A federal regulation is changing the way patient health information is shared — and making it easier for patients to access their medical records when and where they want to.
The 21st Century Cures Act is designed to improve interoperability between health information platforms to encourage innovation and speed. In a key rule under the law, medical providers may not impede the exchange of health information, a practice referred to as information-blocking. By prohibiting blocking, the rule aims to give patients access to their personal health information with few restrictions and without delay. They will be able to see their chart notes, test results and other details, sometimes before their provider does.
What does the rule mean for Asante?
The rule could fundamentally change how providers talk to patients about their health information. For example, test results — which are sometimes withheld to allow providers to coordinate care or talk to their patients about the findings — will be released and viewable immediately.
Two aspects are the most important:
Release of clinical notes: Some outpatient notes are (and have been for two years) immediately released to MyChart when a note is completed. Beginning April 13, inpatient notes will be released at the time of discharge. This applies to eight types of provider clinical notes:
- Consultation note
- Discharge summary note
- History and physical
- Imaging narrative
- Laboratory report narrative
- Pathology report narrative
- Procedure note
- Progress note
Immediate release of test results and studies: Like many health systems across the country, Asante plans to immediately release results, including pathology reports, imaging studies, operative reports, genetic tests, neonatal screens and others to patients through MyChart. The Information Blocking Rule does allow a few isolated exceptions around release to account for flexibility, privacy and security. For example, when the information in a note could lead to harm of the patient or others (like in the case of suspected child abuse).
How will patients access this information?
Asante will be using MyChart to release most of the required information to patients. The Compliance and IT teams are creating patient-centered messaging that will make patients aware of the coming changes. Additionally, the teams are working with subject matter experts to create test-specific information for patients that will be released with their test results to provide additional context, clarity and instructions.
Will anything change in Epic?
Yes. Physicians, physician assistants, nurse practitioners, social workers, discharge coordinators, case managers, utilization review/case managers and nurse navigators will be able to block the release of certain notes to MyChart. New tools are being built in Epic to ensure that when automatic release of information is being overridden, it will be done for appropriate reasons that comply with the law. Education will be provided on these workflows in the coming weeks.
We want you to be prepared to navigate this change smoothly and are providing an extensive education rollout and reference materials for general awareness.
Mandatory module on the Information Blocking Rule:
- Module will be assigned to impacted employees (including but not limited to providers, nursing staff and medical assistants) on April 15 with a due date of May 15. If you are assigned the module, you will receive a notification from ALEC/HealthStream.
Helpful education materials will be distributed to providers and staff:
- How to write a shared note
- Information blocking white paper — key changes at Asante
- Information blocking Epic tip sheets: Inpatient Note Unsharing in Epic and Outpatient Note Unsharing in Epic
Information blocking policies and procedures (will be on myAsanteNET by mid-April):
- Restricting clinical notes due to risk-of-harm exception or patient-requested restriction of clinical notes to MyChart, 400-COMP-0040
- Information blocking policy, 400-COMP-0040
- Information blocking exception review and documentation process policy, 400-COMP-0042
Additional education for all employees will be rolled out through 2021 Elements.
Any questions or concerns around the Information Blocking Rule can be sent to [email protected].
If you need answers for a personal work matter, please contact the author or department directly instead of leaving a comment.