For decades, physicians and hospitals have maintained a delicate balance of patient care and privacy. Recent legislative action has changed this balance and requires providers to assume disclosure of Electronic Health Information (EHI) is appropriate unless there is a clear reason to refrain from sharing the information.
What is the change in the law?
Lawmakers recently passed the Federal Century Cures Act to help better ensure patients receive essential data from the EHI. The law uses the HIPAA definition of EHI, but it is important to note the law extends beyond HIPAA Covered Entities. It includes medical and billing records as well as pricing information and algorithms used to create EHI and encourages sharing of this information.
The Information Blocking (IB) Rule within the law shifts physicians from a presumption of privacy to one of disclosure.
What is Information Blocking?
The law defines IB as a practice that:
- Except as required by law or covered by an exception, is likely to interfere with access, exchange, or use of electronic health information; and
- If conducted by a health IT developer or certified health IT, health information network or health information exchange, such developer, network, or exchange knows, or should know, that such practice is likely to interfere with access, exchange, or use of electronic health information; or
- If conducted by a health care provider, such provider knows that such practice is unreasonable and is likely to interfere with access, exchange, or use of electronic health information.
A provider is likely guilty of an IB violation in the following situations:
- Patient’s access. A violation is possible if the medical practice interferes with a patient’s access, exchange, or use of their own EHI.
- Other physicians. IB is also likely present when a physician or medical practitioner is not provided EHI after a request in coordination with treatment and care efforts.
- Payers. The same can apply for denial of attempts to access information to promote transparency.
- Public health. Another example involves requests that are tied to patient safety or overall public health.
The rule further clarifies that any medical provider that knows their actions are unreasonable and will likely interfere with access or use of EHI is likely in violation of the IB Rule.
How will this impact my practice?
The rule can impact medical practices throughout the country. As such, it is wise for practices to review and update their policies to better ensure compliance with the new rule.