Practice Management

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  • 1.  How to properly respond to a patient's request for their MRI report

    Posted 07-01-2019 15:36
    ​We have made it a regular practice to print and mail a radiologist report to our patients who request it.

    Absent a secure FAX number for the patient, mailing the report or making it available at our office for pickup has been our only option.

    I'd like to email these reports when requested and want to make sure that we're in strict HIPAA compliance and advise the patient can waive it with explanation of the risks without placing an undue burden on the patient to receive their report.

    I've checked this out on the web at:

    https://www.hhs.gov/hipaa/for-professionals/faq/570/does-hipaa-permit-health-care-providers-to-use-email-to-discuss-health-issues-with-patients/index.html

    This page states:

    Does the HIPAA Privacy Rule permit health care providers to use e-mail to discuss health issues and treatment with their patients?

    Yes. The Privacy Rule allows covered health care providers to communicate electronically, such as through e-mail, with their patients, provided they apply reasonable safeguards when doing so. See 45 C.F.R. § 164.530(c). For example, certain precautions may need to be taken when using e-mail to avoid unintentional disclosures, such as checking the e-mail address for accuracy before sending, or sending an e-mail alert to the patient for address confirmation prior to sending the message. Further, while the Privacy Rule does not prohibit the use of unencrypted e-mail for treatment-related communications between health care providers and patients, other safeguards should be applied to reasonably protect privacy, such as limiting the amount or type of information disclosed through the unencrypted e-mail. In addition, covered entities will want to ensure that any transmission of electronic protected health information is in compliance with the HIPAA Security Rule requirements at 45 C.F.R. Part 164, Subpart C.


    Note that an individual has the right under the Privacy Rule to request and have a covered health care provider communicate with him or her by alternative means or at alternative locations, if reasonable. See 45 C.F.R. § 164.522(b). For example, a health care provider should accommodate an individual's request to receive appointment reminders via e-mail, rather than on a postcard, if e-mail is a reasonable, alternative means for that provider to communicate with the patient. By the same token, however, if the use of unencrypted e-mail is unacceptable to a patient who requests confidential communications, other means of communicating with the patient, such as by more secure electronic methods, or by mail or telephone, should be offered and accommodated.


    Patients may initiate communications with a provider using e-mail. If this situation occurs, the health care provider can assume (unless the patient has explicitly stated otherwise) that e-mail communications are acceptable to the individual. If the provider feels the patient may not be aware of the possible risks of using unencrypted e-mail, or has concerns about potential liability, the provider can alert the patient of those risks, and let the patient decide whether to continue e-mail communications.

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    So if a patient requests we email them their report I believe it should be OK to advise them that this is not HIPAA privacy compliant and we request they waive this compliance to ensure a timely response to their request.

    Comments, please?


    ------------------------------
    William Kisse
    COO
    Washington Open MRI, Inc.
    Rockville, MD
    bill@womri.com
    (301) 424-4888
    https://www.linkedin.com/in/billkisse/
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  • 2.  RE: How to properly respond to a patient's request for their MRI report

    Posted 07-01-2019 16:01

    I think the simple and safe thing to do is to use email encryption.  Then you don't have to worry about a waiver.  If you don't already have the capability to send encrypted email, you should, because I'll bet people in your organization are emailing PHI externally.  It isn't very expensive.  If you have to add, I would suggest checking ease of use, because that does vary considerably.  My personal experience has been that you can't rely on automatic encryption...it encrypts many emails that don't need to be encrypted, and misses some that do.

     

    The other option you might want to explore is creation of a web portal so patients can view their own reports, saving the labor costs involved in responding to requests.  Many RIS/PACS vendors offer this as an option.  I think many patients are accustomed to having online access to their records, and I imagine quite a few would be disappointed not to have it. 

     

    Dave

     

    David Smith, FACMPE  |  Executive Director  |  785.393.8387

    5800 Foxridge Dr.  Ste 240  |  Mission, KS  66202  |  www.uickc.com

    p-uic-horizontal-03a

     






  • 3.  RE: How to properly respond to a patient's request for their MRI report

    Posted 07-01-2019 16:33
    Thank you, Dave

    We are migrating to Ramsoft and they have a 3rd party vendor that will allow patients to easily access all their images and reports online.

    In the interim I am looking for a safe alternative.

    I'll follow your recommendations about encrypted email as an interim - and alternate - method to accomplish this.

    Regards

    Bill​

    ------------------------------
    William Kisse
    COO
    Washington Open MRI, Inc.
    Rockville, MD
    bill@womri.com
    (301) 424-4888
    https://www.linkedin.com/in/billkisse/
    ------------------------------



  • 4.  RE: How to properly respond to a patient's request for their MRI report

    Posted 07-01-2019 17:48
    So if a clearly-written waiver request acknowledged by the patient will honor the letter of the law I will consider - until we're fully migrated - this method to promptly respond to patient requests.

    My RBMA membership has just paid for itself...

    With my most sincere thanks.

    Bill​

    ------------------------------
    William Kisse
    COO
    Washington Open MRI, Inc.
    Rockville, MD
    bill@womri.com
    (301) 424-4888
    https://www.linkedin.com/in/billkisse/
    ------------------------------



  • 5.  RE: How to properly respond to a patient's request for their MRI report

    Posted 07-01-2019 18:15
    #ProgressThroughSharing

    Tim Barrett, CPA
    Radiology Associates, LLC