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Q&A: Interstate Healthcare Document Issues

With national healthcare reform underway, questions are arising about the how healthcare documents and patient information will be shared between different states. The Healthcare Professionals Sectionspoke with Thomas Loker, chief operating officer with Ramsell Corporation, a multi-state provider of IT, pharmacy and public heath care services based in Oakland, California about these issues and more.

What issues does the industry face in sharing healthcare-related documents between states?
Each state has its own insurance commission and healthcare rules and regulations, and it can make processing healthcare paperwork a nightmare. Also, healthcare programs in different states often act like isolated “silos” when it comes to coordinating information between each other. It makes it harder to spot healthcare fraud — we often have to compare multiple documents from different states in order to catch fraud cases.

How do we deal with situations like the 2007 Apsey v. Memorial Hospitalcase in which a woman’s malpractice suit was rejected because she had an affidavit notarized in a different state?
One of the fundamental issues in U.S. healthcare is that basic processes in different states are similar, but the specific rules vary widely. Document reciprocity between states is widespread, but not universal. The problem right now is determining whose rules apply in each situation — is it the rules of individual states? The federal government? There’s not a clear solution based on court precedent, and it’s an area of confusion Notaries in healthcare have to deal with right now.

What steps must be taken to resolve these issues?
First, we need a more centralized approach in how to carry forward healthcare and process documentation, and to establish more uniform standards between states. Second, we need better electronic transfer of records, and care services need to be more “patient-oriented.” When a single patient is getting care from multiple healthcare services, those services need to work as a “virtual team” and coordinate and share information about the patient between themselves, instead of keeping information separate from each other. This will help to avoid duplication of services and prevent fraud.

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