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Arien Malec
@amalec
, 4 tweets, 3 min read Read on Twitter
1/
A mega-meta-thread on Information Blocking threads I've done:

Overview on Information Blocking


7 Exceptions to Information Blocking


Contractual obligations not an Information Blocking Exception
2/
All about pricing:

Deep dive on pricing:


Cost recovery or profit?
3/
Information Blocking in practice:

Are you an Information Blocker under the Rule


Applying Information Blocking rule to Direct Trust


Applying Information Blocking to MX
4/
Issues with maintenance & unexpected downtime:
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More from @amalec see all

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Arien Malec
@amalec
1/
An interesting wrinkle of #CuresAct

Adhering to contractual requirements is *not* one of the 7 exceptions to information blocking.

Tagging the smartest health policy lawyers I know:

@HealthPrivacy @JodiDaniel @SavageLucia

(Joy Pritts has no Twitter handle?)
2/
Historically, when BAA terms or other contractual terms conflicted with rights possible under #HIPAA, BAA terms have been deemed to hold.

E.g., famously, even though a clearinghouse is a HIPAA CE & has all the rights and obligations of a CE...
3/
...Clearinghouses *also* act as BAs and receive data under a BAA.

Other #HealthIT entities are pure BAs but are also deemed #HealthIT by Cures and this NPRM
Read 8 tweets
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Arien Malec
@amalec
0/
Verily this shall be an Account of the Seven Virtuous Exceptions to the Sin of Information Blocking.

For there are Seven. Not Six. Not Eight. Five is right out.

#CuresNPRM
1/
The First Virtuous Exception to the Sin of Information Blocking is:

Preventing Harm Including:
(a)(1) Corrupt/inaccurate data
(a)(2) Misidentified patient
(a)(3) Life & Safety

All policies need to be fair, and minimally targeted to prevent harm
1 (commentary)/

Being a Commentary on the First Virtuous Exception.

(a)(1) Seems like an excuse to slow/delay.

(a)(2) seems like a hole you could drive a truck through, yeah? If I don't have 100% confidence in my own patient matching (and who does), I can bail?
Read 16 tweets
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Arien Malec
@amalec
1/
#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....
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)
Read 17 tweets

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