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Frequently Asked Questions


Providers FAQs

What is the East Tennessee Health Information Network (etHIN)?

etHIN is a Regional Health Information Organization (RHIO) for healthcare providers that facilitates more immediate access to enhanced medical information about the patients they treat. etHIN is a non-profit organization.



How does etHIN comply with the new Information Block rule?

As a Regional Health Information Organization operating a Health Information Exchange (HIE) between HIE Participants in Tennessee, etHIN will not knowingly or willingly take any action to limit or to restrict the interoperability of any of its HIE software or the EHR software of its connected Participants.

etHIN implements its HIE technology, including all supported interfaces and data transports , in a manner reasonably calculated to ensure its HIE technology is in compliance with available data exchange standards, applicable Policies,  Participant Agreements, and applicable law to enable and allow for timely exchange of structured electronic health information in a secure and trusted bi-directional manner with and among Participants of the HIE.

etHIN responds in good faith and in a timely manner to requests to retrieve or exchange electronic health information, from and among etHIN Participants, in compliance with applicable law and active Participant Agreements.

etHIN will comply with the requirements of the 21st Century Cures Act applicable to health information networks and health information exchanges, including any regulations and guidance issued relating to information blocking under 42 U.S.C. § 300jj-52 (the “Cures Act”).  etHIN acknowledges that it may engage in reasonable and necessary activities that may impact requests to access, exchange or use electronic health information stored or made available through the etHIN network.  Any such activities will be based on etHIN’s good faith belief that such activities meet the conditions of an exception to the information blocking rules identified by the Office of the National Coordinator for Health Information Technology in 45 C.F.R. Parts 170 and 171 or any subsequent regulation or guidance.


Why should I join etHIN? What is the benefit to me and my patients?

Participation in etHIN can provide more immediate access to your patients’ records from other providers with whom your patient has a relationship, including hospitals and other physicians. Participation may also help lower some of your current technology costs because of ease of access to your patients’ information, and you may be able to lower some of your administrative costs as well.


What patient information is available?

etHIN users can access:

  • Lab Reports
  • Medication History
  • Radiology Reports and Images
  • Hospital Discharge Summaries
  • Office Notes
  • Progress Notes
  • Transcribed Reports
  • Pathology Reports

etHIN does not collect sensitive medical data, including substance abuse and mental health information, genetic testing results, and HIV test results.


Who provides data?

Several of the area’s hospital systems and physician groups are participating in etHIN, with more in the process of being added. See a list of current participants.


How do I access patient information through etHIN?

You may access information through your own EMR after integration to etHIN, or, if you don’t have an EMR, through etHIN’s secure Clinical Viewer, also known as the eHIP Clinical Viewer.



I don’t currently use an EMR, and I don’t want anything complicated. Is there any other way to participate in the exchange?

Yes, etHIN can provide access to both the eHIP Clinical Viewer, mentioned above, and DirectSX, a secure healthcare only email system that allows sharing of clinical information. DirectSX is a simple, secure messaging system that allows patient information to be sent or received directly from one healthcare provider to another.


How long does it take to get started?

Implementation time depends on your current systems and the method you decide to use to exchange information. etHIN’s staff will be able to assist with developing a time frame after talking with you to determine the solution that best suits your needs.


How much does access to information through etHIN cost?

The cost will depend on the etHIN solution you decide to use for information sharing and the systems you already have in place. There are several options available to you, and etHIN will help assess your needs and arrive at the most cost effective solution for you and your patients.

Contact us for more information or call us at 865-691-8433. If you prefer, you can email us at info@ethin.org.


etHIN DirectSX Secure Messaging

What is etHIN DirectSX?

etHIN DirectSX is a HIPAA-compliant, secure messaging service that allows users to securely send and receive protected health information (PHI) messages and attachments to other participating healthcare providers.

