Regular information blocking in health systems, EHR vendors

In response to concerns regarding the exchange of patient information by health systems and electronic health record (EHR) vendors, a study published in The Milbank Quarterly examines the extent of “information blocking."

Information blocking is the knowingly interference with the electronic exchange of patient health information, which could benefit vendors and providers but limit overall benefits and efficiency.

Led by Julia Adler-Milstein, PhD, of the University of Michigan School of Information and School of Public Health in Ann Arbor, the study aimed to provide solid data on the extent of information blocking by health systems and EHR vendors for financial gain at the cost of efficiency. A national survey of health information exchange (HIE) leaders regarding the forms of information blocking, frequency and effectiveness of policy strategies were collected from 60 participants with a 57 percent response rate.

“Concerns about perverse incentives have received substantial attention recently, following a congressional request for the Office of the National Coordinator for Health IT (ONC) to produce a report on information blocking,” wrote Adler-Milstein and colleagues. “We sought to answer the following specific research questions: (1) To what extent do EHR vendors and providers engage in information blocking? (2) When information blocking occurs, what are the most common forms that it takes? (3) What policy strategies are perceived as most effective in curbing information blocking?”

Results included:

• 50 percent of respondents reported routine information blocking by EHR vendors.
• 25 percent of respondents reported information blocking by hospitals and health systems.
• The most common form of information blocking between EHR vendors was producing produces with limited interoperability.
• The most common form of information blocking by hospitals and health systems was pressuring providers to implement certain EHR or HIE technologies.

Researchers recommend improving incentives for providers to share information, outlawing information blocking and increasing transparency of EHR vendor business practices.

“Information blocking appears to be real and fairly widespread,” concluded Adler-Milstein and colleagues. “Policymakers have some existing levers that can be used to curb information blocking and help information flow to where it is needed to improve patient care. However, because information blocking is largely legal today, a strong response will involve new legislation and associated enforcement actions.”