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Report Recommends Health IT Changes for 21st Century Cures

July 28, 2015 in News

On Monday, the Bipartisan Policy Center released a report with recommendations to improve the 21st Century Cures Act (HR 6) and accelerate medical innovation, Modern Healthcare reports (Ross Johnson, Modern Healthcare, 7/27).


Earlier this month, the House voted 344-77 to advance the 21st Century Cures Act, which includes several health IT and interoperability provisions.

The Senate is writing its own version of the bill, and it is not yet clear what a compromise measure would include. Bill supporters in the House hope to bring the compromise measure to a vote in the fall (iHealthBeat, 7/10).


The report highlights four policy issues that seek to reduce the time and cost associated with developing new drugs and medical devices (Modern Healthcare, 7/27).

Under the policy issues are several health-IT related actions. For example, BPC recommended that Congress improve interoperability among health IT systems as a way to improve the medical product development process (BPC release, 7/27).

The report, among other things, recommended that Congress require:

  • The federal government to adopt standards for health IT, including those for electronic health records and accurate patient data matching;
  • Federal agencies to annually report on their compliance with such standards; and
  • Testing and validation of standards adoption and systems interoperability.

According to the report, the Office of Management and Budget and the Office of the National Coordinator for Health IT should be responsible for identifying the standards, and the standards should be published every 12 months (BPC report, July 2015).

Meanwhile, the report recommended that Congress clarify regulatory authority, including that related to health IT (BPC release, 7/27). Specifically, the report stated Congress should:

  • Make it clear that health IT should not be regulated as a medical device by FDA, except for cases when the HHS secretary determines a product poses a significant risk to patient safety;
  • Require HHS to allow independent entities to develop voluntary standards, measure compliance and facilitate voluntary patient safety data reporting as a way to improve the use of health IT; and
  • Require HHS to extend privacy protections to health IT developers in order to help them report and receive patient safety data (BPC report, July 2015).

Former Senate Majority Leader and BPC Senior Fellow Bill Frist (R-Tenn.) said, “It’s clearly time to take action to significantly advance medical innovation in the [U.S.]” (Modern Healthcare, 7/27).

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Recently Reported Data Breaches Could Affect Thousands of Patients

July 27, 2015 in News

Several U.S. health care organizations recently have disclosed data breaches, potentially affecting thousands of individuals.

Meritus Health Data Breach

Meritus Health in Maryland has notified 1,029 individuals that their information could have been compromised after an employee at one of the medical center’s vendors might have accessed their data outside of normal job functions, Health IT Security reports.

The hospital uncovered the breach on May 4 during “routine compliance and self-audit efforts.” The inappropriate data access likely occurred between July 2014 and April 2015.

Potentially compromised data included:

  • Ages;
  • Birthdates;
  • Health insurance information;
  • Medical record numbers;
  • Names;
  • Social Security numbers; and
  • Treatment and/or diagnostic information.

Financial information was not affected by the breach.

The medical center said there is no evidence that the information has been misused.

Meritus Health has suspended the employee’s access to its system and launched an investigation. In addition, the medical center is “working to further strengthen controls related to vendor access to patient information” and “enhancing its existing system monitoring capabilities with regard to vendor access” (Snell, Health IT Security, 6/30).

OhioHealth Riverside Methodist Hospital Data Breach

OhioHealth Riverside Methodist Hospital is notifying nearly 1,000 individuals about a potential data breach after an unencrypted thumb drive with patient information went missing, the Columbus Dispatch reports.

The thumb drive was last used on an OhioHealth computer on April 14 and was labeled missing on May 29.

The thumb drive holds data on patients who were valve-replacement candidates or had taken part in research projects on the procedure between July 2010 and December 2014. Information on the device included:

  • Birthdates;
  • Insurance companies;
  • Medical record numbers;
  • Names;
  • Physicians;
  • Referral and treatment dates; and
  • Types of procedures.

The thumb drive also has clinical information and Social Security numbers for some patients.

OhioHealth said it does not believe that the thumb drive was stolen or that its data have been used inappropriately.

However, the health system said it has suspended use of thumb drives in the department where the thumb drive was lost. In addition, OhioHealth plans to implement encrypted thumb drives systemwide (Sutherly, Columbus Dispatch, 7/27).

Orlando Health Data Breach

Orlando Health has notified about 3,200 individuals of a data breach after a nursing assistant accessed patient records outside of normal job responsibilities, Becker’s Health IT CIO Review reports.

