Co-Director of Systems Harmonization, Department of Radiology, Mass General-Brigham; Clinical Operations Officer, Department of Radiology, Massachusetts General Hospital; Harvard Medical School, Boston, Massachusetts.
Radiologist-in-Chief, Massachusetts General Hospital; Juan M. Taveras Professor of Radiology, Harvard Medical School, Boston, Massachusetts.
J Am Coll Radiol. 2021 Jul;18(7):1012-1016. doi: 10.1016/j.jacr.2021.01.016. Epub 2021 Feb 16.
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.
《治愈法案》中的信息阻断条款旨在促进医疗信息技术系统的互操作性，并要求患者、医疗服务提供者和支付方能够立即访问和携带个人电子健康信息。从本质上讲，这项立法要求在进入电子健康记录后，临床信息（包括放射科报告）能够立即访问，不得拖延。但这与许多电子健康记录系统的当前设置相冲突，这些系统采用放射科报告的延迟发布（封存）。在这样的系统中，放射科报告由放射科医生签署后，与报告通过在线患者门户供患者访问之间存在预定的延迟，例如几天到几周。这种做法背后的想法是，延迟可以让转诊医生有时间阅读报告并为患者协调护理，然后患者才会了解到潜在的异常和引起焦虑的影像学发现。在撰写本文时，尚不清楚此类封存程序是否符合信息阻断的定义，从而是否会受到财务处罚。许多医疗服务提供者团体正在为执行信息阻断做准备，他们正在取消报告封存程序。本文描述了通过在线患者门户立即向患者发布放射科报告带来的挑战和机遇，并提出了一些团体可能会考虑的策略，以帮助他们顺利过渡到这种护理模式。
