Cures Act Definition of EHI Expanded to Include Additional Data

The Cures Act Final Rule limited the scope of electronic health information (EHI) that must be shared to data included in USCDI version 1 for approximately 18 months after the Final Rule publication date to allow stakeholders time to ramp up their information sharing capabilities and processes.

On October 6th, stakeholders must begin exchanging more EHI. ONC Deputy National Coordinator Steven Posnak noted in a recent blog post that not all electronic health information is considered EHI under the regulatory definition.

“The good news is that the EHI definition as of October 6th is something with which most information blocking actors have had 20 years of familiarity – the Designated Record Set (DRS) as defined under the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule,” Posnak explained.

A “designated record set” is defined at 45 CFR 164.501 as a group of records maintained by or for a covered entity that is comprised of:

• Medical records and billing records about individuals maintained by or for a covered health care provider;
• Enrollment, payment, claims adjudication, and case or medical management record systems maintained by or for a health plan; or
• Other records that are used, in whole or in part, by or for the covered entity to make decisions about individuals. This last category includes records that are used to make decisions about any individuals, whether or not the records have been used to make a decision about the particular individual requesting access.

For additional information about the Designated Record Set and which data are not included, please refer to Individuals’ Right under HIPAA to Access their Health Information on the HHS website or 45 CFR 164.501.

Posnak’s blog post also addresses eight regulatory reminders from the ONC including the approved exceptions to the information blocking provision of the Cures Act.

As an additional resource, the ONC recently launched a webpage dedicated to information blocking that contains links to basic regulatory information, fact sheets, frequently asked questions, and more. These resources can be useful in helping stakeholders named in the Cures Act broaden their understanding of the regulation.