OCR asked to clarify patient right to records via Direct Messaging

Humetrix, the National Association for Trusted Exchange, the National Council for Behavioral Health and several other organizations have asked the U.S. Department of Health and Human Services' Office for Civil Rights (OCR) to clarify that it's OK for providers to share electronic health record data with patients via Direct Messaging.

In a Jan. 30 letter to OCR Director Jocelyn Samuels and National Coordinator for Health IT Karen DeSalvo, the organizations point out that patients can obtain their electronic records via Direct Messaging from providers who have a certified EHR because those systems are required to include Direct Messaging. Patients merely need to download a personal health record (PHR) app that supports Direct Messaging.

However, providers are not giving patients this access, required by HIPAA, because they're not asking their vendors or health information service providers to upload the PHRs' digital certificates and turn on the Direct function of their EMR, according to the letter. As a result, patients' requests for access to records have been denied or won't work. Some providers also are refusing to provide this access, claiming that the electronic format is not feasible and/or that the records can't be sent to the PHR vendor; both claims are untrue, the letter's authors say.  

The organizations request that OCR issue guidance, perhaps in the form of an answer to a frequently asked question, that spells out that people have the right under HIPAA to receive their information in a PHR through Direct Messaging when a provider has certified EHR technology or other technology that readily supports such access.

In a related blog post, Bettina Experton, M.D., president and CEO of Humetrix, said that Direct and patient-mediated information exchange can help increase interoperability and that Direct "offers a much clearer path" to meet the Meaningful Use requirements than patient portals.

"Business barriers can explain the persistent lack of provider-to-provider EHR exchange, but no such barriers exist for provider-to-patient communication, which can take place now with the existing Direct-enabled EMR infrastructure," Experton writes.

Consumers continue to warm up to the concept of online access to their records. For instance, a survey from Xerox of 2,017 U.S. adults released in December found that 64 percent of respondents don't use online portals, but 57 percent of those would be more involved and productive in their healthcare if they had online access.

At the same time, some patients remain unaware that these tools are available to them; others don't even know if their providers offer digital services.

To learn more:
- here's the letter (.pdf)
- read the blog post

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