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EHR Data 'Blocking' Hobbles HIT, Says ONC

By John Commins  
   April 13, 2015

Technology vendors, hospitals, and health systems restrict data access under the guise of security and confidentiality, but it can be challenging to identify and differentiate information-blocking from more benign impediments, says an ONC report.

The federal government's $28 billion investment in health information technology interoperability is undermined by vendors and providers who don't want to share data with perceived competitors, a new study says.

In a report requested by Congress, the Office of the National Coordinator for Health Information Technology said that "information blocking" is a significant problem that is likely to get worse as expectations and the capabilities for HIT mature and improve.

Because of gray areas that include contract restrictions on the disclosure of relevant evidence, and unavoidable technology glitches and snafus, ONC said it can be challenging to identify and differentiate information blocking from more benign impediments.

"However, 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 health care," ONC said.

"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."

Most complaints about information blocking target HIT developers, ONC said.

"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," the report says.

"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."
 
Providers were not exempt from criticism, particularly hospitals and health systems that ONC said were blocking data access under the guise of security and confidentiality to control referrals and enhance market dominance.

"Such constraints are not information blocking insofar as they are consistent with the requirements and policies established by federal and state law that protect patients' electronic health information," ONC said. "But it has been reported to ONC that privacy and security laws are cited in circumstances in which they do not in fact impose restrictions."

John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.

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