The American Association of Orthodontists clarified the requirements of an upcoming change to patient access to electronically stored health records.

On October 6, 2022, new federal regulations pertaining to the access provided to patients’ electronically-stored health records and information will go into effect for many different kinds of healthcare practices and facilities, including orthodontic practices.

The 21st Century Cures Act, which was passed by Congress in 2016, requires healthcare providers to give patients access to electronically stored portions of their medical records. Under the Act, patients must have easy, unrestricted access to electronic health information that includes:

  • Consultations
  • Treatment Notes
  • Discharge Summaries
  • Imaging Reports
  • Procedure Notes
  • Progress Notes
  • History and Physical Exam Reports

Currently, these requirements apply only to electronic records and data that are stored within the standards set in the United States Core Data for Interoperability (USCDI)—meaning that until now, orthodontic and dental practices did not fall under the requirements of the Act.

According to the AAO, the change of most concern for orthodontists is complying with the prohibitions against information blocking in the new rules.

Information blocking means a practice that interferes with access, exchange, or use of electronic health information (EHI), barring a few exceptions.

According to the upcoming rule, information blocking is any practice by a health care provider that is unreasonable, likely to interfere with access, exchange, or use of EHI, and
not covered by an exception to the rule.

Common information blocking practices include restricting authorized access, use, and exchange of EHI and non-standard implementation of health technology systems that increase the complexity or burden of accessing EHI.

The Information Blocking Rule provides the following applicable exceptions for dental and orthodontic practices:

  • Preventing Harm Exception: It is not information blocking if health care providers engage in reasonable and necessary practices to prevent harm to the patient or others.
  • Privacy Exception: Health care providers may refuse requests if there are legitimate concerns regarding a patient’s EHI.
  • Security Exception: It is not information blocking if a health care provider interferes with the access, exchange, or use of EHI to protect the security of EHI.
  • Infeasibility Exception: Covers situations where it is impractical for health care providers to comply with patients’ requests for accessing, exchanging, or using EHI, whether for technological or legal reasons.
  • Content and Manner Exception: Allows health care providers to limit the scope of the request for accessing, exchanging, or using EHI.
  • Fees Exception: Health care providers can charge reasonable fees for accessing, exchanging, or using EHI

Any practice that is determined to be in violation of the new information blocking rules, will be subject to penalties and disincentives.

For a more thorough breakdown of the rule and answers to questions about the specifics, the AAO’s full article is available online.

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