Major Health IT Groups Push for Proposed Rule on Information Blocking

Sept. 5, 2017
Health IT Now and various other industry organizations have sent a letter to the Office of the National Coordinator for Health IT (ONC) and the Department of Health and Human Services (HHS) pushing for more details on information blocking.

Health IT Now and various other industry organizations have sent a letter to the Office of the National Coordinator for Health IT (ONC) and the Department of Health and Human Services (HHS) pushing for more details on information blocking.

Specifically, the letter to ONC chief Donald Rucker, M.D. and HHS Inspector General Daniel Levinson calls for a proposed rule to be developed by federal officials that answers what the groups attest are important questions to provide clarity around the 21st Century Cures provision around information blocking:

  • What is information blocking and what is not?
  • What constitutes “special effort” in eliminating blocking and promoting interoperability?
  • How ought "should have known" be defined?
  • How should patient access be measured?
  • How does the law interact with existing laws like HIPAA and medical malpractice?

The letter said, “We understand that implementing these provisions will require a nuanced approach and believe the best first step for the administration in implementing these provisions is to gain broad stakeholder input.”

As previously reported by Healthcare Informatics, some of the core health IT components of the Cures legislation, as read in the “Title IV—Delivery” section of the law, include encouraging interoperability of electronic health records (EHRs) and patient access to health data, discouraging information blocking, reducing physician documentation burden, as well as creating a reporting system on EHR usability.

As part of the Cures Act’s definition of interoperability, the legislation says there must be no information blocking as defined in section 3022(a). And, information blocking is defined in the law as, with respect to a health information technology developer, exchange, or network, business, technical, or organizational practices that, “except as required by law or specified by the Secretary, interferes with, prevents, or materially discourages access, exchange, or use of electronic health information; and the developer, exchange, or network knows, or should know, are likely to interfere with or prevent or materially discourage the access, exchange, or use of electronic health information.” And with respect to a healthcare provider, “such provider knows that such practice is unreasonable and is likely to interfere with, prevent or materially discourage access, exchange or use of electronic health information.”

The Cures Act doesn’t come without consequence or penalty, either: regarding information blocking, developers, exchanges, and networks found to have engaged in data blocking and who have submitted a false attestation would be subject to civil monetary penalties not to exceed $1 million per violation.

The letter from Health IT Now and major industry stakeholders such as the American Academy of Family Physicians, the American Medical Informatics Association, and vendors such as athenahealth, McKesson and others, also said that a proposed rule would address things such as what a violation entails of; defining standard vs. non-standard implementation; how active information blocking should be differentiated from business conduct such as contract terms; what constitutes a complete record; and more.

The letter concluded, “We stand ready to assist in the implementation this complex law, and to take the needed steps to put an end to information blocking. We propose a discussion session in September with your team and our stakeholder group to discuss the questions and provide commentary in developing the proposed rule.”

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