WASHINGTON—A government report released last week slammed providers and health information technology vendors for a pattern of business practices that are effectively blocking the easy transfer of electronic health records.
HHS' Office of the National Coordinator for Health IT said “information blocking” by providers and vendors is common, although it couldn't quantify the problem beyond the 60 unsolicited reports of information blocking received in 2014.
The questionable practices outlined in the report included:
- Excessive charges for information-sharing.
- Opaque contract terms between EHR vendors and providers.
- Vendor strategies that make it difficult to download information from EHRs and port that information to competitors' systems.
- Collusion between providers and vendors that prevents easy information transfer between rival software systems or healthcare providers.
An ONC proposed rule released late Friday left the interoperability standard to achieve “meaningful use” at just 10% of EHRs.
Instead, the ONC report recommended the government conduct surveys or require public reporting of complaints to generate better information about the extent of the problem. The report also called for more transparency in contract terms, ramped up field surveillance by certifying bodies to expose and correct anti-sharing practices and turning over cases that might violate existing laws to state or federal law enforcement agencies.
Some EHR vendors welcomed the government's broadside against the industry's poor performance on sharing records. “To the degree there's information blocking, and that can be exposed, that's a good thing,” said Jitin Asnaani, executive director of the CommonWell Health Alliance, a group of EHR vendors formed to promote data-sharing in the healthcare system.
CommonWell includes several of the top EHR vendors in the country but not Epic Systems Corp., the industry's largest software supplier.
The EHR certification process in the government's $30 billion health IT incentive program was supposed to ensure that software met “meaningful- use” requirements such as data-sharing. But many providers complain their newly purchased systems don't perform as advertised.
“Much of the data-blocking is a product of business decisions made by stakeholders that is beyond effective control by the government,” said Robert Tennant, director of health IT policy at the Medical Group Management Association.
Yet stakeholders are reluctant to embrace more far-reaching attempts by government to mandate interoperability. Asnaani, for instance, believes private efforts like CommonWell can address the problem without ONC intervention.
Dan Haley, vice president of government and regulatory affairs for CommonWell member Athenahealth, said he's glad the ONC is shining a light on the difficulties of sharing data. But he wants the agency to take a hands-off approach.
“The market is solving this problem,” he said. “It's not because the federal government is telling us we have to, it's because our clients are telling us we have to.”