Background: Information blocking is a practice by an "actor" that is likely to interfere with the access, exchange, or use of electronic health information (EHI), except as required by law or specified in an information blocking exception. The Cures Act applied the law to healthcare providers, developers of certified health IT, and health information exchanges (HIEs)/health information networks (HINs).

From April 5, 2021, through October 5, 2022, EHI is defined as limited to the EHI identified by the data elements represented in the U.S. Core Data for Interoperability (USCDI). Starting October 6, 2022, the EHI definition is no longer limited to the EHI identified by the data elements represented in the USCDI.

What This Means: On October 6, 2022, the information blocking definition expands to include the entire scope of the definition of EHI—including, electronic protected health information (ePHI) that is or would be in a Designated Record Set (DSR). Note that the definition of EHI incorporates terms (ePHI and DRS) defined by HIPAA.

An abridged definition of EHI provided by the Office of the National Coordinator of Health Information Technology (ONC) states the following: EHI is electronic protected health information (ePHI) to the extent that it would be included in a designated record set. If the information is individually identifiable health information that is maintained in electronic media OR transmitted by electronic media AND would be included in certain groups of records AND is not excluded from the EHI definition, then it is EHI. The groups of records include:

• medical records and billing records of a provider about individuals
• enrollment, payment, claims adjudication, and case or medical management record systems maintained by or for a health plan
• records used in whole or in part, to make decisions about individuals

A list of exclusions can be found here.

Actors who are likely to interfere with the access, exchange, or use of EHI could be considered information blockers and subject to penalties or disincentives. EHR vendors and HIE/HINs can receive up to $1 million in civil monetary penalties per violation. Penalties and other "disincentives" for physicians have yet to be determined by the U.S. Department of Health and Human Services (HHS).

Practices may want to review and assess their information blocking compliance policies and procedures and contact their EHR vendors to find out how they are preparing to assist practices in meeting the October 6 EHI deadline.

Please see the following resources from ONC for additional information:

• Understanding the Scope of Electronic Health Information (EHI) for the Purposes of the Information Blocking Definition
• Understanding Electronic Health Information – includes EHI definitions, exclusions, and how to determine if information is EHI

For even more on information blocking please see ONC’s Information Blocking website.

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