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information blocking provision of 21st Century Cures Act

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10 comments

  • Lisa Hardebeck

    Hello! After reading the explanation posted by Ruth (above) I felt some relief at not needing to really change anything in my practice. However, I just finished reading an article put out by the American Psychological Association recently (original article December 2020; updated March 2021) which states:

    "What psychologists are impacted by the rule? This rule applies to all psychologists who use EHR systems, including systems that are not certified by the HHS Office of the National Coordinator for Health IT (ONC). Psychologists are not affected if they keep only paper records or electronic records that are not part of an EHR."

    The end notes to the article offers this definition for an EHR: "For example, some psychologists write their notes in a Word document on their computer. This is not considered having an EHR. CMS defines an EHR “as an electronic version of a patient’s medical history, that is maintained by the provider over time, and may include all of the key administrative clinical data relevant to that persons care under a particular provider, including demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports. The EHR automates access to information and has the potential to streamline the clinician's workflow. The EHR also has the ability to support other care-related activities directly or indirectly through various interfaces, including evidence-based decision support, quality management, and outcomes reporting.” https://www.cms.gov/Medicare/E-Health/EHealthRecords. HHS has also proposed defining EHR in the proposed changes to the HIPAA Privacy Rule."

    Based on all that, it sounds to me as though those of us using SP are, in fact, affected by this rule. I'm kind of hoping I'm missing something here (because this will change up how I write my progress notes). Are others understanding this differently? 

    I would love it if SimplePractice would chime in again - perhaps the information has shifted or become more clear since the last posting?

    Thank you!

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  • Tracy Masiello

    This federal law goes into effect next week, and means that clients automatically have access to their progress notes and other forms/notes. Is SP setting it up so that they have a way to "see" the notes automatically, or will there be something we have to do to let clients view their notes in the portal?

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  • Sarah Linfield Wilson

    https://www.hklaw.com/en/insights/publications/2020/10/onc-information-blocking-requirements-what-you-need-to-know

     

    I do not know exactly where to find the most correct information, But I do  not believe we will have to give 24/7 access to all documentation and all EHI for every client at all times. It looks like the main thing is just codifying into law what most counselors already do - if a client requests their EHI we can charge them a fee (or give the EHI for free) and provide them their EHI within a reasonable time frame.

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  • C. Patricia Hanley

    I'd appreciate hearing from Simple Practice as to how they will be handing this.  It looks like, from the link you provided Sarah, that the deadline might be moved because of COVID-19 pandemic. Thank you for bringing this up.

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  • Jamie Wilson

    Gillian, do you know if SP has any future plans to be ONC-certified?  Only asking because of the possible implications for future full access for clients and want to make sure I am preparing for it now.  Thanks!

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  • Ruth

    Hi Jamie, happy to clarify, SimplePractice isn't subject to The Cures Act and neither are the clinicians who use SimplePractice as an EHR.

    The Cures Act is a condition to maintain ONC Certification, most often held by EHRs for large hospitals, clinics, or organizations that provide lab testing and have to do federal reporting. Since #so isn't ONC Certified, we're not obligated to follow the requirements of The Cures Act. ONC Certification is optional and isn't necessarily beneficial for EHRs like SimplePractice to obtain. Please let me know if you have any additional questions! 

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  • Kathleen Howey Murphy

    I have read the same info as Lisa, above here, and I also request and would appreciate if Simple Practice would answer and clarify! Thank you!

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  • Ruth

    Hi Lisa and Kathleen, if you scroll down on the APA's article, "New Federal Rule affects Psychologists with Electronic Health Records," to the section "How will the rule affect psychologists in independent practices?" you'll see that non-certified EHRs are required to make the sharing of Electronic Health Information possible; however, they're not required "to have direct access capacity." Since you can download any part of a client's medical record, or the entire record at once and "Share" it with them through the Client Portal, SimplePractice is fully compliant with HIPAA and this new rule. The article suggests that psychologists, using a non-ONC certified EHR, make sure they're administrative practices are not complicit in "unintentional information blocking." Let me know if you have any other questions! 

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  • Lisa Hardebeck

    Hi Ruth - Thanks for the follow up! Since my previous comment I've don't quite a bit of reading up regarding the new Information Blocking provision. I'm not concerned about SimplePractice being non-compliant with the new rule, it seems pretty clear that non-ONC certified EHRs are exempt at this point. Also, I'm just confident in general that SimplePractice complies with ONC/HIPAA rules; I think you guys do a great job, so that's not my concern. What does concern me at this point is how I might change my session note-taking. Even though SimplePractice is currently exempt (and it seems clear that psychologists using SimplePractice would fall under the "infeasibility" exception, due to the unrealistic hardship of having to switch to an ONC-certified EHR), I will likely change how I go about note taking due to the "open notes" trend that's fueling the Info. Blocking provision. In other words, I will likely only use the progress note for bare bones information, and will switch to the psychotherapy note for information I want to track for my own purposes in treating a patient. So, here's my new question: will SimplePractice be including psychotherapy note templates (or the ability to build our own), as it does for the progress note section? I find that being able to create my own note template has been a huge time saver - I would love to be able to create a personalized template for myself within the psychotherapy notes section, but it doesn't seem possible. Given that many of us will likely start using psychotherapy notes more frequently/regularly, is a function SimplePractice is planning to add?

    Thank you!

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  • Gillian

    I'm happy to clarify. The 21st Century Cures Act only applies to ONC-certified EHRs, and SimplePractice is not currently ONC-certified. However, I'm happy to show you how to share your progress notes with your clients.

     

    You can export and share your data using our Data Export feature, and you can learn how to use our Data Export feature here: Data export: Exporting client information.

     

    After you export your client data, navigate to your client's Overview page and follow these steps:

     

    • Click Uploaded Files on the right-hand side of their file.
    • Click Upload New, and select the exported notes that you'd like to share with your client. ​​
    • Navigate to their Shared with client section, and click Share New. ​​
    • Select the uploaded file to share.
    • Once you select the correct file, click Continue to Email to send it to your client. Your client will then be able to access their notes via the Client Portal.

     

    To learn more about sharing documents with your client, please see Sending intake forms and documents to clients.

     

    Please let me know if you have any questions.

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