Information Blocking is all about the data – access to, exchange of and use of electronic health information (EHI) – regardless of what technology is used. Feel like you have been hearing this term a lot lately? That’s because Information Blocking directly impacts your county, regardless of the healthcare-related services you provide! Fully understanding the key processes, timelines and penalties involved with this regulation is essential to the health, compliance and growth of your provider organization.

Information Blocking stems from the 21st Century Cares Act, when Congress required the Office of the National Coordinator for Health Information Technology (ONC) to identify and define why data was not being shared across disparate platforms or with consumers. The goal of the ONC Final Rule is to give consumers safe and secure access to their EHI. 

What’s considered Information Blocking?

Information Blocking is defined as a practice by a healthcare provider, health information network, health information exchange or developer of certified health IT that interferes with access, exchange or use of EHI.

Specifically, it occurs when health IT is implemented in non-standard ways and increases burden in the exchange of information. Restricting access to information with respect to exporting complete information sets when transitioning between health IT systems is also considered Information Blocking.

What information needs to be shared?

The ONC defined two thresholds. Within the first 24 months (April 5, 2021-April 5, 2023), the initial data made interoperable comes from the United States Core Data for Interoperability (USCDI). This list includes a variety of health information, including allergies, immunizations, medications, vital signs and more. The ONC noted the majority of these elements can be found in Consolidated Clinical Data Architecture (C-CCDA) standard documents.  After 24 months, on Oct. 6, 2022, the scope of shared data will expand to the HIPAA dataset, encompassing many more elements.

Are there any exceptions?

Yes. there eight (8) exceptions.

What about penalties?

While the applicability of the Information Blocking provision officially began on April 5, 2021, there are no penalties defined at this time. However, that does not mean you cannot be identified as an information blocker. In the meantime, the Office of the Inspector General (OIG) has responsibility to define what those penalties are, which would apply to every healthcare provider regardless of incentive program or EHR certification.

While penalties and fines will become a reality for organizations not abiding by the regulation, we are currently in what is being dubbed as a waiting period to allow the industry to adapt to the regulation. Use this opportunity to assess your current technology and create a solid strategy for interoperability.

Create a plan for your organization

It’s essential to understand the impact Information Blocking will have on your organization. Here are several best practices to ensure your agency is prepared and compliant in all facets of the ONC regulation.

• Create a team specifically focused on this Information Blocking framework. This designated team should work to identify where the impacts are across your agency, including tracking requests for EHI to ensure you are managing and accepting these requests through the appropriate channels.
• Facilitate training both internally and externally. Internally, your staff needs to fully understand both what is being requested and how to manage the requests. Externally, ensure your patients or other requesters understand the process they may need to go through to access information.
• Review your internal technical capabilities. If your organization is operating on multiple electronic health records (EHRs), your staff needs to know how to extract data and properly push it through to the requester. It’s important to know what that workflow looks like and how your current technology supports data sharing outside the four walls of your agency.
• Develop policies for response and timeline adherence. The EHI is a request-driven response; therefore, for Information Blocking, you don’t have to push information all the time to patients or other providers. That process is already managed through other regulations, such as inpatient Conditions of Participation or admit/discharge transfers. Be aware of different requests and what is expected of your organization.
• Prioritize audit documentation. While there are not any current penalties, complaints can still be logged. Documenting your possible workflows goes a long way in case of an audit. Have the ability to share what your process is around identifying workflows, how your organization is responding to requests and what your timeframes are. Per the regulation, you need to be able to show you responded to requests within 10 days.

Data sharing helps reduce the cost of care and brings the consumer to the table, making them more involved in their care. Having a viable game plan and a full understanding of Information Blocking is critical for your county to remain compliant, avoid future penalties and stay connected.

To dive deeper into Information Blocking and what it means for your organization specifically, chat with a Netsmart expert today.

Carol Reynolds

Sr. Vice President, Strategic Client Development

Netsmart
creynolds@ntst.com