The breach was discovered on May 27 during a routine patient record access audit (Jayanthi, Becker’s Health IT CIO Review, 7/6).

It is unclear what data were viewed, but the patient records included:

  • Addresses;
  • Birthdates;
  • Medications;
  • Medical tests and results;
  • Names; and
  • The last four digits of Social Security numbers (Snell, Health IT Security, 7/6).

The employee, who has since been fired, also may have accessed insurance information on a “limited number” of patients.

The health system said there is no evidence that the data have been used or removed from the hospital.

Orlando Health said, “We are … re-educating our workforce members and increasing our already vigilant program of auditing and monitoring of patient record access” (Becker’s Health IT CIO Review, 7/6).

University of Pittsburgh Medical Center Data Breach

The University of Pittsburgh Medical Center has reported a data breach affecting 722 patients after a file containing health data was emailed to the wrong address, Health IT Security reports.

The incident was discovered on June 4 and reported to HHS on July 2.

Information in the file included:

  • Birthdates;
  • Insurance plan types;
  • Member identification numbers;
  • Phone numbers; and
  • Primary care physician office names.

The file did not contain Social Security numbers or medical histories.

William Gedman, chief compliance officer at UPMC’s insurance services division, said, “Based on our ongoing investigation, we will make all changes necessary to further enhance our already stringent privacy protections” (Snell, Health IT Security, 7/16).

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NIST Releases Draft Guidance To Bolster Security of Mobile Devices

July 27, 2015 in News

On Thursday, the National Institute of Standards and Technology released draft guidance to help health IT professionals bolster the security of smartphones and tablets used by health care providers, IDG News Service/Computer World reports.


Providers are increasingly using tablets and smartphones to complete tasks, such as:

  • Accessing patient data;
  • Transferring electronic health records; and
  • Submitting electronic prescriptions.

However, the devices might not have security features stringent enough to protect patients’ private health data. NIST wrote in the guidance, “Mobile devices are being used by many providers for health care delivery before they have implemented safeguards for privacy and security” (O’Connor, IDG News Service/Computer World, 7/24).

Details of Guidance

NIST developed the guidance along with private-sector cybersecurity experts from academia and the private sector (Ravindranath, Nextgov, 7/24).

The guide includes detailed explanations of how health IT professionals can implement security procedures throughout an organization’s whole IT system. For example, the guide provides instructions on how to:

Connect Android and Apple mobile devices to commercial mobile device management cloud platforms;

  • Create mobile device certificates;
  • Set up Linux-based firewalls; and
  • Set up other security technologies.

The guide does not provide specific product recommendations, but it does mention commonly used products that can be easily integrated into organizations’ current IT infrastructure.

In addition, the guide discusses which security risks pose the most significant threats to protecting patient data, including:

  • Hackers exploiting weak system passwords; and
  • Stolen devices.

Further, the guide includes an analysis of a mock IT system that was subjected to numerous security attacks and offers advice on how organizations can respond, such as by:

  • Implementing access controls to prevent hackers from viewing patient information after they have breached the system; and
  • Remotely wiping stolen mobile devices that have access to patient records.

According to IDG/Computer World, NIST will accept public comments on the guide until Sept. 25 (IDG News Service/Computer World, 7/24).

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CMS Updates Star Ratings on Hospital Compare Website

July 27, 2015 in News

Last week, CMS updated the star ratings on its Hospital Compare website, showing an increase in the number of five-star hospitals, Healthcare Finance, reports (Powderly, Healthcare Finance, 7/23).


In April, the agency released its first five-star ratings for hospitals as part of a broader effort to offer star ratings on all of CMS’s consumer-facing Compare websites. Medicare first began using star ratings in 2008, when it applied them to nursing homes. It has recently implemented similar programs for home health providers, dialysis facilities and large group practices.

The hospital rating system offers a star rating based on the 11 publicly reported measures in the Hospital Consumer Assessment of Healthcare Providers and Systems survey, which assesses patient experiences (iHealthBeat, 4/16).

Details of Data Update

The updated ratings are based on HCAHPS survey results for the reporting period from October 2013 to September 2014. CMS plans to update the rankings every quarter (Healthcare Finance, 7/23).

