CHICAGO — The American Medical Association (AMA) enthusiastically supports the Biden administration’s proposal to give patients and physicians more control over health records without worrying about administrative and even criminal charges. 

In a letter (PDF) , the AMA said it supported clear, flexible exceptions to information blocking rules that would allow patients to request that physicians deliver life-changing information instead of making it immediately available on electronic health records. The proposal also would allow physicians to protect their patients from efforts to criminalize reproductive health care without triggering information-blocking penalties. 

Accommodating patient preferences

The AMA notes in its letter that patients have diverse needs when it comes to accessing their health data. The Assistant Secretary for Technology Policy/Office of the National Coordinator’s (ASTP/ONC) proposal represents a positive step toward respecting and accommodating how patients prefer to receive life-changing medical information. 

The AMA has long sought clarity in these situations. Patients deserve the right to control how they receive their medical information, particularly in sensitive situations where unexpected results could cause undue distress. This proposal will protect physicians from penalties when honoring the patient’s requests. 

The AMA, however, has identified several issues that must be addressed by ASTP/ONC for its proposals to be successful. These include requiring EHR developers to give patients control of their information and to ensure patients can communicate their preferences in a way that best suits their needs.

Protecting care access

The AMA has long advocated for clear federal policies to protect sensitive electronic health information (EHI) from misuse, ensuring that physicians can safeguard their patients' civil liberties without fear of federal penalties. The ASTP/ONC policies would provide much-needed clarity and flexibility, enabling physicians to prevent the sharing of health information that could result in legal risks for patients and physicians. Physicians would be able to take these steps without facing information blocking penalties. 

“In the aftermath of the Dobbs v. Jackson Women’s Health Organization decision, reproductive health data is increasingly being weaponized by state officials and others. States are targeting individuals who receive or facilitate access to reproductive health care, often identifying them through medical records requests. Confusion surrounding information blocking regulations, and their exceptions, further facilitates unrestricted access to EHI. Currently, there are no exceptions specifically designed to address concerns about the legal risks (e.g., investigations, court actions, or liability) that could arise from the access, exchange, or use of specific EHI,” the letter said.

Without this guidance, physicians are confused, hesitant to use existing exceptions, and fear information blocking accusations or penalties. Instead, the proposals make clear that physicians would be permitted to segment sensitive reproductive records from a patient’s EHI. 

Leveraging technology to improve prior authorization and benefit transparency

The AMA also welcomes ASTP/ONC’s policies to modernize and standardize the prior authorization process using technology. Prior authorization is cumbersome and time-consuming, leading to significant administrative burdens on physicians and delays in patient care. By requiring certified technology and EHR developers to support electronic prior authorization and real-time benefit transparency, ASTP/ONC is taking a significant step towards improving the efficiency of care delivery.

The AMA believes the proposed rule to require real-time information and standardized electronic prior authorization will help alleviate administrative burdens, reduce delays in care, and, most importantly, improve health outcomes for patients.

The AMA strongly encourages ASTP/ONC to collaborate with other government agencies to ensure payors adopt these certified technologies, ensuring seamless communication between payors and physicians and enabling timely access to care.

The full letter can be found here.