Stopping Data Blocking by EHR Vendors

The biggest barrier to participation in the US Wound Registry (USWR) has been data blocking (also called information blocking) by electronic health record (EHR) vendors. Data blocking endangers patients and can prevent physicians from being able to comply with health information reporting requirements under MACRA. The American Academy of Family Physicians (AAFP) and an organization called Health IT Now convened a group of stakeholders to address this issue and on August 29, 2017, wrote a letter to Dr. Donald Rucker, the National Coordinator for Health Information Technology, and to Daniel Levinson, Health and Human Services (HHS) Inspector General.
The letter points out that the The 21st Century Cures Act prohibits information blocking and (finally!) allows vendors to be penalized up to $1 million per violation for activities like charging a fee to exchange information with another entity or simply refusing to share data at all.  However, because some parts of the Cures Act are not clear, the stakeholders asked that the HHS issue a proposed rule to clarify specific points. More than a dozen specific questions were detailed in the letter, but I will only list a few of them here:

  1. What is information blocking and what is not?
  2. What constitutes “special effort” in eliminating blocking and promoting interoperability?
  3. How should patient access be measured?
  4. How does the law interact with existing laws like HIPAA and medical malpractice?
  5. What “reasonable” business practices do not constitute information blocking?
  6. How should “per violation” be defined?
  7. What data should be collected from the public for reports of info blocking?

We get a lot of questions about the last one listed — exactly what information a patient or clinician needs in order to document and report data blocking by their EHR vendor.  It is incredible that certified EHR vendors either cannot, or will not, transmit Continuity of Care Documents (CCDs). I’ll keep you posted on the developments. Meanwhile, here’s a link to the letter.