What Lies Ahead for Optometry with the Repeal of Net Neutrality
By: Bryan M. Rogoff, OD, MBA, CPHM
There are many ODs who are very tech savvy and enjoy practicing with the latest innovations. Today, a lot of new diagnostic equipment integrates with electronic health records: our point-of-service scheduler communicates directly with patients via email and/or text, and the wonderful, high-resolution images we get from our OCT and anterior/fundus camera are automatically uploaded to our image management software in the cloud. But what if I told you that there might be additional costs to keep those technologies operating like they do today? You may not realize some of the federal regulations that changed recently which may affect the way you, and other health professionals, see patients every day.
As of June 2018, the FCC (Federal Communications Commission) repealed the Open Internet Order of 2015, as commonly known as "Net Neutrality." The 2015 order classified the Internet as a public utility, just like electricity and phone services whereby there cannot be any blocking (where Internet service providers, or ISPs, could not discriminate against lawful content by restricting access to websites), throttling (ISPs were prohibited to slow down any transmission of data due to the content) or paid-prioritization rules (ISPs could not create "fast lanes" for consumers or businesses who paid premiums) to it.1 It allowed consumers to load any website, app, video, etc. equally and not be charged regarding the content. ISPs had to treat ALL content equally, not give preference to any digital content providers. However, in December 2017, this all changed when the FCC passed the "Restoring Internet Freedom" order, which curtails the previous order and reclassified the Internet as an "information service."2
Now, this is not nearly as exciting as getting that new swept–source OCT that you want for your practice, but this can affect how you use that instrument as well as other technologies in your practice that you rely upon for day-to-day operations. Internet access is a necessity from patient portals, telemedicine and having direct connections to other providers of a patient’s care team. HIPAA (Health Insurance Portability and Accountability ACT) is able to protect patient health information (PHI) because of the equal access healthcare providers and patients have. If there is now the ability to throttle, or block PHI or other medical content, this would seriously violate HIPAA.
Opposition to this new order have concerns that the Internet may become a pay–to–play technology by having different tiers and access. How will this affect YOUR practice? Will you have the resources to pay for "fast lane" service like larger or corporate practices have?
You may not have anything to worry about...yet. Major broadband and cable providers, like Comcast and AT&T, stated that they will not block or throttle any websites or content, and will not engage in MOST forms of paid prioritization. But there are some strategies you can implement if changes do happen.
You should start by taking inventory of your practice that requires connectivity to the Internet: Electronic Health Records, Imaging Software, VoIP office phones, etc. Review your current contract with your ISP. Contact your ISP vendor to see what their strategy is for the new "Restoring Internet Freedom" order and if they plan to install "fast lanes." If they are, will they pass along the cost to consumers? See if you are locked in to a particular rate for the length of the contract and see if you can negotiate with your ISP to extend your current contract and lock rates.
As YOUR practice moves to more cloud–based systems and real–time communications, those ODs who are proactive will mitigate overall success for any transition.
Bryan M. Rogoff, OD, MBA, CPHM has a unique background in areas of holistic eye care, business management and healthcare reform. He specializes in LEAN clinical management and operations, technology implementation, healthcare strategy, and strategic partnerships. Currently, he serves as a consultant for for the FDA, Immediate Past-President & Education Chairperson for the Maryland Optometric Association, Federal Keyperson and Meetings Committee Member for the American Optometric Association, reviewer for the Council on Optometric Practitioner Education and is the Founder of Eye-Exec Consulting, LLC. To contact Bryan, visit www.eye-exec.com or email firstname.lastname@example.org. He can also be found on LinkedIn, Facebook, Twitter and Instagram.