Report Finds ‘Information Blocking' Stymies EHR Reform
By Christine Kern, contributing writer
Security and confidentiality are often used as excuses for impeding information sharing.
The Office of the National Coordinator for Health Information Technology asserts “information blocking” is an impediment to information sharing which will likely become more pronounced as HIT expectations and technological capabilities continue to evolve and mature. This according to a report to Congress which also discovered technology vendors, hospitals, and healthcare systems often use security and confidentiality as excuses to restrict data access and block information sharing.
According to the report, “Based on the evidence and knowledge available, it is apparent that some healthcare providers and health IT developers are knowingly interfering with the exchange or use of electronic health information in ways that limit its availability and use to improve health and healthcare. This conduct may be economically rational for some actors in light of current market realities, but it presents a serious obstacle to achieving the goals of the HITECH (Health Information Technology for Economic and Clinical Health) Act and of healthcare reform.”
According to ONC, most complaints about information blocking target HIT developers. “Many of these complaints allege that developers charge fees that make it cost-prohibitive for most customers to send, receive, or export electronic health information stored in EHRs, or to establish interfaces that enable such information to be exchanged with other providers, persons, or entities,” report authors write.
“Some EHR developers allegedly charge a substantial per-transaction fee each time a user sends, receives, or searches for (or ‘queries’) a patient's electronic health information. EHR developers may also charge comparatively high prices to establish certain common types of interfaces—such as connections to local labs and hospitals. Many providers also complain about the costs of extracting data from their EHR systems for their own use or to move to a different EHR technology.”
However, Chris Van Gorder, president and CEO of Scripps Health, told Health Leaders Media most providers acknowledge health records belong to the patient, not the healthcare organization. He explained that the only legitimate concern providers might have with data exchanges is confidentiality.
The crucial issue, he continues, is the lack of interoperability of the data. “We have no standards and requirements for interoperability and that is a huge problem. We are at the point now where we are connecting medical devices to electronic patient records, except that the makers of medical devices have not yet done what the makers of USB sticks have done.”
The report also outlines several actions ONC, HHS and other federal agencies can take to address the problem, including strengthening surveillance of health IT in-the-field, constraining standards and implementation specifications, increasing transparency in certified health IT products and services, establishing rules to deter information blocking, and efforts to improve stakeholder understanding of HIPAA privacy and security standards in light of information sharing. The report asserts that “successful strategies to prevent information blocking will likely require congressional intervention.”
Healthcare Dive reports these findings should be surprising, given that providers are struggling with siloed data that many say IT vendors treat as a competitive advantage.