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Record W4415815624 · doi:10.1001/amajethics.2025.815

How Could Legal Standards Promote Equitable Access to EHRs?

2025· article· en· W4415815624 on OpenAlexaff
Jessica L. Roberts

Bibliographic record

VenueThe AMA Journal of Ethic · 2025
Typearticle
Languageen
FieldHealth Professions
TopicElectronic Health Records Systems
Canadian institutionsArtificial Intelligence in Medicine (Canada)
Fundersnot available
KeywordsHealth recordsConfidentialityThe InternetAccess to medicinesLegal actionAccess to information

Abstract

fetched live from OpenAlex

Electronic health records (EHRs) enable patients to access their health records anytime, from anywhere with internet connectivity.Yet not all Americans benefit from these innovations.EHRs can be hard to access for people with a range of disabilities.This lack of access perpetuates inequity and, thus, demands ethical and legal attention.Some federal laws and regulations require accessible EHRs, but even these protections can fall short.This article argues that more clearly defined obligations for EHR developers and clinicians are necessary.Accessing Health Information Electronic health records (EHRs) have made obtaining health data easier than ever before.EHRs are effectively "digitized medical chart[s]" 1 that allow clinicians to readily access and manage patients' information.Integrating EHRs into clinical practice can increase efficiency and improve quality of care. 1,2Specifically, EHRs allow clinicians to coordinate treatment plans with other clinicians and to detect and mitigate errors.Patients, too, can review parts of their health records 24 hours a day, 365 days a year, from anywhere with an internet connection.Patients' reading and understanding of key information in their EHRs can motivate communication and adherence.However, not all patients can reap these benefits.Americans with disabilities experience significant health inequity, and inaccessible EHRs could exacerbate that inequity.Moreover, issues that impede access for patients with disabilities could also affect other populations, such as elderly patients and patients with limited education. 2Inaccessible EHRs are at odds with clinicians' legal 3 and ethical duties 4,5,6,7 to practice inclusively.Thankfully, current federal regulations require covered providers to ensure that information technology is accessible to those with disabilities. 8lthough federal disability rights laws do not apply to technology developers 3,9 and can go underenforced, 10 ethical duties of both clinicians and EHR developers provide a foundation on which to ground health systems' parallel duties to ensure that patients with disabilities can meaningfully access and use their health data. Inaccessibility of EHRsMany websites and apps are inaccessible to people with disabilities.They might use small font, include content written at a high literacy level, rely on complex and hard-tonavigate user interfaces, lack the capacity to customize, or be incompatible with

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.019
metaresearch head score (Gemma)0.003
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesResearch integrity
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: Not applicable
GenreCandidate signal: Empirical · Consensus signal: none
Teacher disagreement score0.632
Threshold uncertainty score0.998

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0190.003
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.001
Science and technology studies0.0010.000
Scholarly communication0.0000.000
Open science0.0010.000
Research integrity0.0000.004
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.105
GPT teacher head0.526
Teacher spread0.421 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designNot applicable
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations0
Published2025
Admission routes1
Has abstractyes

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