point of care,” the proposed rule states.

The regulation change would be a small but notable step in the VA’s quest to improve interoperability with community partners as it finalizes its contract with Cerner to overhaul the health system’s EHR platform. Secretary David Shulkin, M.D., has emphasized the importance of sharing medical records with community providers. During a hearing on Wednesday, he told the Senate Committee on Veterans Affairs that VA initiated a “strategic pause” in the acquisition process to conduct an external assessment of national interoperability language.