Provider Obligations For Patient Portals Under The 21st Century Cures Act

By: Alexander Dworkowitz
– Health Affairs

Manatt Health Partner Alex Dworkowitz wrote an article for Health Affairs on the difficulties health care providers are facing regarding the electronic health information they can and must make available through online patient portals. 

In the article, Dworkowitz explained that hospitals and other providers are changing the available information in their patient portals—the websites through which many health care providers share clinical information with their patients. Under the 21st Century Cures Act, Congress prohibited “information blocking”, a practice that is “likely to interfere with, prevent, or materially discourage access, exchange, or use of electronic health information,” and the Office of the National Coordinator for Health Information Technology (ONC) issued regulations on information blocking in 2020, yet neither made any reference to patient portals. Now, as new regulatory requirements are taking effect, providers are struggling to adapt their practices as they work to navigate this issue. “Changes to patient portals are so far the most visible manifestation of the shift in practices resulting from the information blocking rule,” Dworkowitz stated.  

The ONC issued only limited guidance surrounding this new regulatory framework and the government has left key questions unanswered. In effect, the ONC is interpretating the 21st Century Cures Act to mean that patients have the right to obtain information from their health care providers as quickly as possible, yet in many cases “there is tension between the information blocking rule and privacy laws that limit access to information. Striking a balance can be difficult,” Dworkowitz explained. “In short,” he concluded, “health care providers’ efforts to give their patients better access to their information will be subject to scrutiny for years to come.” 



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