Information Blocking Rule Expands Definition of Electronic Health Information

Information Blocking was established with hopes of improving a patient's ability to access their own medical information and achieving widespread interoperability among HIT.

By:  April Smith, CCS

In May 2020, the Office of the National Coordinator for Health Information Technology, otherwise known as the ONC, released what is known as the Information Blocking Final Rule.  Part of the 21^st Century Cures Act: Interoperability, Information Blocking, and the ONC Health IT Certification Program, it was established with hopes of improving a patient’s ability to access their own medical information and achieving widespread interoperability among health IT.

What is Information Blocking?

Information blocking is anything that interferes with access, exchange or use of a patient’s electronic health information (EHI). This rule applies to “actors” designated as healthcare providers, health information network or health information exchanges and health IT developers.

At the implementation of this rule on April 5, 2021, EHI was defined as health data classes (demographics, vitals, clinical notes) and data elements (patient names, lab reports). However, this year, on October 6, 2022, the EHI definition will expand to include all electronic personal health information (PHI) in the patient’s designated record set.

Preparing for the Information Blocking Final Rule

The more information exchanged between providers planning for coordinating/continuing patient care is beneficial. But that electronic exchange can prove tricky due to non-standardization of some of what is contained in the expanded data elements category.  The rule expansion has provided for that situation by allowing the actor options in how they make those new data elements available.  Actors should be prepared for this rule expansion by planning (1) how they will fulfill the new requirement and (2) by familiarizing themselves with what will be required and permitted.

What are the Information Blocking Exceptions?

There are eight information blocking exceptions divided into exceptions that (1) involve not fulfilling requests and (2) involve procedures for fulfilling requests.  These exceptions are:

• Preventing harm exception: practices that are reasonable & necessary to prevent harm to patient or another person
• Privacy exception: practices implemented to protect privacy of EHI.
• Security exception: practices implemented to protect the security of EHI.
• Infeasibility exception: Denying requests because the request is objectively and verifiably infeasible.
• Health IT Performance: technology maintenance or updates make the information temporarily unavailable to fulfill requests.
• Content and manner: limiting the content of responses to requests or the way in which those requests are fulfilled.
• Fees: charging for costs reasonably incurred when fulfilling requests.
• Licensing: an organization may claim intellectual property rights, but it must respond to requests to license interoperability elements.

For more information on the Information Blocking Final Rule, visit federalregister.gov.

Sources:

National Review

Federal Register