Electronic health records vendors make the process of sharing patient information too expensive and complicated for hospitals and doctors, a problem that affects the quality and cost of care.
That's the conclusion reached by the Office of the National Coordinator for Health Information Technology (ONC), the U.S. government agency that oversees the country's health IT efforts.
In a report released Friday, the ONC outlined challenges that health care providers face as they attempt to exchange patient data.
Among the issues identified: Health IT vendors charge high fees to set up interfaces for hospitals and labs to share patient data. They also force customers to use proprietary technology and refuse to publish APIs (application programming interfaces).
Sharing health data electronically is essential if technology is going to be used to deliver better and more affordable care, the ONC said in a blog post. "Information blocking" by IT vendors hinders this process, the ONC said. The agency didn't call out specific companies.
It's unclear how widespread this problem is, the ONC said. It's difficult to get a more accurate assessment of the problem because vendors contractually forbid customers from discussing topics related to costs and restrictions.
Still, from the information that the ONC has collected, "it is readily apparent that some providers and developers are engaging in information blocking."
Last year the ONC received 60 complaints about information blocking and reviewed anecdotal evidence from news reports and public testimony. The ONC also conducted interviews with health care providers, IT vendors and other stakeholders.
"We are becoming increasingly concerned about these practices, which devalue taxpayer investments in health IT and are fundamentally incompatible with efforts to transform the nation's health system," the ONC post said, adding that data blocking may become more pervasive as technology plays a greater role in health care.
Health care providers were also taken to task for not sharing patient data with each other. Hospitals may block information in an effort "to control referrals and enhance their market dominance," the ONC said.
Some hospitals cite privacy and security regulations to explain why they can't share information "in circumstances in which they do not in fact impose restrictions," the ONC said.
The ONC heard about cases where health care organizations and vendors allegedly joined forces to complicate the sharing of information with third-party care providers.
The U.S. Congress requested the report last December over fears that health IT vendors were profiting from keeping data locked up. The U.S. government has offered financial incentives for care providers to store patient medical information in EHRs instead of using paper files.
Resolving the problem of health information blocking may involve a multi-pronged approach, including new federal legislation, requiring more vendor transparency about software costs and restrictions, assisting law enforcement investigations of information blocking and encouraging interoperability and data sharing via incentives.