Trudging towards interoperability

This week I reported that the next wave of interoperability regulation is coming soon, and it likely won't include the originally proposed changes to information blocking.

The Office of the National Coordinator for Health Information Technology wants to crack down on an illegal practice wherein holders of health data restrict access to it unnecessarily. It's called information blocking and it's a real problem for the entire health care industry. All those cool things that AI and tech companies want to do in health care? They need data.

Accessing health data—as anyone in this industry will tell you—is hard. ONC knows this. The head of the agency, Thomas Keane, has repeatedly promised that the Department of Health and Human Services is going to take action against information blockers. Violators of information blocking stand to lose $1 million per violation.

As part of its war on info blocking, ONC proposed advancing some new definitions within information blocking and removing some exceptions to the rule. But that proposal was met with aggressive pushback (you can read about it here).

I asked “API Guy” Brendan Keeler what he thought about the news. He pointed to a letter the Electronic Health Record Association sent to ONC in February, noting that the agency failed to put together an analysis on how much the regulation would financially impact the industry—a procedural error.

“When you say something like that, you're saying, ‘Hey, don't do this’,” he said. The letter implies, but does not say, that if the proposal had gone forward as written, there would have been an opportunity for legal action (which Keeler wrote about here).

Assessing the news for myself, I am struck by how difficult it must be for ONC to achieve true interoperability with the authorities it has. “Correct conclusion,” Keeler agreed. “You squint at it and ‘you're like, oh my god, how do we ever get anything done?’”

And yet, he's optimistic. “Every EHR is absolutely frightened of being sued and kind of does what you want if you ask,” he says. Information blocking still very much exists, but he thinks there's increasing pressure—via lawsuits and federal scrutiny—to share data.

“The more pressure that's on them, the more we're going to see investments into APIs and controlled [robotic process automation] programs,” he said.

And now, on to the news!

— Ruth