In total, CMS awarded five-star ratings to 336 — or about 9.5% — of the 3,548 eligible hospitals, up from 251 of the 3,553 eligible hospitals in April. In addition:

  • 1,296 hospitals– or about 36.5% — received four stars;
  • 1,320 hospitals — or about 37% — received three stars;
  • 475 hospitals — or about 13.5% — received two stars; and
  • 121 hospitals — or about 3.5% — received one star.

CMS did not rate 1,108 hospitals because the agency did not have adequate patient experience data for the facilities during the survey period (HCAHPS survey data, July 2015).

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Report: Incentives, Development Process Hinder EHR Interoperability

July 27, 2015 in News

Electronic health record vendors are lagging in interoperability and will continue to do so until incentives and development processes change, according to a report by Chilmark Research, MedCity News reports (Versel, MedCity News, 7/24).

Report Findings

According to the report, perceptions of EHR technology differ among vendors and consumers.

The researchers wrote, “Most of the major vendors regard their core clinical systems as comprehensive and inviolable — few readily admit that provider demands are broader than existing EHR feature sets.” The report added, “This stance glosses over the functional gaps, disorganized clutter and general lack of usability in EHRs.”

According to EHR Intelligence, the issue has become more noticeable amid the shift to value-based payment models under which data sharing is necessary.

One obstacle to data sharing is the limited adoption of application programing interfaces, and vendors should reconsider their value, according to the report.

However, some EHR vendors have raised concerns about opening up their systems via increased use of APIs. According to the report, “A prevailing view in health IT has been that opening applications to developers increases the risk that customers could more readily migrate to a competitor.”

The report noted that the leading candidate for API use in health care is the Fast Healthcare Interoperability Resource because of its “relative programming simplicity and better support for discrete data access” (Murphy, EHR Intelligence, 7/24).

However, FHIR is still being developed, and the report cautions against relying too heavily on it (MedCity News, 7/24).

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Health IT Business News Roundup for the Week of July 24, 2015

July 25, 2015 in News

MA, Financial Reports and Funding

NantHealth, a health IT vendor, has acquired Harris Corporation‘s clinical systems integration services…EHR vendor Modernizing Medicine will acquire gMed, an information  platform provider, for an undisclosed sum…Physicians Interactive, a provider of digital health care engagement tools, has acquired QuantiaMD, a Web and mobile community of physicians, for an undisclosed sum.

Quality Systems — a provider of practice management, EHR and revenue cycle management applications — has reported a Q1 2016 income of $6.4 million on $122.2 million in revenue, compared with a Q1 2015 income of $5.2 million on $117.9 million in revenue.

Curely, a developer of a telehealth mobile app, has raised $2 million in a funding round led by Exponential PartnersAccolade, a provider of a consumer health engagement platform for large employers and insurers, has raised $22.5 million in a funding round with participation from multiple investors…Axial Healthcare, a provider of pain management and analytics services, has raised $8 million in a Series A funding round led by .406 Ventures., a developer of virtual care software, has raised $3.5 million in a Series A funding round led by Oregon Angel Fund1DocWay, a telepsychiatry network, has raised $1.7 million in a funding round led by, a provider of a care coordination platform, has raised $8.4 million in a Series A funding round led by Rose Park AdvisorsLimelight Health, a provider of a health insurance quoting application, has raised $3 million in a funding round with participation from multiple investors.


Edwin Gould Services for Children and Families — a provider of care services for foster care children and adults with developmental disabilities — has selected Virtual Health‘s data analytics services…NorthStar Anesthesia, an anesthesia management company, has selected Plexus Technology Group‘s information management system…Keck Medicine of the USC Care Medical Group has selected Kyruus‘ suite of patient access and referral management tools.

The Allgemeine Unfallversicherungsanstalt, an accident insurance company in Austria, has selected Cerner‘s EHR system…Bon Secours Richmond Health System in Virginia has selected MedAptus‘s automated hospitalist coding and billing software…New York-Presbyterian Hospital, an academic medical center, has selected athenahealth‘s EHR system.

Product Development and Marketing

Nuance Communications has integrated its voice recognition and documentation services with athenahealth‘s More Disruption Please program, a partnership aimed at bolstering health care innovation through cloud technology…NextGen Healthcare Information Systems has integrated its connectivity software with the Mass HIway, an HIE in Massachusetts…Logicalis Healthcare Solutions, the health care arm of IT and managed services provider Logicalis, has partnered with Ascendian Healthcare Consulting, a consulting firm specializing in medical imaging, to provide medical imaging resources health IT professionals.

