Medical records giant Epic emailed hospital chief executives on Wednesday urging them to speak out against a proposed regulation that aims to make it easier for patients to access their health information.
The email, which was written by Epic CEO Judy Faulkner and addressed to CEOs and presidents of hospital systems, urges recipients to sign a letter alongside Epic that voices disapproval for rules from the Department of Health and Human Services (HHS), CNBC reported on Wednesday.
Almost a year ago, the Office of the National Coordinator for Health IT (ONC) issued a proposed interoperability and information-blocking rule that defines the demands on healthcare providers and electronic health record (EHR) vendors for data sharing. The rule also outlines exceptions to the prohibition against information blocking and provides standardized criteria for application programming interface development.
The letter Epic sent to hospital chief executives includes an urgent call to action, according to CNBC. “HHS needs to hear from you so they understand that you feel these issues are important,” the letter says. “Very little time is left.”
CNBC published the entire email that was sent to hospital executives.
In the email, Faulkner wrote, "We are concerned that health care costs will rise, that care will suffer and that patients and their family members will lose control of their confidential health information."
ONC may finalize the rule the first week of February, Faulkner wrote, "so we must get the message to them right away."
"It's a smokescreen to protect their interests," Cynthia Fisher, a patient advocate who sits on HHS' Health IT Advisory Committee, told FierceHealthcare in response to Epic's stated concerns about the rule.
"Patients need to be in control of their health and their health information and their privacy and should be able to choose who they want to share their information with," Fisher said. "The interoperability rule empowers the patient to go anywhere and shop for their care. The rule will put patients' information in the palm of their hands."
Epic controls more than a quarter of the hospital EHR market, according to KLAS Research, and, among hospitals with 500 or more beds, Epic has a 58% market share.
Gearing up for a fight
In recent weeks, lobbying efforts to oppose the proposed regulation have ramped up. Former HHS Secretary and Wisconsin Gov. Tommy Thompson wrote an op-ed denouncing the rules on behalf of hometown company Epic and the state's health technology economy.
There is speculation the final regulation could lead to lawsuits, Politico reported.
Sumit Rana, senior vice president of research and development at Epic, told FierceHealthcare the ONC rule goes beyond the scope of the 21st Century Cures Act. "It's not about giving patients access to data, it's about turning EHRs into data repositories," he said, noting the primary beneficiaries of the rule are venture capitalists and others taking advantage of patient data.
The ONC rule is currently under review by the Office of Management and Budget (OMB), the last step before publication. The Centers for Medicare & Medicaid Services' proposed interoperability rule (PDF) also is under review at OMB.
OMB has taken 12 meetings on the two interoperability rules since November, Politico reported. That's a surprising level of interest given the late stage of the rules, which were proposed back in February 2019.
During the Forbes Healthcare Summit in New York City in December, Faulkner said publicly that she had concerns the ONC rule would threaten patient privacy as well as vendors' intellectual property protections.
The regulation will have the unintended consequence of sharing family members' health data without their consent, Faulkner said.
The solution, according to Faulkner when she spoke at the Forbes event, is for ONC to delay putting the rule into effect until more stringent privacy protections can be put in place to safeguard health data shared with mobile apps.
Epic spokeswoman Ashley Gibson told FierceHealthcare in an email on Wednesday, "HHS has encouraged us to get others to share concerns over the proposed ONC interoperability rule, and we have done that."
"ONC has been listening to many who have concerns about the rule, and it’s important to get the views of the organizations that are on the front line of delivering care. Patient and family member privacy and the significant burden to health systems that will increase costs and decrease care are some of the important topics," Gibson said.
In the email to hospital customers, Faulkner said Epic "fully supports helping patients have access to their data." Faulkner noted that patients have been able to download their health information since 2010 and that patients have been able to share their health information with anyone in the world that has internet since 2017.
Fisher countered Faulkner's claims about data access. "Most people have had significant challenges getting access to their health information," Fisher said. "The Cures Act (21st Century Cures Act) came about because hospitals and EHR vendors were not giving the information to patients."
According to the CNBC article, former White House Chief Technology Officer Aneesh Chopra expressed frustration over Epic’s move. “It is unfortunate to see this much effort placed at stalling the important, bipartisan progress we have made to open up health information—at a minimum to consumers and institutions they trust.”