21st Century Cures Act: Patient-Facing Implications of Information Blocking

The information-blocking provision of the Cures Act is designed to promote interoperability of health IT systems and mandates immediate access and portability of personal electronic health information for patients, providers and payers. In essence, this legislation requires no delay in access to clinical information including radiology reports once entered into the electronic health record. This is at odds with the current settings of many electronic health record systems, which employ time-delayed releases (embargo) of radiology reports. In such systems, there is a predetermined delay, such as days to weeks, between when a radiology report is signed off by the radiologist and when the report becomes available for patient access via the online patient portal. The idea behind this practice is that the delay allows time for the referring provider to read the report and coordinate care for the patient before the patient becomes aware of potentially abnormal and anxiety-provoking imaging findings. At the time of this writing, it is unclear whether such embargo programs will meet information-blocking definitions and thereby be subject to financial disincentives. Many provider groups are preparing for enforcement of the information-blocking by removing their report embargo programs. This article describes the challenges and opportunities created by the immediate release of radiology reports to patients via online patient portals and suggests strategies that groups may consider to ease their transition to this model of care delivery.