HealthSpot has opened a network of telehealth stations within Rite Aid pharmacies in Ohio…UMass Memorial Health Care, a not-for-profit health system in Massachusetts, has partnered with Zipnosis, a provider of diagnosis and treatment software, to develop an online diagnosis and treatment service…AncestryDNA, a consumer genetics company, has partnered with Calico, a therapeutics and longevity research company, to develop research projects on the genetics of the human lifespan…Medidata and Validic have integrated their cloud-based digital health platforms.

Vocera has integrated its suite of clinical communications tools with Zebra Technologies‘ mobile computer device…TriCore Reference Laboratories, a provider of clinical diagnostic testing services, has partnered with Sunquest Information Systems, a provider of diagnostic and lab information systems, to develop a diagnostic lab software for population health management…Dell Services has partnered with Baystate Health in Massachusetts to develop a series of programs to improve disease management and population health using predictive analytics, big data and telehealth…insurer Humana has partnered with AMC Health, a provider of patient management services, to develop a post-discharge telehealth program for Medicare Advantage beneficiaries.


Jeffrey Golove — former executive vice president at DHR International, an executive search firm — has been named senior vice president of the managed care/payer and health care technology practices at Gibson Consultants, a search firm for health care and digital health companies…Matt Schlossberg, former manager of publications at Healthcare Information and Management Systems Society Media, has been named digital and content account director at Amendola Communications — a public relations, marketing communications, social media and content marketing firm.

Marilyn Tavenner, former administrator of CMS, has been named CEO and president of America’s Health Insurance PlansArno Elmer — managing director of gematik and scientific director of the Research Group eHealth at FOM Hochschule University of Applied Sciences for Economics and Management in Germany — Mike Fuller — director of marketing at InterSystems UK, a provider of interoperability services — and Line Linstad, department head at the Norwegian Centre for Integrated Care and Telemedicine, have been added to the board of HIMSS Europe‘s Governing Council.

Jack Hemmert — former CIO of Verisk Health, a provider of health care analytics — has been named CIO of Intermedix, a provider of sales management and analytics software…Tim Weldon — former senior manager at the Chartis Group, a health care consulting firm — has been named regional general manager at Wellcentive, a provider of population health management services…Steve Barsh, a professor at the University of Pennsylvania‘s Wharton School of Business, has been named managing partner of DreamIT Health, a health technology accelerator…Wayne Orchard — former vice president of vendor relationships at New Benefits, a Texas-based insurer — has been named vice preside of strategic partnerships at, a provider of cloud-based telemedicine services.

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‘Uber-Like’ Health Apps Aim To Bring Back House Calls

July 25, 2015 in News

Over the past few years, several new “Uber-like” applications have launched that let sick individuals call a doctor to their home, the AP/Philadelphia Inquirer reports.

Although house calls were common in the U.S. in the past, about 90% of general practitioners no longer visit patients in their homes. However, several new companies are seeking to change that.

Pager employs 40 practitioners in New York City and soon is expanding to San Francisco. Heal operates in Los Angeles, Orange County and San Francisco.

Medicast — which was founded in 2013 and is the oldest of these doctor-on-demand companies — recently moved away from a model where it directly employs physicians.

Medicast CEO Sam Zebarjadi said the company discovered that potential users had “a really big issue around trust.” The company now is partnering with hospitals and health systems. For example, Medicast recently developed an app for Providence Health Services to serve the Seattle area.

The services are not yet covered under insurance. For example, Pager users pay $50 for a first visit and $200 for subsequent visits. According to the AP/Inquirer, that often is less costly for uninsured individual than a trip to a hospital’s emergency department

Further, Medicast expects its services will be covered within a few months.

Skepticism From Physicians

Physician Robert Wergin said a doctor summoned by smartphone might not know a patient’s medical history in the same level of detail. In addition, Wergin noted the model is not conducive for long-term care.

Jonah Feldman, a specialist at Winthrop University Hospital, said the “transactional” nature of apps such as these “exposes patients to the risks of overtreatment” (Perrone, AP/Philadelphia Inquirer, 7/22).

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AAFP Continues To Raise Concerns Over Meaningful Use Audits

July 24, 2015 in News

The American Academy of Family Physicians has sent a letter to CMS acting Administrator Andy Slavitt expressing concerns that meaningful use audits place an undue hardship on physicians, FierceEMR reports.

