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#CuresNPRM Information Blocking deep dive.
As a reminder, the PHSA defines "provider" broadly & "permitted purposes" are purposes that are, well, permitted.
#CuresNPRM Information Blocking deep dive.
As a reminder, the PHSA defines "provider" broadly & "permitted purposes" are purposes that are, well, permitted.
2/
Therefore, unless there are specific exceptions noted, the legislative intent of #21CC could be interpreted that....
Therefore, unless there are specific exceptions noted, the legislative intent of #21CC could be interpreted that....
3/
...if I ask a, say, pharmacy or physical therapist for information to justify a CQM or risk score for a patient we both share (both permitted payment/operations uses)
...if I ask a, say, pharmacy or physical therapist for information to justify a CQM or risk score for a patient we both share (both permitted payment/operations uses)
4/
#CuresNPRM establishes 7 criteria (summarized here: healthit.gov/sites/default/…) for exceptions to information blocking.
#CuresNPRM establishes 7 criteria (summarized here: healthit.gov/sites/default/…) for exceptions to information blocking.
5/
None of those exceptions limit the definition of permitted purpose. In fact...
None of those exceptions limit the definition of permitted purpose. In fact...
6/ 170.102 (Definitions), defines the term "Interoperability" to double down on the #21CC definition:
"Interoperability is, with respect to health information technology, such health information technology that –"
"Interoperability is, with respect to health information technology, such health information technology that –"
7/
"(i) Enables the secure exchange of electronic health information with, and use of electronic health information from, other health information technology without special effort on the part of the user;"
"(i) Enables the secure exchange of electronic health information with, and use of electronic health information from, other health information technology without special effort on the part of the user;"
8/
"(ii) Allows for complete access, exchange, and use of all electronically accessible health information for authorized use under applicable state or federal law; and"
(NOTE: COMPLETE, ALL, "FOR AUTHORIZED USE" -- no limitations)
"(ii) Allows for complete access, exchange, and use of all electronically accessible health information for authorized use under applicable state or federal law; and"
(NOTE: COMPLETE, ALL, "FOR AUTHORIZED USE" -- no limitations)
9/
"(iii) Does not constitute information blocking as defined in § 171.103 of this subchapter."
This establishes a broad baseline for "it's information blocking if you can't get access to data for authorized use unless it's one of the exceptions"
"(iii) Does not constitute information blocking as defined in § 171.103 of this subchapter."
This establishes a broad baseline for "it's information blocking if you can't get access to data for authorized use unless it's one of the exceptions"
10/
The term "Actor" is defined in § 171.102 as "Actor means a health care provider, health IT developer of certified health IT, health information exchange, or health information network."
The term "Actor" is defined in § 171.102 as "Actor means a health care provider, health IT developer of certified health IT, health information exchange, or health information network."
11/
Also in § 171.102:
The term "Health care provider has the same meaning as “health care provider” at 42 U.S.C. 300jj."
For which see: law.cornell.edu/uscode/text/42…
Also in § 171.102:
The term "Health care provider has the same meaning as “health care provider” at 42 U.S.C. 300jj."
For which see: law.cornell.edu/uscode/text/42…
12/
For anyone who works with lawyers: all the good stuff is in the definitions.
If you read the definition of "provider" you'll find that not much is excluded.
Blood center? yup. EMS? yup? dialysis center? yup. Hospital, physician, pharmacy? duh.
For anyone who works with lawyers: all the good stuff is in the definitions.
If you read the definition of "provider" you'll find that not much is excluded.
Blood center? yup. EMS? yup? dialysis center? yup. Hospital, physician, pharmacy? duh.
13/
"Permissible purpose means a purpose for which a person is authorized, permitted, or required to access, exchange, or use electronic health information under applicable law."
So yeah, permitted purposes are those purposes that are permitted.
"Permissible purpose means a purpose for which a person is authorized, permitted, or required to access, exchange, or use electronic health information under applicable law."
So yeah, permitted purposes are those purposes that are permitted.
14/
To repeat: providers are pretty much anyone who provides care, permitted purposes are all purposes that are permitted, and information blocking is anything that....
To repeat: providers are pretty much anyone who provides care, permitted purposes are all purposes that are permitted, and information blocking is anything that....
15/
For providers, is: "is unreasonable and is likely to interfere with, prevent, or materially discourage access, exchange, or use of electronic health information."
For providers, is: "is unreasonable and is likely to interfere with, prevent, or materially discourage access, exchange, or use of electronic health information."
16/
Alas, this rule has yet to define the penalties on providers for information blocking -- much of the rule is #HealthIT/Certification based.
Alas, this rule has yet to define the penalties on providers for information blocking -- much of the rule is #HealthIT/Certification based.
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