ers to market entry for innovation and developing new solutions
or products. Opponents to net neutrality, including many ISPs,
said the rules amounted to over-regulation by the government
and limited their ability to manage internet services as well as
raise funding to expand and update broadband services.
Once this repeal becomes effective, the Federal Trade Commission (FTC) has said it plans to safeguard consumer protections by resuming its jurisdiction to “police the conduct of ISPs,
including with respect to their privacy practices. Once adopted,
the order will also require broadband internet access service
providers to disclose their network management practices, performance, and commercial terms of service.”
3 The FCC and FTC
crafted a memorandum of understanding and explained how
they expect to work together to protect consumers’ privacy and
policing of ISPs through the following actions:
Compliance activities of the Restoring Internet Freedom order
will be driven by informal complaints rather than through an
auditing process. Now, ISPs must publicly disclose information regarding their network management practices, performance, and commercial terms of its internet access services.
The FTC will investigate complaints and take the appropriate course of action once the accuracy of those complaints
has been confirmed.
The FCC and FTC expect to share legal and technical expertise
as well as collaborate on consumer outreach and education.
Impact on Healthcare Services
Although the FCC order was recently determined and the full impact remains to be seen, health IT stakeholders anticipate several
consequences of this decision. Since the adoption and use of telemedicine has gained traction both in terms of reimbursement and
technology use, this data-centric technology relies heavily on the
internet to connect patients to their providers and even remote
monitoring. Providers with adequate resources will have the ability to improve their infrastructure and pay for a “fast lane,” allowing
for more reliable and faster internet service. But smaller healthcare
providers and those in rural communities with fewer resources will
potentially experience a weakened and slower internet service—
negatively impacting patient care and certainty in the service.
EHRs have also become increasingly reliant on the ability to
quickly access patient data that is maintained in the cloud. The
ability to exchange this data with other providers and continue
down the path of interoperability, as described in the 21st Century Cures Act, is critical to patient care. Over the last several
years medical devices and personal devices have become ubiquitous and require connectivity to transmit and use information
for healthcare or for just personal use. Costs to improve speed
and access may be passed down to the consumer or provider.
There has been much controversy associated with Commissioner Pai’s decision, with many groups lobbying Congress to
reverse the change in whole or in part. On December 19, 2017,
House of Representatives Rep. Marsha Blackburn (R-TN) introduced the Open Internet Preservation Act, H.R. 4682, a bill that
ensures an open internet and prohibits blocking of lawful content, services, devices, and applications.
This bill, which has received strong Republican support and
sponsorship, restores two provisions of the FCC’s net neutrality rules: the ban on blocking websites and the ban on slowing
down websites. The FCC’s lifted ban on paid prioritization—the
ability of internet providers to charge money to speed up certain
websites—is not included in Rep. Blackburn’s bill because it focuses on areas of bipartisan agreement—and paid prioritization
is not one of those areas.
4 The Open Internet Preservation Act
has been referred to the House Energy and Commerce Committee for consideration as of press time. But with several other
legislative priority issues facing Congress, the chances of this
proposed legislation moving forward are diminished.
The US courts may also soon weigh in. In January, the Internet
Association—a lobby group representing dozens of companies,
including Google and Facebook—joined lawsuits aimed at stopping the repeal of net neutrality rules.
Net neutrality will remain a controversial issue despite what happens in Congress and the courts, with repeal supporters believing
this change will be an innovation boon for new products and improved ISP services while opponents insist it will negatively impact
critical services required in the transitioning health IT spectrum. ¢
1. Jacobson, Lindsey. “What is Net Neutrality?” ABC News.
December 11, 2017. http://abcnews.go.com/Technology/
2. Federal Communications Commission. “In the Matter of
Protecting and Promoting the Open Internet.” GN Docket
No. 14-28. February 26, 2015. https://apps.fcc.gov/edocs_
3. Federal Trade Commission. “FTC, FCC Outline Agreement to Coordinate Online Consumer Protection Efforts
Following Adoption of The Restoring Internet Freedom
Order.” December 11, 2017. www.ftc.gov/news-events/
4. Fung, Brian. “Days after the FCC repealed its net neutrality
rules, the GOP has a bill to replace them.” Washington Post.
December 19, 2017. www.washingtonpost.com/news/
Adams, Jim and Greg Kuhnen. “Why ending net neutrality will likely
be bad news for health care.” Advisory Board. December 14, 2017.
Spitzer, Julie. “ 3 ways the net neutrality repeal could affect
healthcare.” Becker’s Hospital Review. December 14, 2017.
Allison Viola ( firstname.lastname@example.org) is the director of health IT policy at Kaiser
Permanente Information Technology, based in Washington, DC.