BILL ANALYSIS Ó
SB 850
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Date of Hearing: August 17, 2011
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Felipe Fuentes, Chair
SB 850 (Leno) - As Amended: June 22, 2011
Policy Committee: JudiciaryVote:7-2
Health Vote: 14-0
Urgency: No State Mandated Local Program:
No Reimbursable: No
SUMMARY
This bill requires electronic health record systems or
electronic medical record systems (EHR/EMR systems) to preserve
the integrity of electronic medical information and
automatically record and preserve any change or deletion of any
electronically stored medical information, as specified.
FISCAL EFFECT
Negligible state fiscal impact. This bill mirrors recently
released and pending federal regulations that create new minimum
data integrity and consumer access standards for data stored in
EHR/EMR systems.
COMMENTS
1)Rationale . This bill is intended to improve the integrity of
data stored in electronic medical records. The author states
this bill would ensure consumers have protections in state law
granting them access to information on how their records have
been changed and who has made the changes.
2)Background . Many health care providers are in the process of
transitioning from paper-based medical record systems to
electronic systems. A survey released earlier this year
indicates that approximately half of California physicians are
in some stage of implementing EHRs. Monetary incentives and
Medicare provider payment penalties were enacted as part of
the Health Information Technology for Economic and Clinical
Health (HITECH) Act, a component of the 2009 federal American
Recovery Reinvestment Act (ARRA), to encourage providers to
SB 850
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install EHRs.
In addition to electronic record-keeping within a single
health care facility, widespread use of EHRs enables real-time
exchange electronic health information. Against a rapidly
evolving landscape where electronic exchange and access to
records is becoming more common, consumer advocates have
continued to emphasize the importance of privacy, security,
and integrity of health information.
3)Definitions . There is no definition of "EMR system" or "EHR
system" in state law. Section 13400 of the federal HITECH Act
defines EHR as "an electronic record of health-related
information that is created, gathered, managed, and consulted
by authorized health care clinicians and staff."
4)Recent Federal Regulations . There are two federal rules
relevant to this bill. One proposed rule modifies the Health
Insurance Portability and Accountability Act of 1996 (HIPAA)
Privacy Rule's standard for accounting of disclosures of
protected health information. This HIPAA Privacy Rule change
augments existing privacy protections by adding a consumer's
right to receive an "access report" that indicates, in an
understandable way, who has accessed and/or modified their
electronic health information.
A second federal rule related to incentive payments for EHR
implementation (referenced above) requires that providers
install "certified" EHR systems that meet certain requirements
in order to qualify for the incentives, and further specifies
that one of the certification requirements is the ability to
provide access tracking in the same manner articulated in this
bill.
Analysis Prepared by : Lisa Murawski / APPR. / (916) 319-2081