January 19, 2021

ONC Addresses ACR Concerns in Updated Information Blocking Guidance

The United States Department of Health and Human Services (HHS) Office of the National Coordinator for Health IT (ONC) updated its 21st Century Cures Act “Information Blocking Provision” guidance on Jan. 15, 2021 to address the concerns of the American College of Radiology® (ACR®) and other stakeholders about medically appropriate patient communication policies. Among other issues, the ACR requested clarification on whether it would be viewed as “information blocking” for radiology practices to maintain standard communication policies of releasing radiology reports electronically following a short interval of time intended to facilitate care coordination, consultation, closing the referral loop, direct discussion of complex findings or any other purpose considered medically appropriate by physicians. The complexity of this issue was explored at length in the Oct. 31, 2020 ACR Advocacy in Action e-newsletter issue.

The updated guidance from ONC clarified that providers are not required by the information blocking provision to proactively release radiology reports or other electronic health information (EHI) to patients who have not requested the EHI. Specific requests made by patients should be appropriately responded to in accordance with the information blocking provision.

The ONC’s two FAQ of particular interest are as follows (current as of Jan. 15, 2021). The full list and text of the FAQ are available on the ONC’s website.

Q: Do the information blocking regulations (45 CFR Part 171) require actors to proactively make EHI available through “patient portals,” application programming interfaces (APIs), or other health IT?

A: No. There is no requirement under the information blocking regulations to proactively make available any EHI to patients or others who have not requested the EHI. We note, however, that a delay in the release or availability of EHI in response to a request for legally permissible access, exchange, or use of EHI may be an interference under the information blocking regulations (85 FR 25813, 25878). If the delay were to constitute an interference under the information blocking regulations, an actor’s practice or actions may still satisfy the conditions of an exception under the information blocking regulations (45 CFR 171.200-303)…

Q: Are actors (for example, healthcare providers) expected to release test results to patients through a patient portal or API as soon as the results are available to the ordering clinician?

A: While the information blocking regulations do not require actors to proactively make electronic health information (EHI) available, once a request to access, exchange or use EHI is made actors must timely respond to the request (for example, from a patient for their test results). Delays or other unnecessary impediments could implicate the information blocking provisions. In practice, this could mean a patient would be able to access EHI such as test results in parallel to the availability of the test results to the ordering clinician…

The ACR is continuing to work with ONC and other physician organizations on various information blocking provision implementation and enforcement issues. It is anticipated that more detailed guidance for providers will be coming in future months. In the interim, interested ACR members are encouraged to review the following resources:

Note: This news article is intended for general information purposes only. It is not to be used for compliance or as regulatory guidance of any kind.