HIE Stymied By Closed Systems
By Christine Kern, contributing writer
Health Data Management reports industry stakeholders spoke up at the recent Federal Trade Commission workshop on healthcare competition held in Washington, warning the proliferation of closed data networks means providers and patients are snared into proprietary networks that create barriers to interoperability and competition. Specifically, they charged that some of these health systems use methods to block patient information sharing that have antitrust implications.
"When the government comes with a check and subsidizes the purchase of a system that deliberately does not interoperate, does not communicate with other vendors, the government is effectively perpetuating and supporting that phenomenon," said Dan Haley, athenahealth's VP of government and regulatory affairs. "When the government comes and says we will issue blanket antitrust scrutiny waivers for entities that create ACOs and we will put on the blinders as those entities purchase and implement closed system technologies in an effort to make their networks 'sticky' and consolidate market share, government is perpetuating this problem."
The two-day FTC workshop was designed to study market activities and trends that affect competition in the evolving healthcare industry. According to Jodi Daniel, director of the Office of Policy and Planning in the Office of the National Coordinator for Health Information Technology, from ONC's perspective the goals of market competition and health IT are mutually reinforcing. Competition can be enhanced by interoperable health IT infrastructure, which allows data to flow more freely in the healthcare market, said Daniel. "It can help competition in the healthcare market," which is central to ONC's health IT goals.
Daniel said that ONC is particularly concerned with ensuring that "information follows the patient" by emphasizing interoperability and exchange of health information. "We're both looking at how we can promote innovation and competition to support the exchange of electronic health information, so things like standards and certification, making sure there's trust and confidence through privacy, security and safety, as well as things like exploring how open standards and architectures can lower entrance and looking for governance in health information exchange.”
Haley raised a serious issue, however, when he stated, "When the government comes with a check and subsidizes the purchase of a system that deliberately does not interoperate, does not communicate with other vendors, the government is effectively perpetuating and supporting that phenomenon.
"When the government comes and says we will issue blanket antitrust scrutiny waivers for entities that create ACOs and we will put on the blinders as those entities purchase and implement closed system technologies in an effort to make their networks 'sticky' and consolidate market share, government is perpetuating this problem."
Haley argued that there are many legacy software vendors whose business models are deliberately built around creating closed systems. "If the overriding policy goal is health information exchange and information fluidity nationally, then the government shouldn't be subsidizing those systems," he said. "And, if the goal is sharing information across networks and between networks, then the government shouldn't be turning a blind eye for years to deliberate data lock and market consolidation that comes from it."