How hospital CIOs, IT leaders prepared for the new information-blocking rule

A new rule went into effect Oct. 6 that allows patients complete access to their electronic health records, without unreasonable delay or costs.

As part of the 21st Century Cures Act, ONC implemented the regulations to improve health data transparency and interoperability. CIOs and other health system IT leaders have been preparing for the changes for some time now, despite the American Hospital Association and other groups calling (unsuccessfully) for a delay. The Oct. 6 rule expands the definition of what is considered electronic health information.

Becker's reached out to IT executives to see what their hospitals and health systems did to prepare for the changes. Here are five who responded.

Charles Wagner. Senior Vice President and CIO of Franciscan Health (Mishawaka, Ind.): Two years ago we created a dedicated multidisciplinary team to deliver the capability to meet the requirements for provider organizations under the 21st Century Cures Act. As of Oct. 6, we have made significant progress but recognize we have some gaps in our capabilities that need to be addressed.

Our predominant EMR and revenue cycle platform since 2016 is Epic, and by the end of 2022 we will have operationalized all available capability from the vendor to support 21st Century Cures.

We will continue to be challenged with our many archived and noncertified EMR and billing platforms and will need more time to deploy information-blocking capability in those areas. The intensity of information-blocking activities by our dedicated team will continue through 2023.

Like many health systems, given the high level of effort required under 21st Century Cures Act, we are in favor of an additional time extension, or at a minimum, clarity on an enforcement extension.

Jim Feen. Senior Vice President and Chief Digital and Information Officer of Southcoast Health (New Bedford, Mass.): While our Cures Act steering group has not taken our eye off the ball off things like the USCDI v3 changes over the summer, our focus, like many others, had to shift to finalizing updates to our designated record set policy — to incorporate "nonstandard electronic health information" as best we could and making sure the release of information processes is hardwired with operations in ways that would not put the organization at any new risk for information blocking.

In many ways, the time commitment and effort leading into this October change was just as big behind the scenes as the April 2021 changes for the experts in our health information management, compliance, privacy, legal and digital teams.

The continued challenge will be sustaining the energy and focus to maintain compliance amongst a myriad of challenges facing healthcare right now (financial, labor and consumer/patient behavior changes).

Ellen LeClair. Director of Health Information Management and Privacy Officer of Door County Medical Center (Sturgeon Bay, Wis.): Door County Medical Center strives to offer patients optimal access to their health information, which most often is provided through our patient portal. Recent information-blocking rules have led to adjustments within our processes due to the exceptions that can be applied.

The number of requests we receive in health information management is low at this time, which helps with the management of these types of records. Our process begins at the direction of a provider, before they sign the document. We collect all pertinent information from the provider, which includes a blocking time frame that is determined on a case-by-case basis. These documents are then marked as sensitive and are not viewable in the patient portal.

The work of many departments and staff members has determined how we can best apply these new rules to our organization's policies and procedures. Every situation is different when it comes to blocking information. This is important for us to keep in mind as we handle each request with vigilance and respect.

Linda Stevenson. CIO of Fisher-Titus Medical Center (Norwalk, Ohio): We began working on this about two years ago. The most important work focused on the education of the medical executive committees and the board, so they understood the requirements and reasons behind them. We set clear deadlines and then opened up all documentation and interoperability to patients and other caregivers, as it should be. We continue to monitor and educate on the need to share information for patient engagement as well as continuity of care.

Pranav Jain, MD. Chief Medical Information Officer of Wellstar Health System (Marietta, Ga.): We are continually challenging ourselves to empower our patients with their clinical data so they can make healthier choices. In fact, Wellstar recently reached 1 million patients on MyChart, an important milestone representing how we are helping patients take charge of their healthcare journey. We recognize and support the efforts of the U.S. Department of Health and Human Services in creating policies to encourage deep interoperability and innovation.

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