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Administration Threatens Penalties for Blocking Health IT

By Rebecca Adams, CQ Roll Call

April 10, 2015 -- The Obama administration warned Friday that any health IT developers, medical providers, or others who might be deliberately making it hard to share electronic health records could pay a price for obstruction in the future.

Hospitals and other providers have often found it challenging to transfer electronic health records to other systems. The Office of the National Coordinator (ONC) said in a 39-page report to Congress Friday that in addition to the typical technical and practical hurdles to achieving interoperability, some IT developers and providers are deliberately interfering with the exchange of electronic health information.

ONC officials outlined a series of steps that federal agencies are taking or considering to prevent the blocking of information. Options include creating new rules to discourage the blocking of health record-sharing, referring any illegal business practices to law enforcement agencies and coordinating with the Health and Human Services Office of Inspector General to deter any interference with record transfers.

The report also said ONC officials may work with the Centers for Medicare and Medicaid Services to affect the pay of groups that are blocking the sharing of information. CMS could coordinate health care payment incentives to reward interoperability and penalize those who block information.

Congress also should step in, according to the report.

"Successful strategies to prevent information blocking will likely require congressional intervention," the report stated.

One example of blocking is when IT developers charge high transaction fees that hit every time a user sends, obtains or searches for a patient’s electronic health information. Some health IT developers also may charge high fees for creating common interfaces that can communicate easily with other systems.

The ONC already proposed in a certification criteria rule issued last month that accrediting boards should do more surveillance and require that providers be informed of what any transaction fees could be before they sign contracts.

Another example is when a hospital or physician’s practice blocks information in order to control referrals and enhance their market dominance.

The report noted that sometimes "even conscious decisions that prevent information exchange may be motivated by and advance important interests, such as protecting patient safety, that further the potential to improve health and health care. These interests must be carefully balanced with the potential benefits from sharing of electronic health information."

But ONC officials said that often there are not any reasonable justifications for obstacles to record-sharing.

"It is a serious problem—and one that is not being effectively addressed," said the report, which called on Congress to change the status quo.

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