DENOMINATOR: Number of unique patients seen by the EP during the EHR reporting period.

NUMERATOR: Number of patients in the denominator who receive an electronic copy of their electronic health information within three business days. 

EXCLUSION: An EP who who has no requests from patients or their agens for an electronic copy of patient health information during the EHR reporting period would be excluded from this requirement. EP's must enter "0" in the Exclusion box to attest to the exclusion from this requirement.

The provider is permitted, but not required, to limit the measure of this objective to those patients whose records are maintained using certified EHR technology.

When responding to patient requests for information, the EP should accomodate patient requests in accordance with the HIPAA Privacy Rule, as specified at 45 CFR 164.524, Access of individuals to protected health information. HIPAA contains requirements for providing patients copies of their health information.

Information that must be provided electronically is limited to that information that exists electronically in or is accessible from the certified EHR technology and is maintained by or on behalf of the EP. At a minimum, this would include the elements listed in the ONC final rule at 45 CFR 170.304(f) for EP's and as required for EHR technology to become certified.

An EP may withhold information from the electronic copy of a patient's health information in accordanced with the HIPAA Privacy Rule, as specified at 45 CFR 164.524.

An EP should provide a patient with all of the health information they have available electronically, subject to withholding as described in the HIPAA privacy rule, as specified in 45 CFR 164.524.

Form and Format shoudl be human readabale and comply with the HIPAA Privacy Rule, as specified at 45 CFR 164.524 (c). The media could be any electronic form such as patient portal, PHR, CD, USB fob, etc. EP's are expected to make reasonable accomodations for patient preference as outlined in 45 CFR 164.524 (b).

The charging of fees for this information is governed by the HIPAA Privacy Rule at 45 CFR 164.524.(c)(4) which only permits HIPAA covered entities to charge an individual a reasonable, cost based fee for a copy of the individual health information.

If provision of the copy involves the mailing of physical electronic media, then wit would need to be mailed by at least the third business day follwoing the request of the patient or their agent.

Third Party Requests: Only specific third party requests for information are included in the denominator. Providing the copy to a family memor or patient's authorized represetative consistent with federal and state law may substitute for a disclosure of the information to the patient and count in the numerator. A request from the same would count in the denominator. All other third party requests are not included in the numerator or the denominator.