Since April 2021, federal rules requiring physicians to give patients prompt access to their electronic health information (EHI) have been focused on a narrow subset of those data. As of Oct. 6, the so-called information-blocking requirements broadened that scope significantly, despite medicine's call for a delay to address a lack of clarity and technical support for the change.
The regulations stem from the 21st Century Cures Act, implementation of which Congress has phased in since 2020. Until now, physicians were responsible for providing common types of information within electronic health records: discharge summaries, history and physicals, progress notes, consult notes, imaging reports, laboratory reports, pathology reports, and procedure notes. This information represented a limited subset of health data called the United States Core Data for Interoperability (USCDI), according to an American Medical Association analysis.
As of Oct. 6, “physicians and other actors will be responsible for the access, exchange, or use of the full EHI requirement,” AMA’s summary said. That requirement broadens the definition to include all electronic protected health information a patient can access per HIPAA.
AMA, the Medical Group Management Association, American Hospital Association, and several other medical and hospital groups wrote to the U.S. Department of Health and Human Services (HHS), petitioning for a one-year delay pending clearer guidance, saying, “there is no clear definition of EHI, and there is a lack of a technical infrastructure to support its secure exchange. … If large providers are unable to discern this, small and lesser resourced providers are even more confused – if they are even aware of the policies at all.”
The Texas Medical Association had similarly urged HHS Secretary Xavier Becerra to delay the expansion until electronic health record (EHR) vendors have time to prove all EHI can be shared via patient portals with little to no burden on physicians and practice staff.
Those requests did not come to fruition. According to AMA, penalties and other disincentives for physicians have yet to be determined by HHS, and a proposed rule is expected late this year. But for now, physicians participating in the Promoting Interoperability Program could see an impact to their Centers for Medicare & Medicaid Services Quality Payment Program incentives if they are found to be information blockers.
Experts recommend practices take steps to comply with the requirements and take advantage of available resources. AMA advises practices to:
- Make sure they’ve implemented a process to evaluate and comply with the information-blocking requirements; and
- Contact their EHR vendors to find out how they've prepared to assist practices in meeting the new requirements. By Dec. 31st, all EHRs are required to provide their customers with new technology that better enables access to EHI.
TMA’s 21st Century Cures Act Resource Center has articles, explainers, CME, white papers, and more to help practices with compliance.
And check out these HHS resources: