Information Blocking has been making headlines for nearly a year now. On April 5th, 2021, the Information Blocking provision of the 21st Century Cures Act went into effect, but you may still be asking yourself “what is information blocking?”.
The 21st Century Cures Act, passed in December 2016, largely focused on National Institutes of Health (NIH) funding for research and drug development, to streamline the drug approval process. But a portion of the legislation focuses on empowering patients to take ownership of their healthcare, in part by ensuring expedient access to the electronic health information (EHI). The term information blocking was coined; defined as any practice that is likely to impede access to, the exchange of, or use of EHI.
Who can be accused of information blocking?
The legislation groups “actors” into three categories: health IT developers of certified health IT, health information networks/exchanges, and healthcare providers. The healthcare provider definition is broad and includes both inpatient and outpatient care settings (hospitals and physician offices, labs, pharmacies, dialysis facilities and surgery centers, to name a few). For organizations that fit into one of these “actor” definitions, it’s important to understand what constitutes information blocking.
What types of information are included in this legislation?
If you’re not familiar with what documentation types are included in the United States Core Data for Interoperability (USCDI), be sure to review. For example, clinical notes include consultation notes, progress notes, imaging narratives – to name a few. This includes all clinical notes, regardless of the author or specialty.
What is interesting is that there ARE exceptions to the rule that are incredibly specific, so organizations should not expect to apply broad stroke policies under the guise of these exceptions. Gone are the days of open-endedly delaying lab results until the physician has had a chance to review them.
Do organizations have to pro-actively send EHI?
Patients now have the right to receive access to their EHI, once requested, without delay. Those two little words (Once Requested) are an important distinction. While no organization wants to be accused of information blocking, this legislation does not require proactively pushing all EHI to the organization’s patient portal. The patient must first initiate a request for EHI. But once requested, granting expedient access is vital.
Organizations may be unintentionally blocking information; it may be occurring due to outdated policies or practices. Gone are the days of leaning on HIPAA’s 30-day turnaround requirement if state legislation has not established more stringent response times. Ensure your organization has updated policies that clearly define the elements of both the Legal Health Record and the Designated Record Set to align with the documentation and elements outlined in the USCDI. It might be time to conduct a Legal Health Record assessment!
Jennifer McCann, RHIA, CHPS, CTR
Jennifer brings over twenty years of experience in the healthcare industry to her role as a Senior Consultant with Haugen Consulting Group. She began her HIM career working in acute care settings in Rhode Island and Massachusetts before relocating to Denver in 2002. Prior to joining the Haugen Consulting Group, Jennifer spent several years in operational roles, successfully building and managing teams through complex projects and implementations. She is well versed in retention, legal health record, HIPAA privacy and security and workflow analysis.