New rules for information blocking effective Nov. 1
“Information Blocking,” the practice of not releasing notes, results or reports to patients immediately upon their being signed or finalized, will no longer be allowed per federal legislation after Nov. 1.
There are three main changes to current practice that are required for compliance with the new rule:
- Notes/results from departments that are currently restricted, can no longer be restricted, with these exceptions:
- Adolescent proxy access.
- Federal Part II Substance Use Disorder information
- Information related to research studies will be restricted during the time of the study but must be released upon its completion
- All Open Notes information prior to June 2017 will become available
- A subset of lab/test orders that are currently institutionally delayed will now require providers to manually select the delay option and provide justification in MiChart
Notes currently restricted
- Notes that are not signed by the attending will continue not to be released.
- Many notes from departments that are currently institutionally restricted will no longer be restricted. The largest impact will be to Psychiatry and Social Work. We are working with these areas to mitigate this impact.
- Proxy access to adolescent Patient Portals for sensitive information will continue to be institutionally restricted. However, the release of results to the adolescent’s Patient Portal will be immediate by default unless specified in the order (see section 3 below).
- Federal Part II Substance Use Disorder information will remain institutionally restricted.
- Research studies will be institutionally blocked but will require that all notes and results be released at the end of the research study.
Open notes prior to 2017
- Notes dated back to June 2017 that are part of “Open Notes” are currently released; going forward any available “Open Notes” notes prior to June 2017 must be released as well.
Delays to patient portal release of test results
Currently, Michigan Medicine has a discrete subset of orders that are automatically delayed from release to the Patient Portal or other individuals/institutions. This is to allow the practitioner the opportunity to review results, consider a treatment plan and share this information in a considerate manner with the patient
The spirit and the impact of the process will remain the same: Allowing practitioners to exercise their best judgement in regards to how and when to share troubling health information with patients. The key difference is that there will no longer be an institutional delay on this subset of orders; any delay will have to be manually selected and justified for each individual order at the time it is placed.
The default will be to immediately release results to the patient. For an identified subset of orders, the practitioner can select the “Delay” option and provide a justification. The delay is specific to the order and based upon current practice.
The effective date for this legislation is Nov. 1. We will continue to keep you updated as the work progresses to make this change as seamless as possible.
Please continue to contact Kimberly Bologna, project manager, Office of Clinical Informatics, if you have questions.