There has been a policy push for provider organizations to adopt electronic health record systems (EHRs) since 2009 (see A Meaningful Use Update and Financial Incentives Key Driver For EHR Adoption). The rationale was simple – we would require (and incentivize) provider organizations to invest in EHRs because consumer data sharing would permit care coordination, reduce duplicate services, and reduce costs.
Where are we with the data sharing part of the proposition? Not far, it appears. The results of the 2016 OPEN MINDS Health & Human Services Technology Survey, released at our recent 2016 OPEN MINDS Technology & Informatics Institute, showed that about 29% of provider organizations are exchanging data with other organizations – of those organizations, 44% of organizations are exchanging data with multiple organizations in different formats. And, we have covered some of the issues of policy and practice that get in the way of data sharing (see Interoperability Initiatives Focus On Facilitating Patient Access To Electronic Health Records; Fixing The Data Sharing Problem; and Should 42 CFR, Part 2 Be Aligned With HIPAA?).
But there is another issue that has cropped up. There have been reports that some EHR vendors are making it difficult — or charging “extraordinary fees” — to facilitate data sharing. A recent Politico article about data sharing between provider organizations and specialty registries highlights the problem (see Specialty Societies Say EHR Vendors Are Blocking Their Registry Work). According to the article, several medical societies (including the American Board of Family Medicine, the American Academy of Ophthalmology and the American College of Cardiology) have said that EHR vendors are blocking physicians from uploading consumer data to specialty registries that monitor and analyze data on specific conditions, like tumors, or events, like hip replacements.
These specialty registries rely on a third-party software system, which is where the problems arise. The medical societies have said that EHR vendors, including Epic, have refused to allow data to be uploaded from a physician’s EHR to the registry. The suspected reasons for not allowing data sharing mainly revolve around the idea that the EHR vendors view the third-party software as competition. On the other side of the argument, Epic maintains that these third-party vendors have “ulterior motives for monetizing the data.”
Why is this happening? Situations like these are symptomatic of how big the potential opportunity is for software vendors. They want more of the client’s wallet, not less. Vendors like Epic are finding that the care record is morphing into the broader context of population health and care management, and they are trying to find ways to keep those opportunities. A better approach would be to recognize the value of these registries in achieving better outcomes and finding ways to work with clients (and their partners) to supply data in an easy and secure way. That, or EHR companies need to offer more competitive solutions. To simply overcharge or threaten to shut someone off is, in my opinion, bad business. And it certainly doesn’t further the cause of improving health outcomes.
How can provider organizations move forward? Unfortunately, in this specific situation, your hands are tied at the moment. The Office of the National Coordinator (ONC) has said that they need additional legislative authority to go after this type of information blocking. There are two things that provider organizations can do in the contracting phase when they are considering an EHR vendor: First, ensure that your EHR solution includes base capabilities to export data in a secure manner. This sounds simple, but if it was easy, then this situation wouldn’t be an issue. Second, have a clear understanding of who “owns” or controls your EHR data, how the data is being stored, and how you can access and backup the information. Outlining these issues in your contract from the outset will save trouble and contention down the road (see Who Owns Patient Records?).
For more on the issues and solutions shaping data exchange, check out these resources in the OPEN MINDS Industry Library.
- The Dividing Line On Sharing Of Addiction Treatment Data
- Making Behavioral Health System Information Exchange Work
- The Dismal State Of Data Exchange
- ‘Prohibited Disclosure’ – Behavioral Health Locked Out Of HIEs
- In EHRs, Does Broader Or Bigger Or Smaller Make A Difference?
Finding a solution to this issue is especially important — not only to specialty registry software organizations, but also for specialist provider organizations that run the risk of being one step behind on coordinated care, integrated care, and value-based purchasing. In any case, health information exchange is, and will remain, a strategic challenge to future sustainability. What are you doing to keep up? Share your stories with us on Twitter @openmindseditor – #datasharing.
For more on how to align your EHR with your organization’s strategic goals, join me for a free web briefing, Leveraging Your IT Partner For Long Term Sustainability & Growth, on January 9, 2017 at 1:00 p.m.