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.