Trouble Getting Polysomnogram from Hospital

[brucifer]

Has anyone else had trouble getting their polysomnogram from their hospital/sleep-study center? I underwent a sleep study on July 10 at a local hospital. It was ordered by my (former) pulmonologist who also happens to be the director of the hospital's sleep center, and she is also the person who read my polysomnogram and wrote the report. The problem I am having is actually getting a copy of the polysomnogram. The hospital records office provided me with the sleep doctor's report which I had already received from the pulmonologist's office staff. The sleep doctor's office staff claim that they do not have my polysomnogram, and directed me to hospital records. Hospital records claims they don't have the polysomnogram and that it is unusual for a patient to request a copy of one. I don't buy that line for a second. In fact, I know better.

I have been nice with the hospital and the pulmonologist's office staff up to this point, but I plan to insist upon obtaining a copy of my polysomnogram. I paid for the study, and under the HIPAA law I am entitled to see and receive a copy of ALL my medical records. The hospital has been great in the past providing copies of MRI and x-ray films; however, waiting patiently for over two months to receive a copy of my polysomnogram is bordering on the ridiculous. Has anyone else had problems getting a copy of their sleep-study polysomnogram?

[Sir NoddinOff]

Getting satisfaction/response from a medical establishment who is too often obsessed with some selfish need to keep their little secrets, all I have to offer is to say good luck. Hope you get your records.

[greatunclebill]

put your request in the form of a registered letter citing the hippa law. they have no choice. they can say anything they want and lie about what they said. when it is in writing the game changes.

[Julie]

For what it's worth, it IS unusual for people to want the actual PSG (vs the report). I'm not sure I know anyone else who asked for one.

[Wulfman...]

Has anyone else had trouble getting their polysomnogram from their hospital/sleep-study center? I underwent a sleep study on July 10 at a local hospital. It was ordered by my (former) pulmonologist who also happens to be the director of the hospital's sleep center, and she is also the person who read my polysomnogram and wrote the report. The problem I am having is actually getting a copy of the polysomnogram. The hospital records office provided me with the sleep doctor's report which I had already received from the pulmonologist's office staff. The sleep doctor's office staff claim that they do not have my polysomnogram, and directed me to hospital records. Hospital records claims they don't have the polysomnogram and that it is unusual for a patient to request a copy of one. I don't buy that line for a second. In fact, I know better.

I have been nice with the hospital and the pulmonologist's office staff up to this point, but I plan to insist upon obtaining a copy of my polysomnogram. I paid for the study, and under the HIPAA law I am entitled to see and receive a copy of ALL my medical records. The hospital has been great in the past providing copies of MRI and x-ray films; however, waiting patiently for over two months to receive a copy of my polysomnogram is bordering on the ridiculous. Has anyone else had problems getting a copy of their sleep-study polysomnogram?

How many pages is the report you have? If it's about 8 pages, that's really all you need. The actual "data" from your sleep study would essentially be useless unless you have the specialized software to play it back and read through it on a computer.
If your study was like many of them, the sleep lab may be linked (networked) to remote place where the sleep doctors interpret the data and the notes from the tech who was doing your study. Then they provide your pulmonologist with the report and then he/she writes up the prescription. That's the way it was with mine.
I finally requested mine (approx. 8 pages which include the tech's notes) about a year and a half after my sleep study and it didn't provide me with a whole lot of additional information. To me, the most valuable information was that I HAD Sleep Apnea and how well my machine was treating me.


Den

.

[Slartybartfast]

What you're asking for undoubtedly appears threatening to the professionals involved. Under HIPPA http://www.hhs.gov/ocr/privacy/hipaa/un ... g/summary/ it is absolutely your right to have all your medical records, including raw data and reports. However when someone is contemplating suing them for who-knows-what, the request, and the method of request (certified mail) would be the same. So imagine how your unusual request must appear to them.

The certified mail request will certainly do the trick, but if you sense reluctance, it's because they wonder whether there's something lurking in the records that might bite them.

[avi123]

If I was the manager of the clinic who did your PSG I would not provide you the raw data that I used. Only a short report (including an hypnogram) to the physician who sent you. This b/c I am not obliged to and also you might be a "spy" of a competing clinic.

