Last year the Office of the National Coordinator for Health Information Technology (ONC) released a rule implementing provisions of the 21st Century Cures Act requiring physicians to comply with new regulations on the access, exchange and use of patients' electronic health information (EHI). Information blocking is defined as practices that are likely to interfere with, prevent, or materially discourage the access, exchange or use of EHI. Physicians, hospitals, electronic health record (EHR) vendors, health information exchanges (HIE) and health information networks (HIN) are all subject to ONC's rule and are collectively referred to as "Actors." 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. EHR vendors and HIE/HINs can receive up to $1 million in civil monetary penalties per violation. Penalties and other "disincentives" for physicians and other health care providers have yet to be determined by the U.S. Department of Health and Human Services (HHS). However, physicians participating in the Promoting Interoperability (PI) Program could see an impact to their Centers for Medicare and Medicaid Services Merit-based Incentive Payment System (MIPS) incentives if they are found to be information blockers. The AMA is urging HHS to refrain from creating any new or additional physician penalties. The AMA is also engaged with the Administration to address concerns that HHS' rule forces physicians to release office notes and test results prior to physicians reviewing the information with the patient. The AMA is working to reduce the complexity and costs required to comply with these new regulations.
Actors are required to comply with ONC's information blocking regulations starting April 5, 2021. To help meet the new requirements, the AMA has created a two-part educational resource to help physicians and their medical practices 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 a summary of exceptions for when physicians may restrict the access, exchange or use of EHI. Part 2 will help physicians start down the path of compliance, including questions to consider, considerations for maintaining a compliance program and next steps.
The new rules also regulate your EHR vendors and restrict them from blocking information. Your EHR vendor is prohibited from blocking your access, exchange, or use of medical information through contractual, technical, or financial limitations. This could include, but not limited to, excessive fees charged by your vendor to connect to the local HIE, contracts limiting your ability to send information to a clinical data registry, or implementing proprietary technology in a way that prevents you from exporting reports, connecting to diagnostic facilities, or switching EHR vendor products. Like all Actors, EHR vendors must comply with these regulations by April 5, 2021. Information blocking not only affects patients but also physicians; you should reach out to your EHR vendor to discuss what they are doing to come into compliance.
The AMA will continue to update these resources as the federal government releases new guidance. Below are several additional resources to help navigate the regulations: