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Medical groups want more time to comply with rules on information blocking

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Potential $1 million fines are possible for physicians and health care providers who won’t share patient electronic health information.

Physicians’ groups and other medical organizations say they need more time to comply with a new set of federal rules about sharing – or not sharing – patient information.

Oct. 6 is the next deadline for another set of requirements about electronic health information (EHI), as outlined in the federal 21st Century Cures Act that Congress approved in 2016.

Physicians, other health care providers, their information technology staff, and vendors agree patients should have access to their medical records in a digital format, and they have been working to comply with the regulations. But more time is needed, according to 10 major medical organizations who say many in the industry are not yet ready for the changes – or potential fines up to $1 million for “information blocking” if they cannot comply.

The organizations cosigned a letter to the U.S. Department of Health and Human Services (HHS) asking to clarify definitions and processes, and for another year to ensure the EHI rules, records, procedures, and technology all mesh.

America’s Essential Hospitals, the American Academy of Family Physicians, the American health Care Association, the American Hospital Association, the American Medical Association, the Association of American Medical Colleges, the Federation of American Hospitals, the Medical Group Management Association (MGMA), the National Association for the Support of Long Term Care, and the College of Healthcare Information Management Executives (CHIME) joined to request more time.

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“CHIME members remain steadfast in their dedication to be a trusted partner for patients and safeguard their ability to access their healthcare records, but it’s clear that more time is needed to ensure that providers have a thorough understanding of these important policies,” CHIME President and CEO Russ Branzell said in a news release. “There has not been enough guidance on best practices and potential enforcement.”

HHS, its agencies, medical groups, and analysts all have published summaries, fact sheets, and analyses about the rule changes taking effect on Oct. 6. Even so, the organizations’ letter to HHS catalogued the “significant knowledge gaps and confusion” that exists in the provider and vendor communities.

“A chief factor limiting compliance readiness is the widespread inability to support access, exchange, and use of EHI,” the letter said. “There is no clear definition of EHI and there is a lack of a technical infrastructure to support its secure exchange.”

If providers and vendors will be held accountable for EHI, consistency in interpretation is critical. Adding to the confusion are rules and eight exceptions for information blocking in instances when EHI cannot or should not be exchanged, the medical groups’ letter said.

The situation is worse for small and lesser-resourced health care providers. Some of them are unaware of the new rules, while many of those who are aware are relying on vendors that have compliance deadlines that come as long as a year and three months after physicians and providers must comply, the letter said.

The federal Centers for Medicare & Medicaid Services, the Office of the National Coordinator for Health Information Technology, and the HHS Office of the Inspector General should launch an education campaign for providers and clinicians, especially focusing on small, medium-sized, and lesser-resourced organizations, the medical groups said.

“Providers want and need best practices and implementation guides that they can reference as they strive to prepare for the investigation and disincentive phase of information blocking regulations,” the letter said. “Without real-world guidance, providers will continue to struggle with implementing internal policies to avoid allegations of information blocking.”


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