Under the 2009 economic stimulus package, providers who demonstrate meaningful use of certified electronic health records can qualify for Medicaid and Medicare incentive payments (Durben Hirsch, FierceEMR, 7/21).


In April, HHS’ Office of Inspector General began auditing meaningful use payments made to eligible professionals as part of its fiscal year 2015 work plan.

According to OIG spokesperson Donald White, the audits are being conducted to determine whether CMS is appropriately using taxpayer funding, rather than to identify fraudulent reporting by eligible professionals.

However, White added that if “auditors come across information that might involve enforcement issues, they might provide that information to CMS or OIG.”

Daniel Gottlieb, a lawyer with McDermott Will Emery, said that providers will have to repay incentives if OIG finds that they have received inappropriate payments.

Meanwhile, an external auditor for CMS has been reviewing all incentive payments made since 2012 (iHealthBeat, 4/10).

Details of Letter

In the letter sent earlier this month, AAFP cited several issues with the audits, including the:

  • Excessive administrative burdens placed on providers and practices to comply with requests;
  • Extensive back-and-forth communications and prolonged audit processes;
  • Lack of defined processes to end audits;
  • Lack of follow-up by auditors; and
  • Long periods of time between correspondences with auditors.

In the letter, AAFP stated, “Family physicians who have implemented and fully use [EHRs] in the spirit of the meaningful use program should have a reasonable expectation that the accompanying financial subsidy would help offset the implementation costs and associated initial decrease in practice productivity.” The letter added that “AAFP is concerned that auditors are causing undue hardship for family physicians with unreasonable and burdensome documentation requests which result in additional, significant expenses to be a meaningful user” (FierceEMR, 7/21).

AAFP Board Chair Reid Blackwelder in the letter said family physicians have the right to know:

  • Details of the audit selection process;
  • The overall pass/fail rate of audits completed; and
  • The percentage of eligible professionals undergoing audits.

The letter called for immediate attention to the issue and a follow-up meeting (AAFP release, 7/17).

AAFP in April sent a similar letter to CMS that also called for immediate attention to concerns about auditing practices and a follow-up meeting. The April letter has not been answered (FierceEMR, 7/21).

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Survey Finds Low Consumer Awareness of Telemedicine

July 24, 2015 in News

Forty-one percent of consumers have not heard of telemedicine, according to a new survey by HealthMine, Health Data Management reports.

Survey Details

The survey included responses from 1,200 consumers (Slabodkin, Health Data Management, 7/23).  They were asked:

  • Whether they would use telemedicine if their physician offered it as an alternative to an in-office visit; and
  • Whether they knew when it would be best to use telemedicine.

Consumers could select “I’ve never heard of telemedicine” as a response to the second question.

Survey Findings

The researchers found that:

  • 45% of respondents would use telemedicine if offered;
  • 16% would not; and
  • 39% were not sure (Comstock, MobiHealthNews, 7/20).

The rates of consumers who said they would use telemedicine varied by age, with:

  • 58% among respondents ages 25 to 34;
  • 44% among respondents ages 35 to 44;
  • 41% among respondents ages 45 to 54; and
  • 37% among respondents ages 55 to 64.

The percentage of respondents in each age group that did not know about telemedicine was:

  • 30% among respondents ages 25 to 34;
  • 42% among respondents ages 35 to 44;
  • 46% among respondents ages 45 to 54; and
  • 46% among respondents ages 55 to 65 (HealthMine release, 7/21).

Meanwhile, the percentage of respondents who said they believe they understand when it is best to use telemedicine was:

  • 52% among respondents ages 25 to 34;
  • 46% among respondents ages 35 to 44;
  • 34% among respondents ages 45 to 54; and
  • 38% among respondents ages 55 to 64 (MobiHealthNews, 7/20).
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Senate Committee To Urge HHS To Delay Meaningful Use Stage 3

July 24, 2015 in News

On Thursday, Senate Health, Education, Labor and Pension Committee Chair Lamar Alexander (R-Tenn.) announced that the panel will recommend that HHS delay Stage 3 of the meaningful use program, Modern Healthcare reports.

Alexander’s announcement followed a HELP committee hearing on information blocking and electronic health record interoperability (Dickson, Modern Healthcare, 7/23).


Under the 2009 economic stimulus package, providers who demonstrate meaningful use of certified EHRs can qualify for Medicaid and Medicare incentive payments.

In March, HHS released a proposed rule for Stage 3 of the meaningful use program.

