OHC Issues Plan for Overcoming Health Information Blocking

According to the 2015 Report to Congress on Health Information Blocking, since the enactment of the Health Information Technology for Economic and Clinical Health Act (HITECH), the federal government has invested over $28 billion to facilitate the development of health information technology. The purpose of these investments was “to enable an interoperable learning health system in which electronic health information is available and can be securely and efficiently shared, when and where it is needed, to support patient-centered care, enhance health care quality and efficiency, and advance research and public health.”

While many healthcare stakeholders support this vision, some are using security and confidentiality regulations to avoid sharing data with competitors. Market realities sometimes make it advantageous for corporations to control electronic health information in ways that limit its availability and inhibit its use. According the report, some entities are interfering with the exchange or use of electronic health information in ways that frustrate the goals of the HITECH Act and undermine health care reform.

Information blocking occurs when persons or entities knowingly and unreasonably interfere with the exchange or use of electronic health information. The questionable practices listed in the report included: excessive charges for information sharing; unclear contract terms between EHR vendors and providers; vendor strategies that make it difficult to download information from a competitor’s system; and collusion between providers and vendors that inhibits the transfer of information between competitors. These practices are contrary to the public interest in promoting effective exchange and use of electronic health information.

Information blocking not only interferes with effective health information exchange but also negatively impacts many important aspects of health care. To make informed health care decisions, providers and individuals must have timely access to usable information. Information blocking impairs providers’ ability to make medical decisions, diminishing their ability to provide safe, high-quality care. It also impedes progress towards reforming health care delivery and payment because the sharing of information is essential as we move to a person-centered, high-performing health care system.

In April 2015, the Department of Health and Human Services’ (HHS) Office of the National Coordinator for Health IT (ONC) outlined a plan to address information blocking. According to ONC, information blocking can be most effectively addressed through a “comprehensive approach,” consisting of both “targeted actions” to deter information blocking as well as “broader strategies” that address its further implications. The report lists several immediate actions ONC, HHS, and other federal agencies can take to address information blocking. In its report, ONC outlined a number of targeted actions to deter and remedy such conduct.

Examples of these targeted actions include: strengthening in-the-field surveillance of Health IT certified by ONC; constraining standards and implementation specifications; promoting greater transparency in certified Health IT products and services; establishing governance rules that deter information blocking; improving stakeholder understanding of the HIPAA privacy and security standards related to information sharing; coordinating with OIG and CMS to reward interoperability and discourage information blocking; referring illegal business practices to appropriate law enforcement agencies; and promoting competition and innovation in Heath IT and heath care.

ONC developed this report to provide stakeholders with practical guidance on information blocking, to address the clear public policy concerns in a way that respects the legitimate economic interests of stakeholders, and to assist in identifying information blocking and distinguishing it from other barriers to interoperability and health information exchange.

Brian King is a current student at DePaul University College of Law in Chicago.  Dr. King holds a PharmD from Purdue University and is a practicing Pharmacist in the Chicago area.  He will complete his law degree and certificate in health law in 2017.