On April 5th, 2021 the 21st Century Cures Act took effect to promote healthcare interoperability with competing IT companies and EHR systems. Since the implementation of the Cares act, healthcare IT companies are now required to participate in an interoperable exchange of healthcare information. Since the COVID-19 pandemic broke out in the U.S. in March of 2020, the need for interoperability has become paramount. However, due to a history of information blocking in the healthcare industry, IT companies were initially reluctant to share life-saving information. In this article, we will define what information blocking is, how it works, and how the Cares Act is changing how EHRs interact and share information. First, let's find out what constitutes information blocking in healthcare.
What is Information Blocking?
Let’s explore what information blocking is and how it affects healthcare interoperability
Before we can explore the major changes that have taken place for information blocking in 2021, we should first understand what information blocking is. Information blocking is the practice of healthcare IT developers interfering with the access, open exchange, and use of EHRs. Information blocking is common among healthcare IT companies and can make it more difficult for patients and providers to access potentially life-saving medical information.
For example, physicians will run into roadblocks when trying to access patient data from other IT providers, migrating their information from one system to another, or sharing data with local health information exchanges. For patients, information blocking can pop up when patients are trying to access or send their records to a new practice.
Since information blocking prevents important information from being exchanged and hinders healthcare interoperability, the practice has received criticism from the U.S government. In recent years, legislation like the Cures Act is part of a movement to stop the restrictive information blocking practices of healthcare IT companies.
What Does Information Blocking Look Like In Practice?
Information blocking has been used to restrict access and make exchange of EHR information more complex
There are several different practices that constitute information blocking. By making information exchange complex or technologically impossible, healthcare IT companies can increase their profits and user base by requiring practices to use their services to access certain information. Here are a few of the most common forms of information blocking as defined by the American Medical Association and Cures Act:
- Restricting authorized access, exchange, or use of pertinent treatment information.
- Using health IT programs in a way increases the complexity or makes information exchange difficult.
- Disabling or restricting the use of EHR sharing services.
- Refusing to implement a system that allows patients to access their EHRs.
- Using IT systems to prevent the exchange of information between different IT systems, including overcharging healthcare practices for data migrations or actively delaying information transfers.
- Practices that hinder advancements and assist fraud or abuse of power.
- Placing restrictions on EHR access in contracts.
- Earning greater profits by manipulating the markets by restricting information sharing, otherwise known as rent-seeking.
All of these practices are potentially harmful to patients and even prevent entire healthcare systems from working properly. After the need for information sharing during the COVID-19 pandemic, it has become clear that information blocking needs to be controlled for the greater good of the U.S healthcare system.
How will the 21st Century Cures Act Affects Information Blocking and Healthcare Interoperability
By defining information blocking, the Cures Act can penalize healthcare IT companies who prevent access to necessary information
Enacted in 2017, implemented in 2020, and taking effect in 2021 the 21st Century Cures Act effectively stops the long-standing practice of information blocking in favor of easier information access. The Cures Act was a long time coming and has finally put in place penalties for companies that engage in information blocking practices. Now that the COVID-19 pandemic irreversibly affected our healthcare system, now is the ideal time to halt the information blocking practices that made the pandemic even more difficult to understand in its early stages.
The new rules set forth requirements for information sharing and prevent healthcare IT companies from blocking further information in the future. Healthcare systems have had the last year to get ready for the new information blocking rules and, since April 5th, 2021, must begin focusing on compliance. Lawmakers expect that more EHR data will be available almost immediately since all of the EHR information is now digital. Until now, information sharing in healthcare has remained stagnant, but thanks to the Cures Act, providers and patients will have more access to their EHR data than ever.
What Are the Exceptions to Information Blocking?
Though the Cures Act is doing away with a lot of the practices of information blocking, there are still some valid reasons to restrict access to electronic health information
Now that there are new rules and standards regarding information blocking, there are also some exemptions that have been established. In this case, exemption means that there are some valid reasons to withhold EHR data from physicians or patients if there is a perceived risk of privacy violation or that harm could be done to the patient by releasing their health information. For example, if a patient’s authorization is required to release information, but there is no authorization on file. These exceptions are important for providers to use as a defense if they are accused of information blocking. There are two main categories of exceptions to information blocking we will explore — not fulfilling access requests and correct procedures for fulfilling access requests. In the first category, not fulfilling access requests, a few of the exceptions are:
- Preventing patient harm
- Patient privacy
- Patient security
- Infeasibility of exchanging information
- Health IT performance
In the second category, procedures for fulfilling access requests, a few of the exceptions are:
- Content and manner
- Fees
- Licensing
It is important to distinguish that information blocking regulations are different from HIPAA, which dictates when information is allowed to be exchanged. Because all information requests are now required to be completed, these exceptions provide guidelines for the proper use of EHR information.
Healthcare providers are always looking for ways to stay compliant and improve the patient experience using the most cutting-edge technology. As healthcare interoperability increases due to the 21st Century Cures Act, healthcare systems are rapidly adjusting. Luckily, Iron Bridge remains ahead of other healthcare technology companies by providing leading IT solutions in data technology, aggregation, public health management, and patient access systems. Contact the team today to learn more about Iron Bridge’s innovative health IT solutions.
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