EHR vendors, health systems frequently engage in information blocking, study shows

With a little over two months to go before federal rules prohibiting information blocking take effect, a new study has found that the practice is prevalent among EHR vendors and providers.

The Department of Health and Human Services will implement its long-awaited interoperability and information blocking rules in April. This move will provide patients with unprecedented access to their health data.

Researchers from the HHS’ Office of the National Coordinator for Health Information Technology decided to study the prevalence of information blocking prior to enforcement of the above rules.

Published in the Journal of the American Medical Informatics Association, the study is based on a national survey of health information exchange organizations. Eighty-nine of 106 HIEs (84%) meeting the inclusion criteria responded to the survey.

The first major finding of the study was that more EHR vendors engage in information blocking than health systems, according to HIEs.

More than half of HIEs (55%) indicated that at least some EHR vendors engaged in information blocking, and 14% indicated that most or all vendors did so. But, only 24% of respondents indicated that at least some health systems engaged in information blocking, and about 6% indicated that most did so.

Among vendors, the most common form of information blocking was through charging high prices, with 42% of HIEs reporting this type of blocking. Artificial barriers to information were the next most common, with 23% of HIEs reporting that they often/routinely observed vendors engaging in this form of blocking.

Refusing to exchange information was the most common form of information blocking among health systems, with 15% of HIEs reporting that this often/routinely occurred and 41% reporting that health systems sometimes engaged in it.

For study authors, this was the most surprising finding. But the researchers “do wonder if those health systems refusing to exchange information have a valid reason that the HIEs are not aware of,” said Peter Ashkenaz, director of content and media affairs at ONC, in an email.

This is one of the limitations of the study. Though HIEs are uniquely situated to provide insights into EHR vendors’ and providers’ information blocking practices, they may not have complete insight into these practices and the potentially legitimate reasons behind it, researchers said in the study.

Another key study finding was that more EHR vendor competition was associated with higher reported levels of information blocking. In relatively competitive vendor markets, 47% of HIEs reported high levels of information blocking, while 14% reported low levels.

In relatively low competition markets, 16% of HIEs reported high levels of information blocking by vendors, while 58% reported low levels of the practice.

But, according to researchers, “more work needs to be done to better understand how local market and competitive dynamics might play a role in information sharing or information blocking,” Ashkenaz said.

As the HHS gets ready to implement its interoperability and information blocking rules, the study’s insights can help determine how enforcement efforts might be targeted, the researchers said.

Photo: marchmeena29, Getty Images



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