Information blocking an 'underappreciated' problem

Information blocking is a major problem that should be receiving more attention, according to a recent post to the Health Affairs Blog by Julia Adler-Milstein, Assistant Professor at the University of Michigan's School of Information.

The post notes that the industry left health information exchanges (HIE) alone on the theory that stakeholders would see the benefit of interoperability. However, it has been "underappreciated" that they would find more benefit to not share their patients' information.

"Achieving the right balance between competition and information-sharing has remained an elusive goal, and federal agencies may need to decide to err on one side versus the other," Adler-Milstein says.

She points out that the "public goal should trump private gain" and that the Office of the National Coordinator for Health IT report clarifies that information blocking is not acceptable and creates a framework for tackling the problem. However, there are challenges to resolving the problem, she says. For example, one of the hallmarks of unacceptable information blocking is when there is no reasonable justification for it. However, there is no one definition for what would be reasonable justification, meaning people can and will interpret if differently.

"[R]educing information blocking is not only a necessary step, it is perhaps the most critical step," Adler-Milstein says. "Now that we have a clear statement that public benefit and public policy goals take precedent, and there is serious talk about enforcement mechanisms, providers and vendors may finally be convinced to shift their business practices and business models to deliver on these. When the C-suite truly believes that they can be most successful by competing on the basis of sharing and using data, rather than hoarding and controlling data, we will know that we have succeeded."

Congress instructed ONC in December to deal with information blocking. ONC released its report on information blocking to Congress April 10, citing both providers and vendors to blame for it. The report suggests a number of steps to combat such blocking, including governance rules deterring it, referring illegal business practices to law enforcement, incentives to interoperability and provider education on HIPAA. 

The New York Times corroborates in an article this week that competition is a major cause of information blocking.

To learn more:
- read the blog post
- check out the New York Times article

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