- Regulators have yet to determine an appropriate punishment for providers found blocking the free flow of information between disparate systems, but "that work is now well underway," according to Micky Tripathi, head of the Office of the National Coordinator for Health IT.
- The 21st Century Cures Act passed in 2016 said regulators could fine up to $1 million per information-blocking incident, but left it up to the secretary of HHS to define exact punishment. "Unfortunately, not only have such disincentives not been identified, there was no process in place to see how they be defined," Tripathi said, speaking virtually on Tuesday at HIMSS' annual healthcare conference in Las Vegas.
- HHS has formed a workgroup to talk about defining appropriate disincentives, but Tripathi declined to share more detail on its timeline, though he's previously said disincentives would be codified by the end of 2021. An ONC spokesperson declined to comment if that timeline still held, or provide specifics on what members or stakeholders comprised the disincentives workgroup.
ONC's top five priorities right now are the COVID-19 response and supporting public health, aligning with federal partners, working to improve health equity, improving EHR and interoperability standards adoption and renewing emphasis on implementing the 21st Century Cures Act, Tripathi said.
Following two delays because of the pandemic last year, a compliance deadline for two sweeping regulations implementing key interoperability provisions of the five-year-old law finally kicked in April this year. Since then, hospitals and EHR vendors have had to be able to exchange certain types of medical data with one another, to ensure patients can access their information where and when they need it.
But the fact that HHS has yet to codify appropriate disincentives for providers found guilty of information blocking is probably the "biggest gap to be filled on the enforcement side," Tripathi said.
According to 21st Century Cures, CMS defines what the disincentives are for providers, while HHS' Office of the Inspector General actually enforces them. Tripathi told Healthcare Dive in May ONC was working with OIG and CMS to line up the timing and appropriate disincentives would likely be codified before the end of the year.
On Tuesday, Tripathi said he would share more information with the public "as soon as it's available."
Also at the panel on interoperability and public health infrastructure, the health IT veteran, who took the reins of ONC in late January, reaffirmed that ONC doesn't hold responsibility for adjudicating individual cases of information blocking, but reminded industry about the eight exceptions to the rule if they're uncomfortable sharing patient data.
Those "reasonable and necessary" exceptions to the definition of information blocking are: preventing harm, promoting electronic health information privacy, responding to infeasible requests, maintaining and improving health IT performance, promoting information security, recovering reasonably incurred costs, licensing interoperability elements and the "content and manner" exception, which an actor can satisfy if it provides at least the content within the USCDI in response to a request for access.
"We recognize there are good and valid reasons not to share information," Tripathi said. "I strongly urge you to look carefully at the exceptions."
Tripathi also outlined ONC's progress with the Centers for Disease Control and Prevention in fulfilling an executive order from President Joe Biden directing health regulators to enhance federal collection, sharing and analysis of coronavirus data, and include a review of interoperability and connectivity in public health data systems.
The joint ONC-CDC workgroup is currently in the middle of analyzing the U.S. public health landscape and is outlining recommendations for improvement, said Daniel Jernigan, the CDC's Acting Deputy Director for Public Health Science and Surveillance. Jernigan, who joined Tripathi on Tuesday's panel, said the workgroup would likely be working through the fall and expected to send a report to HHS Secretary Xavier Becerra by the end of the year.