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The Vermont Department of Health Access (DVHA) has recently recommended that the Vermont health information exchange (VHIE) change its approach to how Vermonters consent to sharing their health information with the medical staff that use the exchange. 

Currently, Vermonters must agree to have their information shared across the exchange, an approach known as “opt-in.” DVHA is advocating that the Green Mountain Care Board adopt an “opt-out” policy, where health information is automatically available to medical providers using the VHIE unless a patient specifically requests that it not be shared.

The health information exchange is a statewide platform that collects and shares medical information about patients between medical providers. It is hosted by Vermont Information Technology Leaders (VITL), which reports that they take patient consent very seriously.

Only 38% of Vermonters have willingly enrolled since the programs launch in 2005, in large part because providers often fail to ask patients about opting-in. When asked, 95% agree to make their information available across providers so their care can be better coordinated.

State officials argue that an “opt-in” system is too burdensome to providers and that the VHIE will not reach its full potential as a tool for improving healthcare delivery unless the consent structure changes. Among States that have a consent policy, most use an “opt-out’ approach.

Stakeholders and professionals who oppose the switch are concerned about protecting patient privacy and the right to choose how one’s health information is used. Advocates from the mental health community, for example, have long argued that it should be easy for patients to keep their mental health history private if that’s what they want.

At last week’s presentation, Kirsten Murphy, Executive Director of the Vermont Developmental Disabilities Council, voiced her concern that the change would degrade patient privacy. “Soliciting patient consent is part of delivering fully integrated care, an opportunity to engage individual Vermonters in our State’s new approach to healthcare,” she said.

For more information read the article by Vermont Digger.

Side note:

  • Vermont is only one of four states that follow a "opt-in" model to a statewide health information exchange.