Because the CAP and the American Medical Association asked for a broader definition of potential harm, the National Coordinator for Health Information Technology (ONC) office added new language to account for emotional and psychological harm in the agency’s information blocking regulations. The agency recently released an updated Frequently Asked Question (FAQ) document, which enables physicians to consider whether the patient or another person may suffer “substantial harm,” is defined to include “physical, emotional or psychological harm. ”

The FAQ document further clarified that this expanded definition can be considered when evaluating the release of medical records, or test results, to a patient’s performance representative. However, the FAQ does not include an expanded definition when patients request their records.

The Preventing Harm Exception permits clinicians to deny a request for electronic health information (EHI) under certain circumstances that could lead to harm. Both the CAP and the AMA have urged the ONC for clear guidance regarding the information blocking regulations and consider psychological harm as necessary consideration as other harms.

The Preventing Harm Exception allows physicians to deny on a case-by-case basis a request for EHI if it can lead to patient harm, but depends on:

1. Who is requesting access to a patient’s EHI
2. Who is referenced in the EHI
3. What type of harm may occur

The ONC guidance enables physicians to consider emotional and psychological harm and physical harm when releasing a patient’s medical records to the patient’s representative, which is different when a patient requests their medical records. While the CAP appreciates the expanded definition, there is still a potential for psychological or emotional harm for patients accessing their information.

The CAP will continue to advocate with the ONC to develop exceptions for patients who wish to speak to their doctors before receiving alerts about potentially severe or life-threatening illness.