Home Forums Thread Like Summary - Information Blocking

Any thoughts about the new "Information Blocking" law going into effect nationwide on April 5, 2021? Specific relevance to use of AC? I just heard about it today, because, apparently, I live in a cave.... Most information sources I have come across are replete with jargon and legal prose, and not directed at physician office practice with practical guide to implementation.

It is great to have AC (Mark) in on this discussion. However, the link provided for API leads to a page that includes:

This documentation is intended to provide direction for accessing patient data from the Common Clinical Data Set using the Amazing Charts Common Clinical Data API to satisfy 2015 CEHRT Regulations § 170.315(g)(7), § 170.315(g)(8), and § 170.315(g)(9).

Click here to access the API documentation. (THIS IS MOSTLY PAGES OF CODE)

Click here to request API access. (THIS LEADS TO A BLANK PAGE)

So.... Not sure how this helps us poor little Luddites. To facilitate this conversation, may I define a few relevant inquiries:

Specifically, how does this law change more traditional medical record information exchanges, where a written request is made of a provider and the information is subsequently faxed (which in my state by law allows 15 business days to be accomplished, after any applicable medical record fee is paid, barring emergency requests from physicians which are addressed ASAP without fee).
For example:
1. If a patient requests information from their record, do they still have to fill out a medical record request (per HIPAA). Will patients be in a two class system, those using the old methods and those using the new?
2. Can a medical record fee still be charged for non-emergent requests before providing the information?
3. Do we have to join to an app that allows direct patient access to their records (to some degree) at all times?
4. Does the AC/Updox portal provide the same functionality as an app would?
5. Must patients register with provider specifically for this direct access before it it provided?
6. I receive study and lab reports in PDF format and they are stored in PDF format in AC. Can I get examples of how to provide notes and reports to patients under the new law using AC?
7. I get records and reports from other providers. Do I / can I provide access to these to patients?

While some of the above might not be in the purview of AC, the AMA recommends that we ask our EHR vendor the questions that are pertaining to access implementation via the EHR.
Well, asking done!
(But Grandma, what a big onus you have!)

OK, crickets. I believe the sound I am hearing is crickets.

I emailed AC support directly about how to use AC to implement the Cures Act requirements, I'll pass along any info.

Am I making a bigger deal about this than needed? It's just that I saw articles about OIG investigations and criminal penalties, and had to cut back on my fiber intake...

Anyway, everyone have a great day!

Hi Jack..

Thanks for your questions. Sorry I didn't respond right away, but I don't check the board on a daily basis.

On the API link I put in previously, yes the document is very technical. It is really designed for IT and developers to use to make an API interface with AC. It is not something that the normal person can just look at and understand right off the bat. Think if handing your patients a medical textbook. They might have a harder time understanding that. At this time, that is all CMS requires us to do, is show that we can have an API if needed.

The link for requesting should prompt a "mailto:" command to have you email our support team. I will have our webmaster look at that to see why its not working.

As for your questions, here are some of the answers to them. I just want to make it clear that I am not part of our development team, so I am not privy to any features that are being developed. I work on the training side and assist practices with MIPS.

1. If a patient requests information from their record, do they still have to fill out a medical record request (per HIPAA). Will patients be in a two class system, those using the old methods and those using the new? I would assume yes, they would still need a HIPAA release. This should not change with how the information is delivered. (paper/electronic/whatever new technology emerges)

2. Can a medical record fee still be charged for non-emergent requests before providing the information? Fees can be charged, but they cannot be a “for profit fee”, meaning it can only be the cost involved in providing the records (employee time/materials). It has to be a reasonable fee.

3. Do we have to join to an app that allows direct patient access to their records (to some degree) at all times? At this time, no. As long as the patient can access the information from their device, that would satisfy the requirement.

4. Does the AC/Updox portal provide the same functionality as an app would? At this time, yes. Updox and the portal is a web based application and as long as they can access the via the web from their device, then that fulfills the requirement.

5. Must patients register with provider specifically for this direct access before it it provided? Unclear at this time, but I would assume if they were going to use a 3rd party app to get their health info, there will be a registration and linking process that will need to happen, similar to patient portal registration or HIE connectivity.

6. I receive study and lab reports in PDF format and they are stored in PDF format in AC. Can I get examples of how to provide notes and reports to patients under the new law using AC? You can send them now to the portal by right clicking on the item in the imported items and selecting “send to portal”. Patients can then go on the portal and get the file. The upload keeps the original file type in most cases (labs from an interface get changed).

7. I get records and reports from other providers. Do I / can I provide access to these to patients? This may be something the practice decides on their own, but I would say if the patient requests their entire record, and this is part of it, then you would send it. If its in the imported items section, then you can send it to the portal just as you would a lab.

The one thing to remember about all of this is that at this time, there is nothing for you to do on the practice side. In the current stage, its all on the development side with getting development plans ready and declaring intent. You will most likely not see any change in how you deliver information till late next year.

If you, or anyone else on the board, has any questions. You are always free to reach out to me directly at mdabeck@harriscomputer.com