Physicians will have more time to comply with federal rules aimed at improving data-sharing after the U.S. Department of Health and Human Services announced yesterday it will delay enforcement of certain provisions from Nov. 2 to April 5, 2021, due to the COVID-19 pandemic.
The “information blocking” rules are meant to enable widespread access and sharing of electronic health information (EHI) among physicians and their patients, for example, through smartphones or other devices. Physicians, hospitals, electronic health record (EHR) vendors, health information exchanges (HIE), and health information networks (HIN) must comply with the regulations.
The rules implement certain interoperability provisions of the 21st Century Cures Act – passed by Congress in 2015 and put into regulation earlier this year by the Office of the National Coordinator (ONC) – and are the first in a series of regulations set to take effect on a rolling timeline.
“We are hearing that while there is strong support for advancing patient access and clinician coordination through the provisions in the final rule, stakeholders also must manage the needs being experienced during the current pandemic,” said Don Rucker, MD, national coordinator for health information technology. “To be clear, ONC is not removing the requirements advancing patient access to their health information that are outlined in the Cures Act Final Rule. Rather, we are providing additional time to allow everyone in the health care ecosystem to focus on COVID-19 response.”
The information blocking provisions require that patients and their physicians be given immediate electronic access to significant portions of the patient’s EHI upon request. This includes clinical notes and specifies eight types: discharge summaries; history and physicals; progress notes; consult notes; imaging reports; laboratory reports; pathology reports; and procedure notes.
ONC does not specifically state that “open notes” are required (“open notes” refers to the automatic release of all clinical notes). But TMA experts say the agency continues to move toward increased transparency of EHI, and physicians should prepare for “open notes” if they are not already releasing them.
The American Medical Association has created a two-part educational resource to help physicians understand the requirements and develop an information blocking compliance program.
Part 1 outlines what information blocking is, key terms to know, examples of information blocking practices, and, importantly, a summary of exceptions for when physicians may restrict access, exchange, and use of EHI.
Part 2 helps physicians start down the path of compliance, including considerations for maintaining a compliance program and next steps.
Several policies in the final rules, including those related to information blocking and application program interfaces (APIs), will impact EHR interoperability and the way data is exchanged between patients, physicians, payers, technology developers, and other health care stakeholders.
TMA experts say a patient portal should be helpful in satisfying the rule requirements andstrongly encourage physicians to utilize this in order to comply. Check with your EHR vendor to see if it has made the necessary upgrades to comply with the Cures Act. Also, TMA anticipates future clarification on topics such as adolescent confidentiality and advises physicians to move cautiously and to think through whether certain types of notes fit the ONC exceptions.
TMA will be providing additional educational resources to assist you with compliance in the coming months. Register now to be notified when the on-demand webinar is available.Additional details and fact sheets are located on the ONC’s website. TMA continues to digest these regulations and will keep you apprised of new developments.
Questions about the 21st Century Cures Act or other office technologies? Contact TMA’s Health Information Technology department.
Amy Lynn Sorrel
Associate Vice President, Editorial Strategy & Programming
Division of Communications and Marketing