As electronic health information exchange (HIE) becomes more prevalent among providers, payers increasingly are seeking direct access to electronic health record (EHR) systems for automated medical record collection and aggregation. The electronic exchange of protected health information (PHI) allows physicians, nurses, and other healthcare providers and patients to appropriately access and share PHI—improving the quality, efficiency, safety, and cost of patient care. So, why do payers want access to EHRs?

Payers suggest that access to EHRs can expedite claims processing, reviews, and audits without negative impact to the provider. However, there are inherent risks to the provider’s financial health, privacy, security, and information governance when they give access to payers. Providers should recognize that they have choices about how to share this data with payers, and they should carefully evaluate the benefits and risks to their organizations and their patients when doing so.