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Information blocking by electronic health record (EHR) vendors is still highly prevalent, despite recent policymaking that prohibits information blocking practices, according to a recent study published in the Journal of the American Medical Informatics Association (JAMIA).
To identify the extent of the problem, the researchers conducted a national survey of health information exchange organizations (HIEs). HIEs were chosen as they are directly connected to EHR vendors and health systems and are therefore in an ideal position to assess interoperability and data sharing.
86 out of the 106 HIEs that met the qualification criteria responded and answered three questions:
- How often do EHR vendors and health systems practice information blocking?
- How are these information blocking practices conducted?
- What is the impact of local market competitiveness on information blocking behavior?
A majority of HIEs (55%) reported cases of information blocking by EHR vendors at least some of the time and 14% said all EHR vendors engaged in information blocking. 30% of respondents said information blocking occurred with some health systems.
The information blocking practice most common with EHR vendors was setting unreasonably high prices, which was reported by 42% of respondents. The second most common information blocking practice, reported by 23% of respondents, was artificial barriers.
The most common information blocking practice by health systems, reported by 15% of respondents, was refusing to share health information. 10% of respondents said artificial barriers. The researchers found a correlation between information blocking and regional competition amongst vendors, with some geographic regions experiencing more cases of information blocking. 47% of respondents said there were high levels of information blocking by EHR vendors in more competitive developer markets, and 31% said there were high levels of information blocking by health systems in competitive markets.
The HHS’ Office of the National Coordinator for Health Information Technology’s (ONC) final interoperability rules prohibits intentional information blocking. “As enforcement of the new regulations begins, surveillance of stakeholders with knowledge of information blocking, including HIEs, will be critical to identify where reductions occur, where information blocking practices persist, and how best to target continued efforts,” suggested the researchers.
The findings of the study mirror a previous study in 2016, with the results of both serving as a baseline against which information blocking can be measured in the future.
“Given persistently high levels of information blocking reported by knowledgeable actors, our findings support the importance of defining and addressing it through the planned implementation of the final regulation, definition of penalties, and enforcement for those found to engage in information blocking,” wrote the researchers. “Our findings also provide insight into how enforcement efforts might be targeted and one useful approach to monitoring their effectiveness.”