Cures Act information blocking rule

The idea of letting patients read what their clinicians write had been tested a decade earlier. In a 2010 to 2011 study at three health systems in Boston, rural Pennsylvania and Seattle, 105 primary care doctors invited 13,564 patients to read their visit notes through a secure web portal. Delbanco, Walker and colleagues reported in 2012 that 11,797 of the patients opened at least one note, 77 to 87 percent of those surveyed felt more in control of their care, and 99 percent wanted to continue. No doctor chose to stop. By 2019 the three systems had opened notes from nearly all their clinicians, and in a survey of their patients, 98.5 percent of respondents who had read notes called online access to them a good idea.

Congress wrote the principle into law. The 21st Century Cures Act, signed on 13 December 2016, authorized regulations against information blocking, defined as a practice likely to interfere with the access, exchange or use of electronic health information. The Office of the National Coordinator for Health Information Technology published its final rule on 1 May 2020. It called for standardized application programming interfaces so patients could pull their records into smartphone apps, and required that patients be able to reach all of their electronic health information without charge.

The information blocking provisions took effect on 5 April 2021, requiring clinicians to give patients rapid access to all clinical notes and test results. At Vanderbilt University Medical Center, which complied from 20 January 2021, the share of previously delayed results that patients saw before any clinician rose from 10.4 to 40.3 percent. Patient messages sent within six hours of reading those results rose from a median of 77.5 to 146 a day, Bryan Steitz and colleagues reported in October 2021.