TIPS FOR PROVIDERS REGARDING RESULTS RELEASE TO PATIENT PORTAL :
IMPLEMENTATION STRATEGIES
Education about the new requirements is key to successful implementation of electronic medical record sharing , via information provided to the patients on after visit summary printouts , in the portal , and in person , reminding them they may be seeing results prior to their clinician ’ s review . Providers and their staff should be taught to field questions more easily and to understand exactly what is being shared to patients and when . Practices should make concise tip-sheets and provide them to staff . 11 I have included an example below :
“ We believe you deserve easy and secure access to your health information . Federal regulation requires that we share your test results with you as quickly as possible . You may see test results before your health care provider has had a chance to view or review them . Some results can be hard to understand without context and discussion with your health care provider . Please allow two business days to review your results . We will contact you with any results that concern us .”
Physicians should document in the chart when items ( such as notes or results ) are NOT shared with patients . Most clinical applications have built required menus of phrases to choose from when documenting an exception such as a risk of patient harm . Practices and health care organizations should develop and update policies to assure compliance together with their legal , compliance and IT leaders . Health care providers should know when exceptions are appropriate or “ reasonable .” For example , emotional harm is not considered to qualify for the prevention of harm exception . 11
In short , federal regulations are in place to facilitate medical record transparency and access via portals . The rollout of these rules has brought significant challenges to routine practice , especially when enforced during a pandemic . As always , communication with patients is paramount . Practices that promote trust by making their own records more easily accessible have been shown to enjoy enhanced care collaboration with patients , who improve understanding of their health , aiding better compliance with the medical plan .
References
1
Gettinger A , Zayas-Cabán T . HITECH to 21st century cures : clinician burden and evolving health IT policy . J Am Med Inform Assoc . 2021 Apr 23 ; 28 ( 5 ): 1022- 1025 . doi : 10.1093 / jamia / ocaa330 . PMID : 33576379 ; PMCID : PMC8068412 .
2
Office of the National Coordinator of Health Information Technology . 21st Century Cures Act : Interoperability , Information Blocking , and the ONC Health IT Certification Program , https :// www . federalregister . gov / documents / 2020 / 05 / 01 / 2020-07419 / 21st-century-cures-act-interoperability-information-blocking-and-the-onc-health-it-certification ( 2020 ).
3
The Office of the National Coordinator for Health Information Technology . 21 st Century Cures Act : ONC ’ s Cures Act Final Rule , https :// www . healthit . gov / curesrule / overview / about-oncs-cures-act-final-rule ( 2021 )
4
The Office of the National Coordinator for Health Information Technology . 21 st Century Cures Act : ONC ’ s Cures Act Final Rule , Information Blocking FAQs , https :// www . healthit . gov / curesrule / resources / information-blocking-faqs ( 2021 )
5
Office of the National Coordinator of Health Information Technology . 21st Century Cures Act : United States Core Data for Interoperability ( USCDI ), https :// www . healthit . gov / isa / united-states-core-data-interoperability-uscdi ( 2021 )
6
Office of the National Coordinator of Health Information Technology . Cures Act Final Rule : Information Blocking Exceptions , https :// www . healthit . gov / sites / default / files / cures / 2020-03 / InformationBlockingExceptions . pdf ( 2020 )
7
Gerber DE . 21st Century Cures Act : Implementation Without Understanding Implication ? JCO Oncol Pract . 2021 Aug 26 : OP2100436 . doi : 10.1200 / OP . 21.00436 . Epub ahead of print . PMID : 34436944
8
Naftalovich R , John Iskander A , Discepola PJ , Schweitzer AA , Eloy JD . Patient Anxiety Caused by the Cures Act . Anesthesiology . 2021 Aug 1 ; 135 ( 2 ): 373-374 . doi : 10.1097 / ALN . 0000000000003847 . PMID : 34029367 .
9
Mehan WA Jr , Brink JA , Hirsch JA . 21st Century Cures Act : Patient-Facing Implications of Information Blocking . J Am Coll Radiol . 2021 Jul ; 18 ( 7 ): 1012- 1016 . doi : 10.1016 / j . jacr . 2021.01.016 . Epub 2021 Feb 16 . PMID : 33600778 .
10
Bell S , Mejilla R , Anselmo M , et al ., When doctors share visit notes with patients : a study of patient and doctor perceptions of documentation errors , safety opportunities and the patient – doctor relationship , BMJ Qual Saf doi : 10.1136 / bmjqs-2015-004697
11
American Medical Association : Part 2 : How do I comply with info blocking and where do I start ?, https :// www . ama-assn . org / system / files / 2020-11 / info-blocking-compliance . pdf ( 2021 )
12
Schapiro NA , Mihaly LK . The 21st Century Cures Act and Challenges to Adolescent Confidentiality . J Pediatr Health Care . 2021 Jul-Aug ; 35 ( 4 ): 439-442 . doi : 10.1016 / j . pedhc . 2021.03.005 . Epub 2021 Apr 14 . PMID : 33865680 .
13
DesRoches C , Bell S , Dong Z , et al ., Patients Managing Medications and Reading Their Visit Notes : A Survey of OpenNotes Participants , Ann Intern Med . 2019 . [ Epub ahead of print 28 May 2019 ] doi : 10.7326 / M18-3197
14
OpenNotes : Effects of Open Notes : FAQs for Clinicians , https :// www . opennotes . org / effects-of-opennotes-faqs / ( 2021 )
15
American Medical Association ED Hub : Stepsforward : Sharing Clinical Notes With Patients , https :// edhub . ama-assn . org / steps-forward / module / 2781026
( 2021 )
FEATURE
Dr . Dues is a hospitalist and is Chief Medical Information Officer at UofL Health . ( non-member )
NOVEMBER 2021 27