FAQ on Information Blocking: EHR and Health IT System Guidelines

Describes EHR functionality needed and highlights questions to ask your vendor.

“I am a physician reviewing my practices’ compliance with Information Blocking Regulations. When in that review should I talk with my EHR vendor? How do I talk with my EHR vendor?”

As used throughout this FAQ, “Information Blocking” references the body of works that are the information blocking provisions of the 21st Century Cures Act. For every change in policy, procedure, or workflow that is being considered, practices should ask their EHR vendor precisely what they offer or plan to offer to support that item. The  answer from the vendor could trigger a change in plans, and it is much better to know what the EHR implementation will look like before deciding on steps to take. For example, ahead of the Information Blocking applicability date (currently April 5, 2021), you should review your practices’ current EHI exchange practices and EHR functionality versus required, or necessary, functionality. The goal for any physician, regardless of which EHR vendor they use, should be to ensure all USCDI v1 data elements are available, and to know how to set up exchanges and maintain a chain of accountability. As timelines progress, it will be important to maintain an open line of communication with your EHR vendor as to identify and resolve issues early and swiftly.  

What should physicians look for in EHR systems?

It is important that physicians ensure their technology aligns with the 21st Century Cures Act mandates. Physicians will also want to confirm their systems are compliant and should review specific functionalities related to information exchange. Below are a few features a physician may want to look for in an EHR system.

  • Compatibility with HL7 Fast Healthcare Interoperability Resources (FHIR®) Release 4.
  • Optimized patient portal features that allow easy sharing and downloading of records.
  • Ability for patients to share or link their information to third parties, such as smartphone applications and other mobile health applications.
  • Ability to document when EHI is not provided when requested, along with the documentation necessary to support the appropriate exception.

Increased patient access to EHI is at the heart of the implementation of the Information Blocking regulations. For that reason, previously constructed embargos on records release may be problematic. If a physician’s practice has embargos in place, should they be removed? Is there any case in which embargos may be recommended?

If you have previous embargos in place, you may need to release those embargos to better ensure you are sharing appropriately. On the other hand, if a practice has identified certain notes that should not be more freely shared (e.g., adolescent pregnancy notes or genetic testing), a physician may want to put embargos in place. In any event, when putting embargos in place, you should think carefully about the types of records you want to embargo, and the relevant implications for information blocking and exchange.

DISCLAIMER - The information contained on this page should not be seen as official technical or legal advice. State laws around data release may affect applicability of the ONC and CMS rules. Consult with your organization’s Health Information Management, compliance, legal, finance, and public affairs teams to find out how it applies to you.