Are you prepared for the Information Blocking Rule’s expanded criteria?

The second deadline for the Information Blocking Rule, which is part of the 21st Century Cures Act of 2016, is quickly approaching. Requirements for the Oct. 6, 2022, deadline expand the rule’s initial compliance criteria.

2021 rule refresher

The initial April 5, 2021, deadline was to ensure patients had secure electronic access (e.g., via a patient portal) to the United States Core Data for Interoperability, Version 1 (USCDI V1) data set. That data set includes demographics, allergies, labs, medications, smoking status, diagnoses and treatment plans, immunizations, vital signs, etc.¹ The USCDI V1 is closely aligned with the Common Clinical Data Set (CCDS), which is used in the Promoting Interoperability program requirements of the Merit-based Incentive Payment Program, or MIPS.

2022 rule overview

This fall, the required data to be securely shared expands to include medical, billing and payment records, and any information used to care for patients. This will make the definition of electronic health information (eHI) for the Information Blocking Rule match the HIPAA Privacy Rule’s definition of a complete designated record set (DRS) rather than being limited to the USCDI V1 or CCDS data elements and eHI only.

Some key differences from the USCDI V1 to the HIPAA-defined DRS include:²

• HIPAA provides a patient the right to access health information about the patient that is maintained in a “designated record set.”
• This includes the medical record, billing records, and any other information that is used to make decisions about the patient. It is not limited to information in the electronic health record (EHR).
• The designated record set includes information that you add to the medical record that originates from other health-care providers. You cannot deny access to health information in your records on the grounds that someone else created it.

Remember, HIPAA also requires you to provide patients with the requested information in the “form and format” they choose, if possible.² If practices have done a good job of providing secure access through patient portals, this will likely be the most convenient option for both parties moving forward.

Get ready

If you haven’t already, now is the time to check on your compliance with the Information Blocking Rule.

• How are you doing with calling patients, care providers, and pharmacies back and filling records and prescription requests promptly? (Interoperability programs consider “timely” as 4 business days.)
• Have you made your medical records clearer and reduced unnecessary abbreviations for patients reading them at home?
• Have you checked your state laws for additional eHI provision considerations (i.e., right of access timeline differences, etc.)?
• Have you contacted your EHR vendor to find out if any updates are needed to comply with the October Information Blocking Rule deadline? (The wide array of certified EHR technology from 2015 and later provides practices with the capability of secure information sharing; however, a version update may be required for this 2022 rule.)

Everyone can contribute

While there are still rare situational exceptions to the Information Blocking Rule,³ it widely applies to eyecare practices. Therefore, it’s best to prepare the practice as early as possible for the Oct. 6 deadline. OP

REFERENCES:

1. USCDI: United States Core Data for Interoperability Version 1 (July 2020 ERRATA). The Office of the National Coordinator for Health Information Technology. bit.ly/3SORtj3 . Accessed July 11, 2022.
2. Patient Records Electronic Access Playbook. American Medical Association. bit.ly/3QPnsOt . Accessed July 11, 2022.
3. Cures Act Final Rule: Information Blocking Exceptions. The Office of the National Coordinator for Health Information Technology. bit.ly/3bTxfnA . Accessed July 11, 2022.