Information blocking rule difficult for ONC to sort out

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Without health IT interoperability, the country will not be able to achieve patient-centered care and build a healthcare system that delivers value, according to National Coordinator for HIT Don Rucker, MD.

Interoperable electronic health information is at the heart of a modern healthcare system that is economically efficient, Rucker said Monday during the opening session of ONC’s second Interoperability Forum in Washington.

“If we’re going to have empowered patients who are going to be able to control their medical care, it is hard to imagine that isn’t going to happen through the tools and fruits of interoperability,” he declared.

As directed by the 21st Century Cures Act, Health and Human Services and ONC are required to improve the interoperability of healthcare information. Currently, Rucker’s office is developing a proposed rule that will be used by the HHS Office of the Inspector General to take enforcement activities against those “bad actors” that impede the electronic flow of health data.

On Monday, 14 organizations—including the American Medical Informatics Association and Health IT Now—sent a letter to ONC and the OIG, noting that more than 600 days have passed since the Cures Act was signed into law and that “it is past time” for proposed information blocking regulations to be released.

“Every day that the administration delays implementation of these critical provisions places patients at risk of harm,” state the groups in their August 6 letter, adding that “the lack of clear rules of the road needlessly creates uncertainty for vendors and providers alike.”

Also See: Health IT Now, professional groups push ONC on info blocking regs

However, Rucker told the interoperability conference on Monday that information blocking is a difficult issue to “sort out,” particularly when it comes to coming up with exceptions to the definition of information blocking defined in the Cures Act.

“There are things that are pretty clearly information blocking—there are things that are sort of technical complexity, and how do you draw those lines?” said Rucker. “Our rulemaking here is a work in progress. And, it’s a complicated process in D.C. to do these types of things. But we’re in charge with coming up with exceptions to information blocking.”

“What Congress has asked us to do is to think about what are the exceptions to information blocking—and, that’s what we’re currently working on in our rule,” said Elise Sweeney Anthony, executive director of ONC’s Office of Policy. “Information blocking may have occurred. What are the reasons why it has occurred? And is that a legitimate reason? Those are some of the things we’re thinking about as we think about exceptions.”

Under the Cures Act, the HHS OIG is given the authority to investigate claims of information blocking and assign financial penalties of as much as $1 million per violation for practices found to be interfering with the lawful sharing of electronic health records.

“We hear complaints about information blocking on a regular basis at ONC,” observed Rucker.

“It would be cool if in three years information blocking was not an issue any more,” Sweeney Anthony added.

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