title: Honoring Dental Patients' Privacy Rule Right of Access in the Context of Electronic Health Records.
abstract: A person's right to access his or her protected health information is a core feature of the U.S. Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule. If the information is stored electronically, covered entities must be able to provide patients with some type of machine-readable, electronic copy of their data. The aim of this study was to understand how academic dental institutions execute the Privacy Rule's right of access in the context of electronic health records (EHRs). A validated electronic survey was distributed to the clinical deans of 62 U.S. dental schools during a two-month period in 2014. The response rate to the survey was 53.2% (N=33). However, three surveys were partially completed, and of the 30 completed surveys, the 24 respondents who reported using axiUm as the EHR at their dental school clinic were the ones on which the results were based (38.7% of total schools at the time). Of the responses analyzed, 86% agreed that clinical modules should be considered part of a patient's dental record, and all agreed that student teaching-related modules should not. Great variability existed among these clinical deans as to whether administrative and financial modules should be considered part of a patient record. When patients request their records, close to 50% of responding schools provide the information exclusively on paper. This study found variation among dental schools in their implementation of the Privacy Rule right of access, and although all the respondents had adopted EHRs, a large number return records in paper format.
authors.affiliation: Dr. Ramoni and Dr. Asher contributed equally to this study. Dr. Ramoni is Assistant Professor of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine and Executive Director, Undiagnosed Diseases Network Coordinating Center, Department of Biomedical Informatics, Harvard Medical School; Dr. Asher was a dental student at Harvard School of Dental Medicine at the time of this study; Dr. White is Professor, Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco; Dr. Vaderhobli is Associate Clinical Professor, Department of Preventive and Restorative Dental Sciences and Dental Director, LMC/UCSF AEGD Residency, School of Dentistry, University of California, San Francisco; Dr. Ogunbodede is Visiting Professor, Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine; Dr. Walji is Associate Professor, Department of Diagnostic and Biomedical Sciences and Associate Dean for Technology Services and Informatics, University of Texas School of Dentistry at Houston; Dr. Riedy is Lecturer, Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine; and Dr. Kalenderian is Chair, Department of Oral Health Policy and Epidemiology and Chief of Quality, Harvard Dental Center, Harvard School of Dental Medicine.
authors.forename: Rachel B
authors.initials: RB
authors.lastname: Ramoni
authors.affiliation: Dr. Ramoni and Dr. Asher contributed equally to this study. Dr. Ramoni is Assistant Professor of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine and Executive Director, Undiagnosed Diseases Network Coordinating Center, Department of Biomedical Informatics, Harvard Medical School; Dr. Asher was a dental student at Harvard School of Dental Medicine at the time of this study; Dr. White is Professor, Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco; Dr. Vaderhobli is Associate Clinical Professor, Department of Preventive and Restorative Dental Sciences and Dental Director, LMC/UCSF AEGD Residency, School of Dentistry, University of California, San Francisco; Dr. Ogunbodede is Visiting Professor, Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine; Dr. Walji is Associate Professor, Department of Diagnostic and Biomedical Sciences and Associate Dean for Technology Services and Informatics, University of Texas School of Dentistry at Houston; Dr. Riedy is Lecturer, Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine; and Dr. Kalenderian is Chair, Department of Oral Health Policy and Epidemiology and Chief of Quality, Harvard Dental Center, Harvard School of Dental Medicine.
authors.forename: Sheetal R
authors.initials: SR
authors.lastname: Asher
authors.affiliation: Dr. Ramoni and Dr. Asher contributed equally to this study. Dr. Ramoni is Assistant Professor of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine and Executive Director, Undiagnosed Diseases Network Coordinating Center, Department of Biomedical Informatics, Harvard Medical School; Dr. Asher was a dental student at Harvard School of Dental Medicine at the time of this study; Dr. White is Professor, Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco; Dr. Vaderhobli is Associate Clinical Professor, Department of Preventive and Restorative Dental Sciences and Dental Director, LMC/UCSF AEGD Residency, School of Dentistry, University of California, San Francisco; Dr. Ogunbodede is Visiting Professor, Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine; Dr. Walji is Associate Professor, Department of Diagnostic and Biomedical Sciences and Associate Dean for Technology Services and Informatics, University of Texas School of Dentistry at Houston; Dr. Riedy is Lecturer, Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine; and Dr. Kalenderian is Chair, Department of Oral Health Policy and Epidemiology and Chief of Quality, Harvard Dental Center, Harvard School of Dental Medicine.
authors.forename: Joel M
authors.initials: JM
authors.lastname: White
authors.affiliation: Dr. Ramoni and Dr. Asher contributed equally to this study. Dr. Ramoni is Assistant Professor of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine and Executive Director, Undiagnosed Diseases Network Coordinating Center, Department of Biomedical Informatics, Harvard Medical School; Dr. Asher was a dental student at Harvard School of Dental Medicine at the time of this study; Dr. White is Professor, Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco; Dr. Vaderhobli is Associate Clinical Professor, Department of Preventive and Restorative Dental Sciences and Dental Director, LMC/UCSF AEGD Residency, School of Dentistry, University of California, San Francisco; Dr. Ogunbodede is Visiting Professor, Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine; Dr. Walji is Associate Professor, Department of Diagnostic and Biomedical Sciences and Associate Dean for Technology Services and Informatics, University of Texas School of Dentistry at Houston; Dr. Riedy is Lecturer, Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine; and Dr. Kalenderian is Chair, Department of Oral Health Policy and Epidemiology and Chief of Quality, Harvard Dental Center, Harvard School of Dental Medicine.
