Indy, great stuff as usual. #2 seems to be the most viable option unless UpDox works.
The next generation of doctors that we mentored are going to embrace all of the digital media whether there is HITECH or not. Unfortunately, our generation has difficulty with it. And, remember, there is a selection bias for those on the board.
www.certifiedmail.com will is completely HIPAA compliant. (I have to admit I don't recall its attachment capabilities. It is relatively inexpensive. I used to use it. ALL a doctor on the other end had to do was click on the link in the email, it would take him/her to the secure site, automatically fill in his or her email as the user name. They would simply need to type in a password. It was free for them, and they could access the data after logging in. From that time forward, they just entered the password.
I would hazard a guess that over 50% would email be back via regular email and ask that I sent the email in the "normal fashion." So, I would oblige and type. I have a patient, A.R., with anemia, etc. They either couldn't figure it out or more likely from what they told me, they were afraid they would incur charges and have to have an actual account.
But, on the other hand, just having it may fulfill the requirement. Again, I don't know how much bandwidth you are allowed.