Introduction
In an era when information has become a lifeline for patient care, the concept of information blocking in healthcare may seem counterintuitive. Healthcare organizations and Electronic Health Record (EHR) vendors are expected to prioritize the seamless exchange of patient information to ensure the best possible care. However, the unfortunate reality is that information blocking has been a persistent issue, with both providers and vendors implicated in these practices. Let’s review the complex motivations that drive these actions.
The HITECH Act and Unintended Consequences
The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 was a watershed moment for healthcare technology. It provided incentives for healthcare providers to adopt EHRs and promote interoperability. However, with these well-intentioned incentives came unintended consequences.
- Financial Incentives: EHR vendors saw a surge in demand for their products due to HITECH Act incentives. This led to a proliferation of EHR systems in the market, creating a competitive landscape where vendor lock-in became a concern. Some EHR vendors started using information blocking as a strategy to retain customers and ensure recurring revenue from maintenance and upgrades.
- Interoperability Challenges: Achieving interoperability across the diverse array of EHR systems proved more challenging than anticipated. Healthcare organizations and EHR vendors encountered technical hurdles, such as incompatible data formats and standards.
- Data Control: Healthcare organizations have legitimate concerns about data security and patient privacy. Sharing patient data across systems raises cybersecurity and compliance risks. Information blocking could be seen as a way to maintain control over patient data and minimize potential liabilities.
The Profit Motive
Profit-driven motives have played a significant role in information blocking:
- Vendor Lock-In: EHR vendors sometimes intentionally make it challenging to migrate to a different system. They create barriers to data export and integration, effectively locking healthcare organizations into their platforms. This strategy ensures a steady stream of revenue from ongoing support and maintenance contracts.
- Competitive Advantage: Healthcare organizations may view their patient data as a strategic asset. By restricting data sharing, they aim to maintain a competitive advantage over rival organizations. This practice is particularly prevalent in competitive healthcare markets.
- Secondary Markets: Patient data has become a valuable commodity for research, pharmaceutical companies, and marketers. Some healthcare organizations and EHR vendors capitalize on this by monetizing de-identified patient data, often without patient consent.
The Regulatory Quandary
Efforts to combat information blocking in healthcare were first introduced in the 21st Century Cures Act, signed into law in 2016. Included in the law are provisions that require healthcare providers and EHR vendors to facilitate data exchange. As of September 1, 2023, the Office of the Inspector General (OIG) now has the legal authority to enforce information blocking penalties. According to the OIG, “If OIG determines that an individual or entity has committed information blocking, they may be subject up to a $1 million penalty per violation.”
Due to the overwhelming number of information blocking reports the OIG expected to receive (787 possible claims of information blocking were received in the first month, the majority by patients), a triage process was put into place.
Conclusion
Information blocking in healthcare is a multifaceted issue driven by a complex interplay of motivations. Financial incentives, competitive pressures, data control concerns, and profit motives have all contributed to the persistence of these practices. To combat information blocking effectively, a comprehensive approach is needed—one that includes robust regulations, enforcement mechanisms, and a commitment to prioritizing patient care above all else. As healthcare continues to evolve, addressing information blocking will be vital to ensuring that patient data flows seamlessly, enabling healthcare providers to deliver the best care possible.
Smartlink Health solves the challenge of information blocking with its unique and innovative approach to EHR integration. Smartlink’s integration platform bypasses technical and other vendor-based hurdles by integrating with EHRs via the user interface. To learn more about extracting and inserting virtually any data from any type of EHR system in any operating environment without the need to involve the EHR vendor, visit www.smartlinkhealth.com.
