By Katie Messner, DO

The 21st Century Cures Act is live, and it impacts the entire healthcare industry—including your dermatology clinic. 

Amendments to the Clinical Laboratory Improvement Amendments (CLIA) and the HIPAA Privacy Rule of 2014 allow for the release of real-time laboratory and imaging results to patients. It’s only recently that the law came to include pathology reports. 

The Cures Act drives interoperability within the healthcare industry and expands patients’ access to their medical information via electronic devices or smartphones. This initiative will encourage better care and outcomes for patients and dermatologists. 

“In a future where data flows freely and securely between payers, providers, and patients, we can achieve truly coordinated care, improved health outcomes, and reduced costs,” CMS reports. But what does this drive to interoperability and digital technology mean for your dermatology clinic? 

In addition to implementing EMR technology, these federal changes will require some adjustments in your clinical workflow. Addressing three questions about the impact digital innovation will have on the availability of patient information, transparency, and reporting will reinforce safe and effective practices for efficient care and elevate the patient experience.

When will lab results be available to patients?

Although medical information should be available electronically per a patient’s request, access to pathology test results via a patient portal, for example, shouldn’t supersede the doctor’s opportunity to review the test results before the information is available to the patient.

The good news is that eight exceptions can prevent doctors’ actions from being construed as information blocking. In this case, the infeasibility exception states that it’s not information-blocking if the request can’t easily be granted due to issues with the type of information requested and available resources.

Communicating to your patient during the exam that their test results will be available after being reviewed by the doctor should help minimize confusion. Although the test results are accessible digitally, emphasize that you’d like to meet with them either in person or via a telehealth visit to discuss those results. It would help if you also consider working with a digital lab like PathologyWatch, which offers quick turnaround times on lab results to allow more time to review them.

How will you control transparency?

Per the 21st Century Cures Act, patients can request their whole record. That means patients can see the names of the lab that processed results, the name of the dermatopathologist, and other contact information that may blur boundaries between the patient, your clinic, and the lab testing review process. 

A healthy physician/patient relationship rests on clear communication and trust. Without it, patient care will feel fragmented and confusing. Be proactive in explaining what your patient can expect following their exam. Make it clear that your office is their point of contact for fielding questions about their care. Then adjust your staff’s responsibilities and office processes to ensure those inquiries are handled promptly. 

Who is your audience for reporting? 

To put it simply, it’s no longer a mystery to patients what doctors say about them in their medical files. For instance, if the patient is noncompliant or appears morbidly obese, they can read all about it in their medical file. 

But this newly expanded access to patient information also spurs a debate about the language used in patient files. Should a doctor use more commonly understood terminology and avoid medical jargon for the sake of catering to the patient reading it? 

The primary purpose of recording a patient’s medical information is to create a medical record for you to monitor your patient’s history and bill payers and to communicate with medical colleagues who also treat your patients. Although your patient has access to this information, some dermatologists argue that they are not your audience.

“The psychology of this process seems to detract from the goal of smooth and effective care and the privilege of methodical clinical documentation and discussion without the possible paranoia of wondering who’s reading it,” asserts Lorraine Rosemilia, MD, FAAD

Warren R. Heymann, MD, FAAD, agrees: “While I appreciate the advantages of transparency and disclosure of all medical data, we went to medical school for a reason—to provide compassionate care, enveloped in providing information in the right context.”

The goals for the expansion of data availability are to deliver quick access to care, reduce costs, and improve the quality of care. But this technology evolution requires buy-in from providers committed to adapting their workflow processes to support interoperability.

While this initiative will likely face numerous changes in the coming years, the future of healthcare will undoubtedly continue on the path to better processes that engage patients, providers, and payers with thoughtful digital transformation.