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The 21st Century Cures Act Implementation: What Obstetrician-Gynecologists Should Know

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The 21st Century Cures Act is a comprehensive federal law that, among other things, requires new federal rules surrounding health information. ACOG applauded the act when it was signed into law because it included two long-standing priorities for ACOG: increasing funding for research on medications used by pregnant and breastfeeding patients and ensuring that patients suffering from postpartum depression get needed care. ACOG also urged regulators to take into account and mitigate the administrative burden on physicians when implementing the act.

One aim of the 21st Century Cures Act is to increase patient access to health information and combat information blocking. Under the act, practices and diagnostic providers such as clinical laboratories and medical imaging centers will be required to provide patients immediate digital access to test results. Certain requirements of the act mean that a patient may see test results before their clinicians. These information sharing rules go into effect on November 2, 2020.

I anticipate that obstetrician–gynecologists and other physician offices all over the country will receive panicked calls from patients who are unable to interpret complicated test results or may be using values or interpretations posted on the internet as their benchmarks. There are two potential negative unintended consequences: creating panic, which is not in the best interest of our patients; and disruption of your daily workflow in the office. To prepare yourself, your practice, and your patients, ACOG has developed a checklist  that includes what to review, who to contact, and what to have ready by November 2. I urge you to work with your institution to provide your patients with the information they will need about your workflow so that they will understand when they will receive necessary medical interpretation of their results.

Although well intentioned, the regulatory response to the 21st Century Cures Act did not address the concerns related to administrative burden and the patient–physician relationship. The regulators indicated that delaying access for the clinical interpretation of results does not generally meet the exception requirements. However, there are several exceptions that allow for health information blocking. To assist you and your practice, ACOG released an aid to help you understand the exceptions and to prepare your practice. If you have further queries, please submit them to the ACOG coding ticket database.