authors.forename: Ram
authors.initials: R
authors.lastname: Vaderhobli
authors.affiliation: Dr. Ramoni and Dr. Asher contributed equally to this study. Dr. Ramoni is Assistant Professor of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine and Executive Director, Undiagnosed Diseases Network Coordinating Center, Department of Biomedical Informatics, Harvard Medical School; Dr. Asher was a dental student at Harvard School of Dental Medicine at the time of this study; Dr. White is Professor, Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco; Dr. Vaderhobli is Associate Clinical Professor, Department of Preventive and Restorative Dental Sciences and Dental Director, LMC/UCSF AEGD Residency, School of Dentistry, University of California, San Francisco; Dr. Ogunbodede is Visiting Professor, Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine; Dr. Walji is Associate Professor, Department of Diagnostic and Biomedical Sciences and Associate Dean for Technology Services and Informatics, University of Texas School of Dentistry at Houston; Dr. Riedy is Lecturer, Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine; and Dr. Kalenderian is Chair, Department of Oral Health Policy and Epidemiology and Chief of Quality, Harvard Dental Center, Harvard School of Dental Medicine.
authors.forename: Eyitope O
authors.initials: EO
authors.lastname: Ogunbodede
authors.affiliation: Dr. Ramoni and Dr. Asher contributed equally to this study. Dr. Ramoni is Assistant Professor of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine and Executive Director, Undiagnosed Diseases Network Coordinating Center, Department of Biomedical Informatics, Harvard Medical School; Dr. Asher was a dental student at Harvard School of Dental Medicine at the time of this study; Dr. White is Professor, Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco; Dr. Vaderhobli is Associate Clinical Professor, Department of Preventive and Restorative Dental Sciences and Dental Director, LMC/UCSF AEGD Residency, School of Dentistry, University of California, San Francisco; Dr. Ogunbodede is Visiting Professor, Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine; Dr. Walji is Associate Professor, Department of Diagnostic and Biomedical Sciences and Associate Dean for Technology Services and Informatics, University of Texas School of Dentistry at Houston; Dr. Riedy is Lecturer, Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine; and Dr. Kalenderian is Chair, Department of Oral Health Policy and Epidemiology and Chief of Quality, Harvard Dental Center, Harvard School of Dental Medicine.
authors.forename: Muhammad F
authors.initials: MF
authors.lastname: Walji
authors.affiliation: Dr. Ramoni and Dr. Asher contributed equally to this study. Dr. Ramoni is Assistant Professor of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine and Executive Director, Undiagnosed Diseases Network Coordinating Center, Department of Biomedical Informatics, Harvard Medical School; Dr. Asher was a dental student at Harvard School of Dental Medicine at the time of this study; Dr. White is Professor, Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco; Dr. Vaderhobli is Associate Clinical Professor, Department of Preventive and Restorative Dental Sciences and Dental Director, LMC/UCSF AEGD Residency, School of Dentistry, University of California, San Francisco; Dr. Ogunbodede is Visiting Professor, Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine; Dr. Walji is Associate Professor, Department of Diagnostic and Biomedical Sciences and Associate Dean for Technology Services and Informatics, University of Texas School of Dentistry at Houston; Dr. Riedy is Lecturer, Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine; and Dr. Kalenderian is Chair, Department of Oral Health Policy and Epidemiology and Chief of Quality, Harvard Dental Center, Harvard School of Dental Medicine.
authors.forename: Christine
authors.initials: C
authors.lastname: Riedy
authors.affiliation: Dr. Ramoni and Dr. Asher contributed equally to this study. Dr. Ramoni is Assistant Professor of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine and Executive Director, Undiagnosed Diseases Network Coordinating Center, Department of Biomedical Informatics, Harvard Medical School; Dr. Asher was a dental student at Harvard School of Dental Medicine at the time of this study; Dr. White is Professor, Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco; Dr. Vaderhobli is Associate Clinical Professor, Department of Preventive and Restorative Dental Sciences and Dental Director, LMC/UCSF AEGD Residency, School of Dentistry, University of California, San Francisco; Dr. Ogunbodede is Visiting Professor, Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine; Dr. Walji is Associate Professor, Department of Diagnostic and Biomedical Sciences and Associate Dean for Technology Services and Informatics, University of Texas School of Dentistry at Houston; Dr. Riedy is Lecturer, Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine; and Dr. Kalenderian is Chair, Department of Oral Health Policy and Epidemiology and Chief of Quality, Harvard Dental Center, Harvard School of Dental Medicine. Elsbeth_kalenderian@hsdm.harvard.edu.
authors.forename: Elsbeth
authors.initials: E
authors.lastname: Kalenderian
mesh_terms: D003792:Dental Records / Q000331:legislation & jurisprudence*; D057286:Electronic Health Records / Q000331:legislation & jurisprudence*; D020408:Health Insurance Portability and Accountability Act; D006801:Humans; D033283:Patient Access to Records / Q000331:legislation & jurisprudence*; D028701:Patient Rights / Q000331:legislation & jurisprudence*; D018907:Privacy; D012575:Schools, Dental / Q000331:legislation & jurisprudence*; D014481:United States
keywords: Health Insurance Portability and Accountability Act; access to information; dental education; dental school clinics; electronic health record; legislation and jurisprudence; medical records; patient portal; privacy