What is information blocking?

Information blocking in healthcare refers to practices that prevent providers from accessing Electronic Health Information (EHI) needed for patient care. This creates obstacles that can harm patient care and the healthcare system. 

Examples of information blocking

There are many ways in which intentional actions or practices may obstruct the smooth flow of medical information. 

1. Restrictive access to patient records: This can occur when a healthcare provider intentionally limits or delays access to patient records, either within their own system or for external parties, hindering the smooth transfer of necessary medical information.
2. Interoperability hindrance between health systems: Information blocking might manifest as obstacles in connecting different electronic health record (EHR) systems, making it challenging for them to exchange data seamlessly. This can occur due to technical complexities, deliberate system limitations, or excessive fees imposed by EHR vendors for system connectivity.
3. Excessive fees for EHR interfaces: Healthcare technology vendors may charge unreasonably high fees to set up connections between different health systems, inhibiting the easy exchange of patient information.
4. Technical constraints affecting information exchange: Using non-standard or complex technical methods within EHRs or health information technology can impede the sharing or use of medical information, making it challenging to exchange data effectively.
5. Delaying or limiting information sharing: Physicians or healthcare organizations may introduce policies or practices that delay or restrict the sharing of patient information, potentially impacting the continuity of care.
6. Unresponsive practices: When a healthcare provider possesses the capability to provide immediate access to requested information but intentionally delays or takes an extended time to respond, it can be a form of information blocking.

See also: Cures Act Information Blocking Rule explained

HIPAA and the 21st Century Cures Act provisions

The 21st Century Cures Act complements HIPAA by aiming to overcome the challenges posed by information-blocking practices. It ensures that patients have seamless access to their health data and that healthcare providers can easily exchange information, improving care coordination. 

HIPAA

HIPAA aims to protect patients' health information by setting standards for safeguarding medical records and personal data. The Privacy Rule grants patients control over their information, but HIPAA's implementation sometimes led to information flow hurdles.

21st Century Cures Act

The purpose of this act is to promote better accessibility to medical information. It has a big role in addressing the issues related to information blocking. The Cures Act aims to enhance interoperability in the healthcare system, ensuring that health information is readily accessible and can be securely exchanged between different healthcare entities. It also prohibits certain practices that serve to obstruct the sharing of EHI by health information networks, health IT developers, and healthcare providers. Specific provisions include: 

• The Act identifies various exceptions that allow healthcare providers, developers, and health information exchanges to restrict information in specific cases. 
• The Act promotes patient access to their electronic health information by ensuring they can access and share their health records as needed.
• The Act encourages the seamless exchange of health information by focusing on interoperability among different healthcare systems.

How to deal with information blocking

1. Interoperability focus: Collaborate with EHR vendors or Health Information Exchanges (HIEs) to ensure that systems are interoperable. This facilitates the seamless sharing of EHI between different providers while maintaining compliance with privacy and security standards.
2. Transparent communication: Engage in transparent communication with patients regarding their rights, the protocols for accessing their records, and any potential delays or legal restrictions in sharing certain information.
3. Comprehensive training: Educate staff about information blocking regulations and exceptions. 
4. Patient empowerment: Empower patients to access their medical records. Ensure patients know their rights to their EHI and provide them with secure and timely access to their information.
5. Risk mitigation plans: Develop contingency plans to address any unforeseen challenges or disruptions that could lead to a delay in sharing EHI.

See also: HIPAA Compliant Email: The Definitive Guide

HHS guidance on information blocking

The U.S. Department of Health and Human Services (HHS) has proposed a rule to prevent healthcare providers from blocking access to electronic health information. The rule aims to stop providers from interfering with the access, exchange, or use of electronic health information except when required by law or a regulatory exception.

Read more: HHS proposes rule to establish disincentives for information blocking