Check also:

http://www.nolo.com/legal-encyclopedia/ ... 32220.html

[purple]

Maybe I do not understand why you want the huge amount of raw data. Those on the forum who say, get a copy of the Sleep Study, are (as I understand it) suggesting the few pages of a summary report, which can be used if you are say traveling and need supplies from a local DME, like a hose, mask, or anything. As a Doctor will look at the summary report and be willing to write a script for whatever you want, else you will have to go through a lot of hoops of trying to get one of your regular docs to write a script and send it to wherever you want to have it sent. Trying to get my doctor to just refill a prescription to the same local pharmacy he always writes it to is supposed to take three days.

Then there is the possibility that the doc did not tell you the whole story about what the summary report concluded.

Since reading the raw data requires a huge amount of expertise, I am not sure why you really want it.

I guess my issue is that my rooms almost look like I am a hoarder already, and I do not need more stuff that I will never use.

[Slinky]

Yes, we do need to be clear on just what is wanted and needed. There usually is the doctor's dictated results (1-2 pages) that we usually are given a copy of. Then there is the full scored data summary report w/condensed graphs (about 5+ pages) that is sometimes routinely given to us if we ask or confuses staff for a bit since we so seldom do ask for this copy. The full PSG would be REAMS of paper for the night. Some labs save it on CD now.

[MidnightOwl]

I don't see anything wrong with wanting this. The data is digital, not paper so w's not a matter of printing or storing a foot high pile of paper. However that doesn't mean you're going to be able to get it.

Medical records is probably doesn't have a copy of it. It's unlikely that the raw data is compatible with their computer systems. So they probably have the 4-8 page summary people are describing. You are entitled to get (and pay for) a list of everything they do have if you doubt it. It's probably also true that no one asks for this. Your dealings with them will probably go more smoothly if you don't accuse them of lying when they are not. Your doctor may only have seen the summary too.

However the original lab should have a copy for however many years they are required to keep this stuff. They should be able to make a copy on a disk for you. They may also be able to include an app that allows someone without the full original software to view it. If not, you'd need to find someone (lab) with the same software to read it. Will they? I don't know. Does the law require them to? Again I don't know. It should but who knows. And it really doesn't matter what the law says if you can't get it enforced.

You might try asking the lab directly for this. Or, if it was a hospital department, you could try enlisting records as your ally, explaining to them that there are records that the lab is keeping separately, that you need.

I hope you succeed. If I'd thought there was a chance in hell I could have gotten mine I would have tried. For me that would have just been curiosity - there's nothing to suggest I'm anything but plain vanilla apnea. As it was it was a struggle just to get the summary reports. And yes - that was definitely worthwhile.

Interpreting polysomnograms still has a subjective element - just like reading xrays does. If nothing else we should have a right to take that raw data to someone else for a second opinion just like you do with an xray. (I just did that with an xray and the diagnosis changed from "fine" to "serious break")

Good luck.

[brucifer]

Thanks for the responses. So far, all that the hospital and pulmonolist have provided me is a two-page summary report, and most of that report just states summative data, the pulmonologist's interpretation of my sleep study, remarks concerning her discussion with me post-sleep study, and her treatment recommendations. There is a lot of good information in the report, but I would like to see the data for myself instead of relying on her interpretation. I have a lot of medical issues, so I have become somewhat cynical over the years in dealing with medical folk. The pulmonologist is the director of the hospital lab, so she has access to all sleep-study data for all patients who have had a sleep study at that hospital.

Although I am becoming impatient, I have only discussed this issue on this forum and with my wife. I have been nice to the hospital staff as well as to the folks who work in the pulmonologist's office. The hospital has done a fine job in the past providing me the records that I request. This is the first time they have seemingly dragged their feet. I know that by HIPAA rules (and law), I am entitled to all medical records. IMHO that should include a more thorough summary sleep-study report.

I don't necessarily need all of the raw data. I would be satisfied if the hospital provided a summary report that included summary graphs of my OSA events during the sleep study as well as the corresponding pressure readings and adjustments. Some in-depth sleep-study reports have been posted by some of the members here. That's what I am would like to see provided. My insurance company paid the hospital and pulmonologist a between two-and three thousand dollars thus far for the sleep study and the report, and I paid a hefty co-pay as well as my insurance premium, so I believe that I am not asking too much.

I have a good relationship with the hospital and have been going to them for years. In general, I have few complaints. However, I will send a certified letter stating my request in writing if they do not do better than they have done thus far. That being said, I don't want to jump the gun and accuse anyone of anything if I am the one who is uninformed. I can post a redacted copy of the report my pulmonologist provided me if anyone wants to judge whether or not the report is satisfactory. Thanks.

