If your practice uses an electronic health record (EHR) system, then it’s important to understand how the 21st Century Cures Act affects you. The Cures Act, signed into law in December 2016, is the foundation put in place by the HITECH Act via the 3 stages of Meaningful Use. The Cures Act in many ways should be thought of as the next version or next “stage” of Meaningful Use.
21st Century Cures Act: Getting the Basics
The Cures Act covers many areas of research, including drugs, medical devices, and software. For example, some funding is intended for the creation of new research competitions and loan repayment programs for certain researchers. It also speeds up the FDA drug approval process for new uses for existing drugs, and breakthrough treatment options for patients with life-threatening diseases.
Mental health is addressed by the Cures Act through the incorporation of the Helping Families In Mental Health Crisis Act. This act increased bed availability for short-term psychiatric hospitalization. It also required the Substance Abuse and Mental Health Services Administration to set up an interagency committee to turn evidence-based findings into systems of care.
Another part of the Cures Act calls for the Secretary of the U.S. Department of Health and Human Services (HHS) to issue “Guidance Related to Streamlining Authorization” under HIPAA. This relates to instances when an individual authorizes researchers to use and disclose their protected health information.
The Cures Act also requires HHS via the Office of the National Coordinator for Health Information Technology (ONC) to create plans to improve health IT interoperability. This goal has been in place for over a decade and is further standardizing the communication and data sharing among providers, payers, and patients. When we all follow the same standards, organizations and patients can communicate better. It also seeks to give patients more power over their health information and care decisions. This will have a significant effect on your practice. Let’s take a closer look.
Cures Act Interoperability Requirements
What does the Cures Act have to do with Electronic Health Records (EHRs), and your practice specifically? It’s all about interoperability and being able to seamlessly communicate with patients and other providers.
First, let’s define “interoperability” – it helps different systems, software, or devices share information. Interoperability can make patient care more efficient by letting providers exchange data more easily and is an important part of value-based care.
Two sections in the Cures Act are especially crucial to understand: 45 CFR Parts 170 and 171. Together, they are referred to as the rules for Interoperability and Information Blocking.
Health IT Certification Requirements
Part 170 is “Health Information Technology Standards, Implementation Specifications, and Certification Criteria and Certification Programs for Health Information Technology.”
This section is related to the specific standards, implementation specifications, and certification processes that were developed around “Meaningful Use.” Meaningful Use became “Promoting Interoperability,” with a new certification called the “2015 Edition Cures Update Test Method”
Under this section of the Cures Act, your EHR must complete another HITECH certification process, starting April 2022. This process should be completed for all ONC-certified EHRs by the end of 2022. All health IT vendors being reimbursed by CMS must comply with these requirements.
Certification testing will cover the following criteria for all EHRs:
- Electronic Health Information export
- Encrypt authentication credentials
- Multi-factor authentication
- Standardized API for patient and population services
- United States Core Data for Interoperability (USCDI)
All EHRs must be recertified by your EHR vendor, including Epic, Netsmart, Streamline, Cerner, Qualifacts, etc.
Preventing Information Blocking
Part 171 of the act covers “Information Blocking,” which is prohibited under the Cures Act. Information blocking generally refers to the prevention of appropriate access, sharing, or use of EHR data. It can happen when patients are prevented from seeing their health records, or when providers cannot link their EHRs.
The Cures Act requires healthcare providers to improve how easily patients can access and update their health information. Under the ONC Cures Act Final Rule, which took effect April 5, 2021, all healthcare professionals must share eight types of notes and records with patients who request them:
- History and physical notes
- Consultation notes
- Procedure notes
- Progress notes
- Discharge summary notes
- Imaging narratives
- Laboratory report narratives
- Pathology report narratives
Sometimes information may be denied for legitimate reasons, such as preventing harm or licensing issues. Your practice should establish a process for evaluating information requests and train staff members on it, including potential exceptions.
Have more questions about the Cures Act, or need help finding the right compliant EHR solution for your practice? Contact Ted Wright today to get your questions answered.