Rucker: Problem of info blocking in healthcare is improving

The problem of electronic information blocking in healthcare has been improving since the 21st Century Cures Act was signed into law, according to National Coordinator for Health IT Don Rucker, MD.

In 2015, ONC sent a report to Congress detailing how “bad actors” are interfering with the exchange or use of electronic health information in ways that are frustrating the goals of the HITECH Act as well as undermining broader healthcare reforms.

However, in a keynote address on Friday at ONC’s 2018 Annual Meeting, Rucker told the audience that since the enactment of the Cures Act, information blocking has become less of a problem.

“We’ve already seen a lot of behavioral change just since the Cures Act was passed in December of 2016,” said Rucker, although he did not provide any metrics quantifying the improvement during the past two years. “I think we’re definitely making progress there.”

Nonetheless, ONC’s 2015 report on information blocking noted that current economic and market conditions are creating business incentives for some healthcare providers and EHR vendors to exercise control over electronic health information in ways that unreasonably limit its availability and use.

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Donald Rucker, MD

“What we want to do is to have as much of that be as broadly available as we can,” noted Rucker. “Information needs to be shared in a pro-competitive way. It cannot just be that one part of the economy or one sector in healthcare has built sort of an isolated system—and that does happen.”

As directed by the Cures Act, the Department of Health and Human Services and ONC are required to improve the interoperability of healthcare information. Currently, the Office of Management and Budget is reviewing ONC’s long-awaited proposal that will seek to define those exceptions to the definition of information blocking in the Cures Act.

“I think you’re going to see the provisions we have are largely common sense kinds of things,” added Rucker. “ONC is charged with defining the exceptions. OIG does the enforcement.”

Also See: Information blocking rule difficult for ONC to sort out

Under the Cures Act, the HHS Office of the Inspector General is authorized to take enforcement activities against those persons or entities that impede the electronic flow of health data. Specifically, the 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 EHRs.

“We’re hoping that as the (application programming interfaces) get better—as the technology gets better—that this will not be an issue,” concluded Rucker.

Lisa Lewis, deputy national coordinator for operations at ONC, said that the agency’s Notice of Proposed Rulemaking on information blocking and APIs—which has been under review by OMB since September—will be available for public comment soon.

The rulemaking would implement certain provisions of the Cures Act, including conditions and maintenance of certification requirements for health IT developers under ONC’s HIT Certification Program, as well as the “necessary activities that do not constitute information blocking.”

“21st Century Cures (Act) allows us to unlock the power that only technology brings,” added Lewis.

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