Letter to ONC argues that either the Doctors Hospital of Augusta is breaking the law, or Meditech’s EHR systems are deficient
ATLANTA – July 20, 2021 – Lloyd Bell of Bell Law Firm today confirms that a formal communication has been sent from his office to the office of Elise Anthony, Executive Director, Office of Policy at the Office of the National Coordinator for Health Information Technology (ONC), regarding several entities – namely the Doctors Hospital of Augusta (DHA), electronic health records technology firm Meditech and records staffing firm Ciox Health – and their shared refusal or inability to produce EHR records in a text-based PDF format.
The letter to the executive director states that the above-mentioned parties appear to be involved in information blocking, in violation of the 21st Century Cures Act and its implementing regulations. The letter stems from an incident regarding the care of Dorothy Anthony, whom Bell Law Firm represents.
Dorothy has Downs Syndrome, and was admitted to DHA in Augusta, Georgia. During her hospital admission, a stage 4 pressure wound developed on Dorothy’s sacral area. This refers to a wound that goes all the way down to bone. These wounds often resist healing and lead to chronic, life-threatening infections as well as pain and disability. The Centers for Medicare & Medicaid Services generally regards hospital-acquired stage 3 or 4 pressure wounds as indicating negligent care.
Dorothy’s sister, her guardian, retained the Bell Law Firm to investigate whether Dorothy had suffered medical negligence. Dorothy’s sister requested the medical records from DHA, which uses a Meditech EHR system. DHA produced the records in a format that deleted all the embedded electronic text data. They also produced the records with degraded image quality.
To get proper copies, Bell Law Firm requested the records again — specifically asking for the records in a pdf-text format that retains the embedded electronic text data. Again, DHA produced the records in a format that deleted all the electronic text data, and again they produced the records with degraded image quality, so that even optical character recognition would be rendered useless.
Here, for example, is the text generated by optical character recognition tools in Adobe Acrobat Pro for one page of nursing notes:
DHA 001318 “O c., -i’ ::. .+ )> 2 -f :I: 0 2 :< 0 0 ;::o 0 -f :I: -< m ::. 0 0 C: ::. …. 11) … Q 0 0 O’I O’) ,+\I> “‘4 co (0 “‘4 (..) ,I:,, “O Ill IQ ID a …. <7> I\) …. • !locurent HJ/1’.;ne Ml NDR lO/lS/lil rernperature F: 97.2 T;,,1,nc,,•;;t,J!’P SettJrce: Tempora 1 section: l NOR NDR A MU f;NH!ONY.DOROlHY MO Pctge: Printed 03/22/19 at 0348 CP CP A
In response to inquiries, DHA and Meditech declined to state clearly whether the systems implemented at DHA allow for the full EHR record in a text-based pdf file. When asked for a clear, explicit answer, Meditech said Bell Law Firm should subpoena them.
“The letter to ONC raises an important question for every Doctors Hospital patient — and beyond that, every patient whose medical records are kept in a Meditech system: Does Meditech’s EHR system lack the elementary functionality to export EHR into a readable electronic format?” said Lloyd Bell, founder of Bell Law Firm. “If the systems are unable to produce such basic records, then Meditech’s EHR systems may be improperly certified as meeting ONC criteria. And if Meditech’s EHR system does possess this basic functionality, then DHA has engaged in information blocking and violated 45 CFR 164.524 by refusing to honor a ‘form and format’ request to preserve electronic data. It’s one or the other.”
The letter to ONC concludes with a request that the ONC investigate this issue and take action.
About Bell Law Firm
Bell Law Firm is Georgia’s preeminent firm for victims of medical malpractice. Founded in 1999 by Lloyd Bell, the firm has recovered more than $100 million for patients and families of people injured or killed due to medical negligence. Bell has more than 25 years of experience in federal and state courts, and he has represented clients in more than 75 jury trials and hundreds of successful settlements. Specializing in litigating misdiagnoses, surgical errors, and other types of malpractice, Bell Law firm differentiates itself with deep legal expertise, a mastery of technology in the courtroom and a compelling manner of storytelling. In 2018, Daily Report, the leading source of legal news in Atlanta, named Bell Law Firm as Personal Injury Litigation Team of the Year. For more information, please visit www.belllawfirm.com.
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