Data Security versus HIT Interoperabilty

The HealthLeaders Media article, "EHR Data 'Blocking' Hobbles HIT, Says ONC", points out a tension between data security concerns and health information technology interoperability.

Find the article here: John Commins, for HealthLeaders Media , April 13, 2015 - http://www.healthleadersmedia.com/print/TEC-315231/EHR-Data-Blocking-Hobbles-HIT-Says-ONC

The byline reads: "Technology vendors, hospitals, and health systems restrict data access under the guise of security and confidentiality, but it can be challenging to identify and differentiate information-blocking from more benign impediments"

Highlighting the issue is a report by the Office of the National Coordinator for Health Information Technology.

Find the report here: http://healthit.gov/sites/default/files/reports/info_blocking_040915.pdf.

Part of the problem derives from concerns about competition.  The HealthLeaders Media reports that "The federal government's $28 billion investment in health information technology interoperability is undermined by vendors and providers who don't want to share data with perceived competitors."

The ONC report says that "information blocking" is a problem that will likely get worse.  Technology itself is an enabler, and the ONC finds -

"However, based on the evidence and knowledge available, it is apparent that some healthcare providers and health IT developers are knowingly interfering with the exchange or use of electronic health information in ways that limit its availability and use to improve health and health care."

Here is one source of the problem according to the ONC finding -

"Some EHR developers allegedly charge a substantial per-transaction fee each time a user sends, receives, or searches for (or "queries") a patient's electronic health information. EHR developers may also charge comparatively high prices to establish certain common types of interfaces—such as connections to local labs and hospitals. Many providers also complain about the costs of extracting data from their EHR systems for their own use or to move to a different EHR technology."

But the report finds providers can also share some of the blame, or a misunderstanding by providers of what federal and state law requires of them -

"Such constraints are not information blocking insofar as they are consistent with the requirements and policies established by federal and state law that protect patients' electronic health information," ONC said. "But it has been reported to ONC that privacy and security laws are cited in circumstances in which they do not in fact impose restrictions."

Example: A provider cites HIPPA privacy rules to deny the exchange of electronic protected health information for treatment purposes, even though HIPPA specifically permits such disclosures.

Of particular interest is the question raised: Who Owns the Data?

Health records belong to the patient.  So says Chris Van Gorder, president/CEO of San Diego-based Scripps Health.

And Consider the power of that ownership in this New York Times article: The Healing Power of Your Own Medical Records: http://www.nytimes.com/2015/04/01/technology/the-healing-power-of-your-own-medical-data.html?_r=0

As reported by HealthLeaders Media -

"The only legitimate concern providers have with patient data exchanges is confidentiality, Van Gorder says, because providers are liable for any release of confidential patient data to anyone other than the patient."

What do you think?  When is data blocking legitimate and not contrary to the interests of the patient?  When does data blocking exceed legitimate legal and business concerns and become an impediment to the patient?