Nationwide electronic health record interoperability, it turns out, isn’t a universal goal.
Some developers and health care providers, motivated by financial gain, try to interfere with the transfer or movement of electronic health records, a practice known as health information blocking.
But last week, the Office of the National Coordinator for Health IT condemned health information blocking. In a letter to Congress, authors wrote that it “frustrate[s] the goals of the HITECH Act,” the 2009 law that invests $35 billion toward the adoption of health IT, “and undermine[s] broader health care reforms.”
“[I]nformation blocking not only interferes with effective health information exchange but also negatively impacts many important aspects of health and health care” and “can undermine consumers’ confidence in their health care providers by preventing individuals from accessing their health information and using it to make informed decisions about their health and health care,” ONC wrote in the letter to legislators on the Appropriations Committee’s Subcommittee on Labor, Health and Human Services, Education, and Related Agencies.
Congress had requested the ONC report on health information blocking as part of its 2015 Consolidated and Further Continuing Appropriations Act.
In its report, ONC said it received 60 unsolicited complaints in 2014 against alleged information blockers, most of which were directed at health IT developers for misconduct like charging fees that prevent easy information sharing and blocking the exchange of information with competitors. Health care providers stymie the movement of electronic health records “to control referrals and enhance their market dominance,” the letter says.
At the same time, ONC said it has a hard time proving an entity is information blocking.
“The full extent of the information blocking problem is difficult to assess, primarily because health IT developers impose contractual restrictions that prohibit customers from reporting or even discussing costs, restrictions, and other relevant details,” National Coordinator for Health IT Karen DeSalvo wrote in a blog post about the letter with Jodi Daniel, ONC’s director for its Office of Policy.
“Still,” they added, “from the evidence available, it is readily apparent that some providers and developers are engaging in information blocking. And for reasons discussed in our report, this behavior may become more prevalent as technology and the need to exchange electronic health information continue to evolve and mature.”
So for now, the health IT agency is focused on actions it can take — many in partnership with other agencies, industry and Congress — to develop a comprehensive strategy to fight information blockers.
“ONC looks forward to working with Congress, industry, and the health IT community to properly address this problem and ensure continued progress towards achieving the goals of an interoperable learning health system,” the ONC officials wrote.