October 6, 2022
21st Century Cures Act & What You Need to Know
Doctors, nurses, and patient organizations have long debated the beneficence of sharing electronic medical information (i.e. lab results and medical notes) with patients.
On one hand, there are traditional medical professionals who, in an attempt to prevent harm caused by misinterpretations or incorrect assumptions by their patients, prefer to withhold medical information such as notes and results until discussing the results with the patient. This stems from the belief that patients can, and should, be provided with the doctor’s interpretation and experience to guide the initial discussion. On the other hand, there are medical professionals who have embraced the potential benefits of sharing health information with their patients. They believe in the benefit of patient autonomy and appreciate how a well-informed patient can foster a medical relationship and productive conversations.
If you walk the corridors of my hospital and ask the first one hundred people you see (patients, nurses, doctors, technicians, visitors, administrators, etc) whether or not patient results and notes should be made immediately available to all patients, you would likely get one hundred different opinions. It is truly, in the eyes of my professional colleagues, a gray area in our practice. Despite the debate our country has legislatively moved forward.
HITECH, ACA, and 21st Century Cures Act
The first substantial move toward preventing “information blocking” and enhancing interoperability when sharing patient data was created in 2009 after the passage of the Health Information Technology for Economic and Clinical Health (HITECH) act. This was quickly followed in 2010 with the passage of the Affordable Care Act that financially incentivised this data sharing. And, at the end of 2016, the 21st Century Cures Act passed which included rules for improving this interoperability and provisions to prevent information blocking. The mandate that patients have access to a fairly broad, but still somewhat limited, amount of their health information “without delay” and for free became enforceable in 2021.
Today, October 6th, 2022, the rule expands to include all information that could be used to make medical decisions for a patient, which includes billing and charges.
But note. There is the rule and the interpretation. And then there is the implementation. And there are concerning signs that even large health systems will not be able to meet this requirement through traditional methods.
Patient Portals & the Engagement Gap
In order to keep patients informed and practices in compliance, health systems need a method to share health information in real-time with their patients. This must be done without overt barriers and done in a way that encourages use: enter the patient portal. Which is, for better or worse, the nearly ubiquitous way that patients access their medical information.
But let’s face it. Patient portals are difficult to use and painful to look at. They can be impossible to access at certain times of day or when a patient is acutely ill–due to the methods of authentication used in provisioning accounts. This access gap is even more pronounced for people who have traditionally had difficulty navigating the healthcare landscape, which can exacerbate socioeconomic differences. Portals also lack common sense medical information, which can worsen the anxiety of receiving results. In spite of their original promise, patient portals can be a major dissasifier for patients who are attempting to access their health information.
Patient portals also lack key pieces of information, such as simple explanations of lab test results and patient-level educational content, which is a cause of confusion and stress for Americans who on average score poorly on health literacy assessments. Because of this, patient portals often have poor utilization in the hospital setting because they are designed to service outpatient medical practices. In 2020, for example, only about 40% of people in the US accessed their portal accounts. For patients with an acute illness or injury in the hospital or emergency department, these barriers are more pronounced. What this amounts to is a system that only helps a small number of patients and is not designed to help hospitalized people.
Real-time Information Sharing
At Vital, we have always placed ourselves in the shoes of our patient-users. If I was a patient sitting in the emergency department waiting area or admitted into the hospital, what would I want to know? What type of information do I need? And what can I expect to happen next?
We help propel information sharing forward – through an EHR-integrated, secure, patient engagement software that is beautiful, simple, and informative. It is designed to work best during acute care episodes, and patients love it. On an average day in the hospital two-thirds of the patients use our software. Our goal is to be a digital helping hand - guiding patients through their stay and giving them what they need at the right place and the right time. Whether that is a key lab result, delivered right before a doctor comes into the exam room or an AI-calculated wait time delivered just as they have taken their seat in the waiting room, we pride ourselves on giving patients the information and context they need to more confidently navigate their illness and recovery. It is also our belief that having more confident and informed patients keeps our doctors and nurses working at the top of their licenses.
Vital’s ability to provide patients with an easy way to access health information in real-time is a reflection of our ability to innovate and use machine learning and predictive analytics to provide a better experience for all. Given the 21st Century Cures Act and the needs of our patient communities, Vital is ready to help you and your patients quickly access the information needed, on your terms.