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MyChart ® Epic Systems Corporation

TERMS AND CONDITIONS OF USE

Mercy Health System is pleased to offer you member information via a Web-based version of our computer systems called MyChart.

We think it is important for you to know how we handle information we communicate via the Internet. This Terms & Conditions statement outlines our practices and our sensitivity to your right to privacy. We reserve the right to revoke access at any time for any reason.

Access to Your Medical Information

Mercy’s MyChart allows you to view portions of your medical record online in a secure manner. MyChart is not designed to represent all of the medical information maintained by Mercy about you. You have the right to review your entire medical record, and you may do so by contacting the Mercy Medical Record Department at the site where you receive care.

Access Code Guidelines

The temporary access code with which you were provided will remain active for thirty (30) days. If you have not activated your account after thirty days, this access code will expire.

Access to Test Results

If you elect to use MyChart, MyChart will be the primary method of communicating test results to you. In most cases, you will no longer receive these results via U.S. mail. You will be notified via email when you have results ready to view in MyChart. In most cases, there will be a 3-5 day delay between when your test results have been completed and when they are released to MyChart. This is to allow your physician an opportunity to discuss the results with you, if necessary. This delay will be longer over weekends and holidays. Mercy assumes no responsibility for how you use the information you obtain from MyChart. You should direct any questions you have about the data available to you in MyChart to your physician or other healthcare provider. MyChart is not a substitute for consultation with your physician.

Response to Electronic Communication

Mercy will try to provide a timely response to electronic inquiries (emails and other electronic communication). You should allow at least two (2) business days for a response. Accordingly, MyChart should not be used to communicate with either Mercy or your physician in emergency situations. In emergencies, you should take appropriate actions, such as calling 911 or going directly to an emergency department. Any messages you send via MyChart will become part of your permanent medical record. They will be accessible by current and future Mercy employees who are appropriately involved in your care.

Website Links

Mercy’s MyChart may offer links to related medical websites not managed by Mercy. These website link(s) are for informational purposes only. Mercy does not endorse and has not verified the accuracy of the information provided by these websites, and you should not rely on any of the information found on the websites for purposes of treatment or diagnosis.

E-Mail Privacy

As a user of Mercy’s MyChart, you will be notified via email when there is new medical information to be viewed via MyChart. This means that any person with access to your email will be able to see this notification. This could include your family members, employer or anyone else who can gain access to your email account. Although no private medical information will be sent to you via email, the notification that new medical information is available via Mercy’s MyChart may be information that you wish to keep private. You should take this into account when providing an email address or using MyChart.

Security

User names and passwords provide two layers of authentication and are stored in an encrypted database that is isolated from the Internet. As a Mercy MyChart user, your role in maintaining the security of your medical information is to change your password on a regular basis and to keep your User name and password confidential. This is part of your MyChart Agreement and Authorization contained in this document.

This website uses encryption software, and Mercy has implemented reasonable and appropriate security measures to protect your medical information. When using Mercy’s MyChart, information will be transmitted over an Internet medium that is beyond the control of Mercy Health System and its contractors. You are responsible for ensuring that the computer system(s) you use to access MyChart have the appropriate security controls enabled.

Your Agreement and Authorization

By accessing or using Mercy’s MyChart, you agree to be bound by the terms and conditions of the following Agreement and Authorization and also Mercy’s Notice of Privacy Practices, which is posted on our website,www.mercyhealthsystem.org.

I understand that I will create a unique identification (ID) code and password to be used to gain access to my health information via Mercy’s MyChart. I understand that this ID and password are unique codes that identify me in Mercy’s computer system. I understand that it is extremely important that I keep the ID and password that I use to access MyChart completely confidential. If at any time I feel that the confidentiality of my password has been compromised, I will change it by going to the Password link on the MyChart website. I understand that the Mercy takes no responsibility for and disclaims any and all liability or consequential damages arising from a breach of medical record confidentiality resulting from my sharing, failing to protect, or losing my password. If Mercy discovers that I have inappropriately shared my password with another person, or that I have misused or abused my MyChart access privileges in any way, my participation in MyChart may be discontinued.

I authorize Mercy Health System (MHS) , to use MyChart to disclose personal health information to me or those for whom I am a legally authorized proxy. If signing as a proxy, I will state my relationship to the patient below. The type of information to be disclosed to me via MyChart includes clinic notes, diagnoses, test results, radiology and lab results, and other information collected by MHS pertaining to my medical care. The purpose for the disclosure is ongoing communication between MHS and me concerning my medical care. By clicking “accept” below, I am agreeing to this ongoing communication of elements of my medical care. I understand that I am under no obligation to sign this form, and that with certain exceptions, health care providers may not condition treatment, payment, or enrollment or eligibility for health plan benefits on obtaining an authorization. I understand that if I choose to re-disclose any information obtained about me to other parties, these parties could potentially re-disclose the information and this information would no longer be protected by applicable privacy laws. I understand that if I choose to revoke this authorization, I may do so by submitting a written request to an MHS Health Information Management Department. I understand that information already released will not be subject to the revocation. A consequence of failing to sign this authorization is that information will not be released via MyChart.