WASHINGTON – Members of the Health IT Standards Committee believe more federal clarification will be required surrounding patient access to their electronic health records (EHRs), as required under the interim final rule on standards and certification.

At the HIT Standards Committee meeting on Wednesday, experts said the rule is not clear enough on how a provider must grant a patient access to their electronic records and what the record must include.

John Halamka, co-chair of the HIT Standards Committee said that how providers should package patient electronic health information is a question for all the patient criteria found in the rule.

Dixie Baker, chair of the committee's privacy and security workgroup, said this particular aspect of the interim final rule is drawing attention and is likely to spur more clarification.

"Do the EHRs need to include real-time lab test results?" she asked. "These are the kinds of things that need to be explored."

According to Baker,  the privacy workgroup had concerns with the rule's definition of a patient's "online access" to their clinical information. "It is unclear, and language is inconsistent with meaningful use objective," Baker said.

In addition, the rule calls for providers to give patients "timely electronic access" to their health information. "It is unclear if this is to be interpreted as real-time access," Baker said. 

It is also not clear whether a patient's electronic health record should be human or machine interpretable – or both, she added. The rule also calls for the electronic health record to provide "meaningful usability" for the consumer, but does not define what that is.

During time allotted to the public, Debra Peel, founder of Patient Privacy Rights, said patients are entitled to their entire electronic health record, not just some form of the record.

"That's what we have now with paper records," she said. "When we ask for a copy, we get everything."

She said some patients may not care to have all the actual data available, but they should be entitled to receive as much as they want.