There are many tools that can launch a message center to send an embedded message center and you have the option to encrypt an outbound message in such a way that one has to have a special downloaded reader (an acrobat model) to view. But every clinician I have known has had their patients sign or opt a HIPAA waiver and has their lab and other messages just emailed to them directly,. Secure web encrypted web messaging, special encrypted packeted email all have solutions–medem, relayhealth, zix, biometric enabled, etc–and most consumers simply do not care. They want their information sent to the same place they work all day long in their own email and where they would get their banking password emailed to them as well! (I am not being facetious, this is just the reality)

Nevertheless, if one used something like relayhealth, for example,, one could just attach the resulting lab report, with comments, or the CCR with comments, etc by opening relayhealth inside the web browser, etc.

This is a very interesting and important topic. We enabled all clinicians, for example to offer a free encrypted medical email account to their patients with a special domain address so it was encrypted out and all going thru one network., Highly practical. And guess what?–the patients would still have it forwarded unencrypted of course to their personal gmail, yahoo or other email, and it was just an extra step. So at the end of the day most clinicians just email the patient directly, out of the patients request and more practical workflow. That is not a system issue, it is a practical and individual preference one.

There is alot of discussion about messaging with patients in EMR users forums, the Ideal Micropractice, specialty AAFP and other primary care forums, and in the medical and general press, as you know. Many clinicians are available who would be happy to share their thoughts as well

AJB

As more of all generations move away from sequestered and constrained information definitions, tools, containers and “others’” rules, and into more open modalities of posting, sharing, sending and even modifying….the individual now has an expansive relationship to information. When we create content with a certain meaning (as of this moment in time) and direction (ie it is for me, or for you, or for a group) we now have to be cognizant of how that same information can be read off line, or real time, synthesized, copied in snippets, become part of some other totally different media, and ultimately traced back partly to us, partly to others, and transformed beyond recognition as of source. It is as though by talking in the phone parts of our “vocal dna” can be mixed with other signals and create a new voice.

Privacy now becomes something that the individual must take a huge responsibility over, not “outsource” to a government or other protective agency, because what is private at one time needs to be more public at another. And humans will need to understand how to manage information just as they do when they are talking face to face real time and interacting with selective words, body language, etc

And along with this will come new accountabilities for the ramifications of our person-generated information being leveraged by others distant in time and place for other purposes. Doctors resist the idea that consumers will put credible information into a personal health record, But if the person entering it actually bears some accountability for the results of how it is used, then he/she will become a much more active participant in its creation, transmission, and maintenance. Just as we should have far more people insisting that they get a text message to their mobile phone to confirm ANY time their credit card is being used and money is leaving their account. The banks might not like the inconvenience of having to “hold money” and lose the float, but they are not the ones who pay the price for our credit card being used inappropriately.

More on this really interesting area later.

AJB