For this week’s discussion, I picked the 21st Century Cures Act, specifically the Open Notes Rule, enacted during the COVID-19 pandemic in 2020. This federal law changed the management of patient care by enhancing care coordination and empowering patients with control over their health information. The most significant impact was the prohibition of “information blocking,” which requires healthcare providers to share medical records with patients almost in real-time. Where records were once primarily for medical staff, they are now accessible to patients, fostering improved communication and adherence to treatment plans, ultimately resulting in better health outcomes.
The implementation of the Open Notes Rule necessitated advancements in healthcare technology. Key components include the requirement for a provider directory, allowing digital contact information to facilitate the sharing of electronic health information (EHI) via mobile apps. Additionally, hospitals now have to send notifications about admissions, discharges, and transfers to primary care providers, enhancing coordination and enabling timely care. These technological improvements required hospitals and healthcare systems to adapt their workflows and embrace new digital tools, bolstering efficiency and communication across the board.
While these changes offer many benefits, I personally wish the law had included a prohibition against blocking visitation. As an RN working in the ICU and a traveling nurse during the pandemic, I witnessed numerous patients facing the end of life without the comfort of loved ones by their side in several hospitals. Implementing measures to prevent visitation blocking could have provided patients and their families with the opportunity for a final goodbye, offering vital emotional support during their last hours. Overall, the transition brought about by the Open Notes Rule has been relatively smooth. I personally use it to manage and view my health care through the VA. However, I often find that information is incomplete or not properly revised almost as if it was just a preset template that they don’t even take the time to fill out correctly. It’s not perfect but I do think the act opens up opportunity for improved patient engagement and more efficient care while setting the stage for future improvements.
References:
Salmi, L., Mansouri, S. A., & Taylor, L. P. (2021). New federal rule requires open notes: what do clinicians and patients need to know? Insights and suggestions from a neuro-oncologist, a neurosurgeon, and a person living with a brain tumor. Neuro-oncology practice, 8(3), 233–235. https://doi.org/10.1093/nop/npab014Links to an external site.
Magid, S. K., Cohen, K., & Katzovitz, L. S. (2022). 21st Century Cures Act, an Information Technology-Led Organizational Initiative. HSS journal : the musculoskeletal journal of Hospital for Special Surgery, 18(1), 42–47. https://doi.org/10.1177/15563316211041613
