Info blocking exceptions need special attention

The 21st Century Cures Act’s information blocking rules, aimed at fostering seamless electronic health information (EHI) exchange, have reshaped the healthcare landscape. Info blocking exceptions need special attention from providers While facilitating better-coordinated care is the ultimate goal, navigating the intricacies of compliance, particularly around exceptions, can leave providers perplexed.

Why do exceptions deserve special attention?

Imagine this: a patient visits a specialist, their primary care physician requests the consultation notes, but the system throws up a “privacy exception” block. In the blink of an eye, continuity of care suffers. Understanding and applying exceptions correctly is crucial to prevent such roadblocks.

The eight exceptions fall into two categories: those justifying not fulfilling EHI requests and those dictating procedures for fulfilling them. Each carries specific conditions that providers must satisfy to avoid inadvertently engaging in information blocking. Let’s delve into some key ones:

1. Preventing Harm: This exception allows withholding information if disclosing it could reasonably harm the patient or others. Providers must document rationale and consider alternative disclosure methods like redacting sensitive details.

2. Privacy: Protecting patient privacy remains paramount. Refusing EHI access due to privacy concerns is permitted if HIPAA requirements or state laws necessitate it. Clear documentation and alternative communication channels are crucial here as well.

3. Infeasibility: Sometimes, technical limitations hinder data segregation, making complete EHI sharing impossible. Providers must demonstrate technical barriers and explore alternative data exchange avenues.

4. Health IT Performance: If sharing EHI significantly burdens the performance of a certified health IT system, providers can invoke this exception. However, they must document the burden and explore ways to mitigate it.

5. Content and Manner: EHI requests with unreasonable content or delivery demands (e.g., excessive frequency) can be denied under this exception. Providers must document the unreasonableness and offer alternative communication methods.

6. Fees: While EHI sharing shouldn’t be driven by profit, reasonable fees for fulfilling complex requests are allowed. Transparency and cost justification are key principles here.

7. Licensing: Sometimes, licensing agreements with third-party data holders restrict EHI sharing. Providers must document such agreements and explore alternative data sources, if possible.

8. Objective of the Exception: This exception allows withholding EHI if fulfilling the request would contradict its intended purpose (e.g., sharing research data for authorized studies). Transparency and documented justification are critical.

Taking precautions:

Remember, exceptions are not shields against scrutiny. Regularly reviewing EHI access logs, conducting internal audits, and seeking legal counsel can help ensure compliance and minimize risk. Proactively informing patients about their EHI access rights and involving them in data sharing decisions fosters trust and transparency.

The road ahead:

As digital health evolves, the contours of information blocking and its exceptions might shift. Providers must stay informed about regulatory updates and engage in open communication with patients and other healthcare stakeholders. By diligently navigating the info blocking landscape, we can pave the way for a truly interconnected and patient-centric healthcare ecosystem.

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