The Office of the National Coordinator for Health Information Technology (ONC) has released regulations implementing provisions of the 21st Century Cures Act (Cures) requiring physicians to comply with new regulations on the access, exchange, and use
of patients’ electronic health information (EHI). Information blocking is a large focus of the new regulations and is defined as practices that prevent or materially discourage the access, exchange, or use of EHI. Physicians, hospitals, electronic
health record (EHR) vendors, and health information exchanges (HIE) and health information networks (HIN) are all subject to ONC’s rule and are collectively referred to as “Actors.” There are Actors whose actions are likely to interfere with the access,
exchange, or use of EHI could be considered information blockers and subject to penalties or disincentives.
Notably, ONC interprets the information blocking prohibition broadly, relying on eight exceptions to carve out protected conduct — the eight exceptions outlined in the rule are:
- Preventing Harm
- Privacy
- Security
- Fees
- Infeasibility
- Licensing
- Health IT Performance
- Content and Manner
The ONC provides specific definitions for how these exceptions can be applied. Documenting how a physician applies exceptions to each information request—and developing organizational policies for handling exceptions—will be important in maintaining compliance
with the information blocking rules.
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.
Actors are required to comply with ONC’s information blocking regulations by April 5, 2021. Providers should start considering how they will plan out next steps, including talking to their EHR vendors to understand their prep plans, considerations
for maintaining a compliance program, and how staff will be trained on the new rule. We will continue to update these resources as the federal government releases new guidance.
The MMS has been engaging with the AMA on advocacy concerns that HHS’ rule forces physicians to release office notes and lab test results prior to physician reviewing the information with the patient—as well as working to reduce the complexity and cost
required for physicians to comply with these new regulations.
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