DirectSX benefits both patients and providers by improving the exchange of health information, making it faster, easier, more secure, and less expensive. DirectSX works with or without an electronic health record (EHR) system, so there is no need to purchase special software for this product. All you need is a connection to the Internet.

In addition, because all Direct messaging users are identity validated, certified, and have been assigned a specific Direct email address, you are assured that the person receiving your PHI message is also HIPAA-compliant.


What are the benefits of using DirectSX?

etHIN DirectSX is a more secure and efficient way for providers to communicate and transmit protected health information between providers than using fax, phone, or courier. The ability to electronically transmit patient records simplifies patient care coordination, enhances communication between providers and may help reduce duplicate tests and procedures.


What type of documents can be sent using etHIN DirectSX?

Any type of document can be attached to a DirectSX message. Some common use examples include referrals, patient summaries, discharge summaries, and lab results.


Is there a limitation on the attachment size I can send via DirectSX?

The file size for one attachment is limited to 10 MB, or there can be several attachments to a message as long as the total attachment size is less than 10 MB. Your user mailbox will store 500 MB of data.


Who can use etHIN DirectSX?

etHIN DirectSX is a healthcare-only secure messaging system that can be used by hospitals, individual providers and their staff, nurses, pharmacies, labs, community health departments, and others who need to send or receive PHI.


How secure are messages that are sent through etHIN DirectSX?

etHIN DirectSX is built on the secure messaging standards created by the Office of the National Coordinator for Health Information Technology (ONC). DirectSX abides by all federal and state policies and standards for health information exchange, including privacy and security standards set by the Health Insurance Portability and Accountability Act (HIPAA).


How do I sign up for etHIN DirectSX?

Simply contact etHIN at 865-691-8433, or you can reach us online by clicking Contact Us.


How will I know when I receive a DirectSX secure message?

You will receive a notification in your traditional email inbox when you receive a new DirectSX secure message. Click the link in the notification email, then login to the Portal. You will be taken to the Member Center, where you will click on your Inbox. To open and read your message, click on the Subject of the email.


How long will messages I receive remain in my Direct secure mail inbox?

For security, DirectSX messages are automatically deleted after 30 days. To prevent losing access to the files that are sent to you, be sure to download and save them to a secure location when you receive the message.


Can I access DirectSX secure mail from my mobile device?

You can use etHIN DirectSX with any computer, tablet, smartphone or other device that has a web browser and Internet access.


Can I send a DirectSX message to someone who doesn’t already have a Direct secure mail account?

No. For security, only another Direct user is able to receive a DirectSX message from you.


How will I find out whether another provider has a Direct account?

We recommend contacting their office directly to obtain that information.


Can I send or forward DirectSX messages to my personal or work email account?

No. DirectSX Secure Messages can only be read within the etHIN DirectSX system.


Can I forward my DirectSX inbox to another DirectSX user in my office when I go on vacation?

No. You should notify your DirectSX contacts of the dates you will be out of the office and instruct them whom to send messages to you while you are away.


I forgot my Direct password. How do I reset it?

There are two ways to reset your password.

1. On the DirectSX login page, below the Secure Member Login box, you will see “Not sure what your password is? Click HERE to reset your password.” Click the HERE link. Enter your DirectSX messaging address when requested. A notification message will be sent to your traditional email account providing information that enables you to reset your password. Follow the instructions in the email.

2. When you are logged into the DirectSX system, go to the Member Center. Under My Account, click on User Information. On the next screen, click the Change Password link and follow the instructions described in the previous paragraph.


How often does my password expire?

Your password is set to expire after 45 days. When it expires, you will be prompted to change your password the next time you log into your DirectSX mail.


Who do I contact if I need help with eHIP or etHIN DirectSX?

You can email HelpDesk@ethin.org or call 865-691-8433. etHIN support staff is available to assist you Monday – Friday, 8 a.m. to 5 p.m. Eastern.

Email critical or downtime issues to HelpDesk@ethin.org, and they will be addressed as soon as possible, seven days a week.

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