[Xney]

If they just provided you with a 2-page summary like "50 AHIs in supine position" or whatever, that does seem inadequate.

Most of us have received the sleep test graphs in addition to detailed breakdowns by type, position, pressures, etc., as well as the written summary and a prescription. (or that's what I've gotten from all of my sleep studies)

[old64mb]

If nothing else we should have a right to take that raw data to someone else for a second opinion just like you do with an xray.

This actually gets to the problem I have with a patient insisting on the full PSG.

This isn't like bringing X-rays or an MRI or test results to another doctor. Interpreting a raw PSG is highly subjective and requires both skill and time and is one reason sleep studies are so expensive, since that work by an MD is built into the price you pay.

Basically, this would be something to get only if a sleep doctor at another clinic was really curious and interested in spending the time necessary to score the results, and I think that's extremely unlikely - I've yet to meet one who wouldn't rather just look at a few previous summaries, go "hmm, this is interesting, lets look for this and that," and then promptly proceed to order their own study.

You're certainly entitled to the results under HIPAA, but using a nuclear weapon when a fly swatter is probably better is overkill (especially since you want to continue your relationship with them). I think a certified letter would be overboard at this point, especially since this may just be the lab and the doctor might being confused as to what you're trying to ask for.

A polite letter to them stating exactly what you said - that you would like a copy of the summary report that included summary graphs of my OSA events during the sleep study as well as the corresponding pressure readings and adjustments along with technician notes - probably would be a more effective way to get what you want.

If they deny that in writing, then you've got more ammunition as well as probably reason to find another lab.

[brucifer]

@old64mb - I have been patient and nice with both the hospital and the pulmonologist's office. I'll only write the certified letter IF I get stonewalled. If that is what ultimately happens, then I really won't want to continue my relationship with them anyway. We have too many excellent hospitals in the Atlanta area for me to put up with inadequate patient care at any one hospital.

Anyway, I have attached below a redacted copy of the Summary Report that the pulmonologist and hospital records offices provided to me:

[MidnightOwl]

Thanks for the responses. So far, all that the hospital and pulmonolist have provided me is a two-page summary report, and most of that report just states summative data, the pulmonologist's interpretation of my sleep study, remarks concerning her discussion with me post-sleep study, and her treatment recommendations.

This is all that was originally sent to my referring physician.

The hospital has done a fine job in the past providing me the records that I request. This is the first time they have seemingly dragged their feet. I know that by HIPAA rules (and law), I am entitled to all medical records. IMHO that should include a more thorough summary sleep-study report.

I'd start with the assumption that they don't understand your request. It's possible they aren't getting the records from the sleep lab and they don't even know it. The doctor who provided the interpretation definitely did have the graphs etc.

I don't necessarily need all of the raw data. I would be satisfied if the hospital provided a summary report that included summary graphs of my OSA events during the sleep study as well as the corresponding pressure readings and adjustments. Some in-depth sleep-study reports have been posted by some of the members here. That's what I am would like to see provided. My insurance company paid the hospital and pulmonologist a between two-and three thousand dollars thus far for the sleep study and the report, and I paid a hefty co-pay as well as my insurance premium, so I believe that I am not asking too much.

This is what I ultimately got and it was very helpful to me. It allowed me to understand the recommendations, it clarified a few inconsistancies that turned out to be typos on the summary report, and it helped me believe in the accuracy of the test as the details corresponded to what I remembered of the test (I spent much of it awake). The graphs showed the episodes against time thru the night. There also were graphs showing pressures used, sleep position, sleep stage, all graphed against time. It also told me useful things like most of my hypopneas disappeared at the lowest pressure, additional pressure took care of the remainder, a short trial at a higher pressure didn't change anything. I believe seeing all of this not only helped me understand what the test showed but helped me accept and adapt to treatment (you might want to spin it that way to your doctor - rather than in terms of checking up though of course it is both).

I think a certified letter would be overboard at this point, especially since this may just be the lab and the doctor might being confused as to what you're trying to ask for.

A polite letter to them stating exactly what you said - that you would like a copy of the summary report that included summary graphs of my OSA events during the sleep study as well as the corresponding pressure readings and adjustments along with technician notes - probably would be a more effective way to get what you want.

If they deny that in writing, then you've got more ammunition as well as probably reason to find another lab.

Agreed.