Health Equity

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Being a physician in the District in the 21st century means being on the front line of the most pressing public health issues in the world. In our small geographic boundaries, physicians help address issue found in every state all in one area. The issues are too lengthy to list on one webpage but physicians are on the front lines of addressing health issues for all District residents.

News, MSDC Statements, and MSDC Testimony on Health Equity Issues

24th Council session information coming soon.

Study: Expanded Patient Record Access Leads to More EHR Inbox Messages

Oct 26, 2021, 11:25 AM by MSDC Staff
Implementing the CURES Act patient records requirement saw a sharp increase in messaging at one medical system, according to a new study.


When the 21st Century Care Act regulations were written, the medical community was concerned about the unintended consequences of unfettered access by patients to their electronic records. A new study published in the JAMA Open Network suggests these changes may be leading to burnout for healthcare providers.

The regulations for the Act require immediate electronic access for patients to their test results, medication lists, and clinical notes. This access may be even before their physician or medical institution reviews it, which may lead to confusion and misinterpretation. 

The study, seen here, suggests as much based on messaging to provider inboxes. The study examined health results on the patient portal at Vanderbilt University Medical Center between January 2020 and April 2021. CURES Act compliance began January 2021, so the study included pre- and post-CURES best practice. 

Prior to January 2021, patients viewed 10.4% of their test results before their clinician. After CURES implementation, that number jumped to 40.3% of patients viewing their results prior. The result was more EHR messages. Pre-January 2021, a median of 77.5 messages were sent within 6 hours of viewing the test results by patients. After CURES, the number jumped to 146 within 6 hours of viewing the results.

While the authors acknowledge the dataset is limited, they also point to the potential burdens on clinician wellbeing. The authors write:

Improved availability of data to patients represents a marked transformation in patients’ opportunity to take ownership of their health care. However, the benefit associated with immediate release of test results may be overshadowed by unintended consequences to patient well-being and clinical workload. Additional consideration of the timing of test result release to patients and clinicians is necessary to ensure that results are made available to patients while maintaining the opportunity for clinicians to apply their expertise and interpretation.

 

Sample of Health Equity Legislation MSDC Tracked 

 

Student Access to Treatment Amendment Act (B23-467)

What does it say? The bill allows for the administration of medicinal marijuana in schools as well as allows students to bring sunscreen to schools and apply it without a prescription.

MSDC position: MSDC supports the language permitting sunscreen application in schools

Current status: A win for DC physicians and public health! The legislation passed the Council in February and was signed by the Mayor. Previous temporary and emergency legislation permitted students to use sunscreen at schools this school year already.

Electronic Medical Order for Scope of Treatment Registry Amendment Act (B23-261)

What does it say? The bill requires DC Health to establish an electronic Medical Order for Scope of Treatment registry (eMOST).

MSDC position: MSDC supports this legislation to more easily allow patients to make their treatment orders known.

Current status: A win for the physician community and our patients! The Council passed the bill in December and the Mayor signed it into law on January 16, 2020.

Healthy Beverage Choices Amendment Act (B23-495)

What does it say? The bill would implement a 1.5 cent per ounce tax on the distribution of "sugary" beverages. The money collected from the tax would establish a Healthy People, Healthy Places Open Spaces Grant Program.

MSDC position: MSDC sent a letter to Council Chair Mendelson asking for a hearing to discuss all of the issues around a beverage tax.

Current status: The bill was introduced October 8, 2019 and referred to the Committee on Business and Economic Development and the Committee of the Whole.