Extensive and effective sharing or reviewing of healthcare information across the healthcare continuum is made difficult by many challenges, among which “information blocking” is one of the most prominent. A recent NY Times report highlights how developers of health information technology and medical centers themselves block the transfer of healthcare data, refusing to send it to their competitors. The Office of the National Coordinator for Health Information Technology (ONC) in its report to the Congress on the subject of information blocking has suggested some possible approaches that may help address this challenge.
Electronic health information comprises many types and there are many factors including legitimate ones that limit its free exchange and use. The “blocking” may be unintentional, and may stem from technological, economic and practical challenges that have been preventing effective sharing of information for long. It may also result from the need to protect patient safety, which may be compromised by revealing sensitive healthcare details.
The ONC, via interviews, customer complaints and other sources found that some technology developers and medical centers have intentionally blocked information sharing. Business-related reasons for restricting data transfer include the following:
- Some companies goad customers into implementing expensive proprietary technology and charge huge fees for sending or receiving information.
- Some hospitals do not share information with providers outside their own networks.
- Large hospital networks that share information internally hesitate to do so with competing hospitals and providers not affiliated with them.
Whatever be the reason, ONC is planning to address information blocking via a comprehensive approach that would comprise targeted actions to prevent and remedy information blocking and broader strategies to address the larger context in which it occurs. To ensure smooth progress towards more meaningful information sharing and interoperability, the following measures are expected to help:
- Ongoing collaboration of public and private sectors to develop and promote the consistent use of standards and standards-based technology that facilitate interoperability.
- Introducing rules and means of engagement and governance for successful electronic health information exchange.
- Introducing new transparency rules that would require developers to reveal the costs and restrictions associated with purchasing their systems.
- Encouraging an environment (clinical, business, cultural and regulatory) that allows easy exchange of healthcare information for enhanced healthcare quality and efficiency.
- Listing clearly all requirements and expectations (in keeping with individuals’ preferences and privacy protections) for the secure and confidential exchange of electronic healthcare data across states, networks and providers.
It is estimated that more than half of U.S doctors have adopted EHRs, which is a direct consequence of the federal government’s efforts via constructive investment of around $28 billion. In spite of the many drawbacks, EHRs remain attractive to providers because of its efficiencies. What is important in the present scenario is to successfully address the limitations that providers face in sending and receiving digital records, and thereby improve the quality of care nationwide.