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November-December 2020

Editor’s Note: Cures Act Delayed But the Show Goes On
By Lee DeOrio
For The Record
Vol. 32 No. 6 P. 4

Just a few weeks ago, Health and Human Services announced it was postponing the federal “Open Notes” rule, slated to go into effect November 2, until next April. Although the decision seemed to be of the last-minute variety, the reasoning was sound.

“To be clear, the Office of National Coordinator for Health IT is not removing the requirement advancing patient access to their health information that is outlined in the Cures Act Final Rule. Rather, we are providing additional time to allow everyone in the health care ecosystem to focus on COVID-19 response.”

The announcement occurred just days before the targeted implementation date and only hours before I received the following message from my provider: “As part of our ongoing effort to provide a superior experience and give you access to the information you need to manage your health, XYZ Health will now share with patients their provider notes, lab, and imaging results via their MyChart account in accordance with the 21st Century Cures Act.”

It was heartening to know that this particular health system was on top of the matter, ready to meet the deadline—so much so, in fact, that it decided to go ahead with the implementation. Here’s hoping that was the case across the country. After all, with the announcement of the deadline being pushed back coming so close to the target date, it’s hard to imagine that a provider intent on meeting the original deadline wouldn’t have everything in place and ready to go.

For HIM professionals at organizations that are on board now with the initiative, it’s vital to know the finer points of the implementation. For example, does your EHR permit access to patient notes to providers across the care continuum? Are community or referred providers allowed to update the primary record with the provider’s patient information? Are patients aware of their options concerning access to clinical notes?

For organizations that are already in compliance with the Cures Act, now is an excellent opportunity to take the extra time granted by the extension to plan for a robust strategy that includes clinician and patient education about the value of shared notes.

Eight types of clinical notes must be made immediately available to patients:
• consultation notes;
• discharge summary notes;
• history and physical;
• imaging narratives;
• lab report narratives;
• pathology report narratives;
• procedure notes; and
• progress notes.

Psychotherapy notes and information compiled in anticipation of a lawsuit are exempt from the rule.