Technical outcome – The health IT must be able to grant access to an identified set of users during an emergency.
Clarifications:
- There is no standard associated with this criterion.
- The criterion is not intended to specify what constitutes an emergency or who would be authorized to access electronic health information in an emergency. Those determinations should be made with applicable state and federal laws, organizational policies and procedures, and the relevant standard of care. Likewise, an “emergency” is not limited to clinical or life threatening emergencies but could include other scenarios such as those related to normal patient care when timely access to electronic health information becomes critical. [see also 75 FR 44617]
- ONC believes this criterion is consistent with the HIPAA Security Final Rule (68 FR 8355), which states “We believe that emergency access is a necessary part of access controls and, therefore, is properly a required implementation specification of the “Access controls” standard. Access controls will still be necessary under emergency conditions, although they may be very different from those used in normal operational circumstances. For example, in a situation when normal environmental systems, including electrical power, have been severely damaged or rendered inoperative due to a natural or manmade disaster, procedures should be established beforehand to provide guidance on possible ways to gain access to needed electronic protected health information.” [see also 75 FR 44617]
- Emergency access is intended to cover a broad range of scenarios, including life threatening emergencies related to the patient as well as normal patient care where timely access to electronic health information becomes critical. [see also 75 FR 44617]
- Emergency access is part of a Health IT' Module's general access control and should be established before the emergency, potentially as a “pre-set” function. [see also 75 FR 44617] The goal of the capability is to ensure that there is a way for identified users to have access (e.g., by elevating their access privileges) in an emergency to gain or maintain access to patient health information, which should be an auditable event. [see also 80 FR 62655] In sum, the "emergency access" functionality should be demonstrated based on the access rules already built into the Health IT Module.
