EHR vendors fire back at ONC data blocking report

Group urges caution when deciding what is and is not malicious information blocking
By Tom Sullivan
07:49 AM
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When the Office of the National Coordinator for Health IT issued its report to Congress in April calling out EHR vendors for blocking the exchange of health information, it went more or less uncontested. Not anymore. 

The EHR Association, in fact, sent a letter to national coordinator Karen DeSalvo, MD, "urging caution" when determining exactly what qualifies as information blocking.

EHRA's core issue is one of interfaces and interoperability services and the work and resources required of providers to build and maintain those.

"Costs must be evaluated in the context of the difficulty of developing and maintaining the interface, the number of potential users of that interface, the compliance with certification standards by the exchange partner, and the value gained from the data exchange," the EHRA, which is run by Healthcare IT News parent Healthcare Information and Management Systems Society, wrote in the letter.

EHR makers that signed the letter include Allscripts, Cerner, Epic, e-MDs, Evident, McKesson, NextGen, and Practice Fusion. – a representation of the technology companies ONC aimed squarely at when contending that it has received "a substantial body of complaints" from hospitals and health systems "about the costs of extracting data from their EHR systems for their own use or to move to a different EHR technology," and that those customers face "a combination of one or more contractual restrictions," such as gag clauses that legally prohibit customers from publicly discussing costs or other details.

Those factors make knowing "the full extent of the information blocking problem difficult to assess," ONC noted. 

The EHRA maintained in its letter that ONC has "a limited number of anecdotes of information blocking" and, what's more, that the term information blocking "is still very heterogeneous," and "could encompass a broad range of actions," that are not all malicious in nature. 

Interoperable health information is widely considered a necessity for the nation to earn a return on the 30 billion meaningful use dollars taxpayers spent digitizing the healthcare system by implementing electronic health records systems, of course, but the fact that some still have to fund the personnel and technology investments to make it happen is a persistent reality.

Perhaps the most telling point in EHRA's letter: "As providers' processes further align to support consistent data exchange and as standards are harmonized around the content and methods of data exchange, it is reasonable to expect that overall interoperability-related costs may go down, but will not disappear entirely," EHRA wrote. 

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