Under the proposal, all eligible professionals beginning in 2018 would report on Stage 3 of the meaningful use program regardless of their previous participation. Providers would have the option to move to Stage 3 starting in 2017 (iHealthBeat, 5/28).

Push for Delay

According to EHR Intelligence, many stakeholders have criticized the Stage 3 proposed rule for being too ambitious.

During the hearing, Alexander said, “[A] hospital told me that Stage 1 and Stage 2 worked ‘okay,’ but they were ‘terrified’ by Stage 3″ (Bresnick, EHR Intelligence, 7/23). He added, “We might want to slow down the implementation of Stage 3, not with the idea of backing up on it, but with the idea of saying, ‘Let’s get this right’” (Slabodkin [1], Health Data Management, 7/24).

According to Clinical Innovation Technology, postponing Stage 3 of the meaningful use program will be one of several recommendations the Senate committee plans to make to the Obama administration (Walsh, Clinical Innovation Technology, 7/23).

Other recommendations likely will focus on:

  • Achieving interoperability;
  • Creating standards to clarify patients’ ownership of their health data;
  • Developing more user-friendly EHRs; and
  • Implementing stronger security requirements for patient data.

Alexander said the recommendations will be crafted as regulations that HHS can implement via rulemaking rather than through legislation (Modern Healthcare, 7/23).

Meanwhile, Rep. Renee Ellmers (R-N.C.) on Wednesday announced a bill that would delay the Stage 3 rulemaking until 2017, meaning Stage 3 would not go into effect until 2019 or 2020, Politico‘s “Morning eHealth” reports (Allen et al., “Morning eHealth,” Politico, 7/24).

Details of Senate Hearing on Interoperability, Information Blocking

During Thursday’s hearing, experts told the HELP committee that current information blocking practices make it impossible for the health care industry to achieve full interoperability, Health Data Management reports.

Committee members heard testimony from:

  • Paul Black, president and CEO of EHR vendor Allscripts;
  • David Kendrick, chair of the Department of Medical Informatics at the University of Oklahoma and CEO of MyHealth Access Network;
  • David Kibbe, president and CEO of DirectTrust and a senior adviser at the American Academy of Family Physicians; and
  • Michael Mirro, chief academic research officer at the Parkview Mirro Center for Research and Innovation (Slabodkin [2], Health Data Management, 7/24).

In his opening remarks, Alexander said, “Information blocking is one obstacle to interoperability, and I’m interested in hearing today from the witnesses the extent to which this is a problem — and the extent to which the government may share in the blame.”

Alexander cited an Office of the National Coordinator for Health IT report that found that some health IT vendors and health care providers are intentionally blocking the sharing of patient information and that congressional action might be necessary to address the practices (Murphy, EHR Intelligence, 7/23).

In his testimony, Kendrick said that there are “so many specific experiences with inappropriate data blocking and sub-standard data quality that we’ve created a nomenclature to classify six common types,” the most common of which is “the high price charged by vendors to implement and maintain interfaces.”

Meanwhile, Mirro noted that many EHR vendors include gag clauses in their contracts that bar providers from publicly addressing issues with their EHR system or unfair pricing.

He said, “Many EHR vendors provide the functionality needed [to connect with other systems], but require the user to purchase their health IT products to make the elements of the EHR interoperable.”

Kibbe said the federal government should play a role in incentivizing interoperability (Slabodkin [2], Health Data Management, 7/24). Kibbe recommended several actions the federal government could take, including:

  • Continuing to expose information blocking issues and working with stakeholders to set expectations for interoperability;
  • Developing an improved EHR certification process;
  • Encouraging federal agencies to use standards-based interoperable health information exchange with providers; and
  • Tying in the use of certified EHR technology with value-based purchasing models (Murphy, EHR Intelligence, 7/23).

Kibbe argued that ultimately “the responsibility for assuring secure interoperable exchange resides primarily with the health care provider organizations, not the EHR vendors and not the government (Bresnick, Health IT Analytics, 7/23).

However, Black disagreed, arguing that federal government action is key to ending information blocking.

Black argued that such practices are the result of the “lack of a strong business case or a true market driver for interoperability” among providers. He added that the “current payment system simply does not provide appropriate financial motivation for providers to truly be invested in creating an interoperable health care environment.”

As such, Black said CMS could produce better results by “creating a direct relationship between payment and data exchange” (Slabodkin [2], Health Data Management, 7/24).

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