Data-sharing fees: A healthcare reform-killer?

The fees associated with sharing patient data threaten to thwart the $30 billion federal push to move the healthcare industry to electronic records--and it could require Congress to step in to change things, Politico reports.

Though a majority of providers have adopted electronic health record systems, most of that information sits on myriad computer systems offered by competing software companies with little incentive to make them work together. Hence, the goal of not only taking healthcare digital, but also enabling providers to share data to improve care and cut costs remains in limbo.

"The No. 1 factor hindering the exchange of information between healthcare stakeholders is the exorbitant fees that most EHRs are charging for integration, connectivity and reporting," Lance Donkerbrook, chief operating officer of Commonwealth Primary Care ACO, an affiliation of 250 independent physicians, tells Politico. That organization's members have 30 different EHRs among them, and each vendor wants $7,500 to $40,000 to connect them, he says.

In general, doctors pay $5,000 to $50,000 each to set up connections with blood and pathology laboratories, health information exchanges or governments, an often times additional fees are charged each time a doctor sends or receives data, according to the article.

The costs providers pay for implementing and upgrading their IT systems is substantial, Morgan Honea, executive director for the Colorado Regional Health Information Organization, told FierceEMR. Honea took issue with comments from Epic President Carl Dvorak, in which Dvorak took a shot at health information exchange organizations for allegedly charging exorbitant fees.

Recent announcements, however, indicate the U.S. Department of Health and Human Services plans to address common complaints, including provider IT costs, according to health economist and policy expert Paul Keckley, managing director at the Navigant Center for Healthcare Research and Policy Analysis.

While clinicians often see health information technology as overly expensive without improving quality, risk-sharing arrangements make interoperability IT a "necessary investment," Keckley said.

In addition, the interoperability problem is more economic and political than technical because the fee-for-service reimbursement model provides a disincentive to data-sharing, according to a new paper from the Brookings Institution.

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