On September 30th Governor Newsome signed Senate Bill 1419, legislation sponsored by the California Medical Association and focused on providing physicians the opportunity to respect patient privacy and wishes when releasing their protected health information.
While the 21st Century Cures Act Information Blocking Rule has allowed patients much greater access to their health care data, this has led to some unintended consequences and unnecessary distress for patients who receive information on their test results electronically with no physician interpretation.
SB 1419, as currently written, makes changes to California law, including: allowing physicians additional time to interpret potentially life-changing test results before electronically releasing them to the patient; providing additional legal protections for very sensitive data, such as teen mental health and reproductive data; and clarifying that clinical notes are considered to be a part of the patient medical record.
This bill would define “test” for these purposes to apply to both clinical laboratory tests and imaging scans, such as x-rays, magnetic resonance imaging, ultrasound, or other similar technologies and would also make conforming changes. The bill would remove the requirement that a health care professional review the results before the results are disclosed to the patient by internet posting or other electronic means.
Minor Patients
The legislation would change California law to say that a representative of a minor shall not be entitled to inspect or obtain copies of the minor’s medical records, including clinical notes, in certain circumstances, including when the health care provider finds that such access by the representative would have a “detrimental effect on the provider’s professional relationship with the minor patient,” the minor’s physical safety, or the minor’s psychological well-being. The decision made by a health care provider shall not lead to any liability for the provider, unless the provider is found to have made the decision in bad faith.
Mental Health Records
The legislation would also amend current law so that if a health care provider deems there would be a “substantial risk of significant adverse or detrimental consequences” to a patient who sees or receives a copy of his or her mental health records, the provider may decline to release the records to the patient, subject to certain conditions.
However, the provider shall allow inspection of the records by licensed physicians and surgeons, licensed psychologists, licensed marriage and family therapists, licensed clinical social workers, or licensed professional clinical counselors, designated by the request of the patient.
Additionally, the provider who rejects a patient’s request for mental health records shall also inform the patient of their refusal to provide access to the records as well as inform the patient of the right to require the provider to permit inspection by/provide copies to one of the above-named medical professionals, designated by written patient authorization.
California Medical Association Comment
“Giving patients access to their own health information is very important because it allows them to be partners in their care. SB 1419 will give patients the support they need when learning of sensitive and potentially life-changing information about their health and well-being,” said California Medical Association President Robert E. Wailes, M.D.