The impact of the Cures Act and information blocking on EHI requests

What steps has your skilled nursing facility (SNF) taken to ensure compliance with the 21st Century Cures Act final rule on information blocking? Preparation for this new regulation requires knowing what qualifies as information blocking, understanding the rule exceptions, and evaluating your agency’s process for providing access to electronic health information (EHI).

Defining information blocking

As part of the 21st Century Cures Act final rule, SNFs and other healthcare organizations cannot perform any actions that could interfere with the access, exchange, or use of EHI. For SNFs using EHR software, patient health information should be shared upon request electronically without human interference, offering clinicians timely access to health data when collaborating with care providers.

To avoid information blocking, the following EHI must be easily accessible upon request:

  • Patient information
  • Vital signs
  • Medication list
  • Assessment and treatment plan
  • Care team members
  • Clinical notes
  • Patient goals
  • Health concerns
  • Labs and medications

Examples of information blocking include:

  • Requiring a patient to provide consent before sharing the patient’s EHI with other providers for treatment or care coordination if such consent is not required by law.
  • Taking several days to respond to an EHI request when the provider can provide same-day access to EHI.

Rule exceptions to information blocking

Some healthcare providers and networks perform functions that are considered both necessary and reasonable. However, they could be misconstrued as information blocking. To avoid confusion and misjudgment, the Office of the National Coordinator (ONC) for Health Information Technology devised rule exceptions allowing these entities to continue certain practices without risk of noncompliance. Currently, there are eight exceptions to the information blocking provision that fall into two categories: exceptions that involve not fulfilling requests to access, exchange, or use EHI (preventing harm, privacy, security, infeasibility, and health IT performance) and exceptions that involve procedures for fulfilling requests to access, exchange, or use EHI (content and manner, licensing, and fees).1

Exceptions that involve not fulfilling requests to access, exchange, or use EHIExceptions that involve procedures for fulfilling requests to access, exchange, or use EHI
  • Preventing harm
  • Privacy
  • Security
  • Infeasibility
  • Health IT performance
  • Content and manner
  • Licensing
  • Fees


Measures an agency can take to ensure compliance

1. Review your agency’s current practices.

Evaluate how your agency currently responds to EHI requests. Then, identify practices that could be considered information blocking. Develop and maintain procedures for documenting and processing EHI requests that keep your agency within compliance standards.

2. Develop a policy on information blocking.

Have written standards that cover this important topic. So, make sure to consult your legal counsel for guidance on development and implementation. Once a policy is in place, educate your staff. Also, make sure all team members understand the importance of incorporating this policy into their daily work functions.

3. Make sure patient health information moves seamlessly across the care spectrum.

Lastly, your agency plays a pivotal role in the effort to provide patients, patients’ families, and other providers with secure access to EHI upon request and at the proper time. So, by understanding the guidelines associated with the 21st Century Cures Act final rule and information blocking, your agency can better evaluate how it manages and shares patient health information to ensure compliance milestones are met.



  1. ONC’s Cures Act Final Rule. Accessed June 11, 2021.

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Amy Ostrem

Amy Ostrem, Vice President, Strategy & Portfolio Management, has been working with our products and service teams for more than 2 decades. She originally was a client before joining the company as a Client Education Consultant and has served in various departments and roles through her tenure. In her current role, she divides her time between client communications, client service teams, sales enablement, and product development teams. Ostrem oversees the Product Strategy, Value Proposition, Commercialization, Product Managers, and Business Analysts. She participates in industry events, client engagement sessions, focus groups, our annual Inspire event, and presents regularly at provider advisory boards. Ostrem holds a bachelors degree from Concordia College in Healthcare Financial Management.

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