Patients should not be paying to have access to their electronic health records, a study from the Brookings Institution contends.

The HIPAA privacy rule requires providers to upon request provide patients with paper or electronic copies of their records at a “reasonable cost.” Brookings authors Niam Yaraghi and Joshua Bleiberg note that fees for paper records—often high—vary substantially from state to state.

Also See: Planning for the Unexpected EHR Downtime

States place caps on the cost of printing paper medical records. Some of the highest costs for copying 75 pages are in Georgia, Pennsylvania, Indiana and Mississippi, ranging from $90 to $101. The lowest caps are in Tennessee, Wisconsin and California with a range of $19 to $29.

But while most hospitals now have a certified EHR, many state regulations remain focused on paper records and the permissible costs for electronic copies may be the same as for paper—despite the costs of reproducing digital records being effectively zero.

The copying fee was intended to ensure providers were adequately reimbursed for the costs of copying records that patients request, according to the authors. They note that EHRs are very expensive but most were subsidized under the meaningful use program. In a small survey conducted in March in support of the report, 68 percent of 102 respondents were not willing to pay anything for their electronic data. Consequently, the authors conclude that state regulators should require that patients receive their electronic medical data for free.

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