ONC “Information Blocking” Rules Cause Confusion, Patient Distress

Alexandria, VA – AMGA today offered recommendations to improve information blocking requirements to help strengthen and support the doctor-patient relationship in a letter to the U. S. Department of Health and Human Services Office of the National Coordinator (ONC) for Health Information Technology. The changes that AMGA is recommending furthers ONC’s transparency goals while also ensuring that patients receive any concerning laboratory and other results in a thoughtful, compassionate way.

Under ONC rules that took effect earlier this year, healthcare providers generally are required to provide patients with immediate access to their electronic health information. Patients expect timely access to test results, and AMGA supports the underlying intent of the rules. Based on our members’ experience, however, the stringent requirements on how quickly clinicians must provide access to the laboratory and other results are causing patient harm and distress, as patients are receiving results via patient portals and other technology and not through a conversation with their clinician. AMGA recommends that healthcare providers be allowed more time to electronically release test results so that they can reach out to patients about sensitive findings and answer questions.

“AMGA strongly supports information sharing and the need for patients to have quick access to test results and other clinical findings,” said AMGA President and CEO Jerry Penso, M.D., M.B.A. “The problem with ‘immediate resulting’ is that patients are learning about cancer diagnoses or other serious conditions from a computer, not a person. The rules unintentionally are favoring speed over compassion.”

AMGA recommends that rather than require patients be immediately alerted when laboratory or other clinical findings are entered into a patient record, clinicians have the option to delay their automatic release for 24 to 72 hours to allow providers the opportunity to discuss the results and answer any questions. A conversation between the clinician and the patient can help prevent needless confusion about abnormal results. The regulations currently allow for a delay in the release of results if there is a potential for patient harm. The rules, however, define harm in purely physical terms. AMGA recommends that the delay be permitted to help prevent or mitigate emotional and mental stress and harm.  

“‘First do not harm’ is not just a slogan, but an underlying principle,” Penso said. “We live in a fast-paced world, and patients expect to have information at their fingertips. As healthcare providers, we can provide that information quickly, but sometimes it needs to be delivered with added context, expertise, and something a computer can’t provide, compassion and understanding.”

AMGA's letter to ONC is available here. 

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About AMGA
 AMGA is a trade association leading the transformation of health care in America. Representing multispecialty medical groups and integrated systems of care, we advocate, educate, innovate, and empower our members to deliver the next level of high performance health. AMGA is the national voice promoting awareness of our members’ recognized excellence in the delivery of coordinated, high-quality, high-value care. More than 175,000 physicians practice in our member organizations, delivering care to one in three Americans.