A survey conducted by ONC found that over 40% of non-federal acute care hospitals perceived practices that constituted information blocking in 2021 by healthcare providers and health IT developers. This perception by hospitals is higher than that of health information exchanges. The study suggested two reasons for this discrepancy: improved information sharing behaviors by health IT developers, and competitive dynamics among stakeholders. The survey also found that for-profit hospitals were more likely to report experiencing information blocking by other healthcare providers. Compliance with information blocking regulations is essential to efficient and effective data sharing.
The Office of the National Coordinator for Health Information Technology (ONC) conducted a survey in 2021 to assess the prevalence of perceived information blocking among non-federal acute care hospitals. The survey revealed that over 40% of hospitals reported perceiving information-blocking practices by healthcare providers and health IT developers. The study aimed to investigate the compliance of healthcare providers and health IT developers with the information-blocking provisions of the 21st Century Cures Act Final Rule that prohibits interfering with, preventing, or materially discouraging access, exchange, or use of electronic health information (EHI). This article will discuss the findings of the survey and explore the potential reasons for the discrepancies observed in the results.
Perceived Information Blocking by Healthcare Providers and Health IT Developers: The ONC survey found that 42% of hospitals observed practices that they perceived to constitute information blocking by healthcare providers. These practices included withholding or limiting access to patient data, charging excessive fees for data exchange, and providing incomplete or inaccurate data. This finding contrasts with the evidence from two surveys of health information exchanges (HIEs) conducted in 2015 and 2019 that found health IT developers were substantially more likely to engage in practices that may constitute information blocking than healthcare providers.
The researchers suggested two likely explanations for this discrepancy. The first explanation is that health IT developers have improved their information-sharing behaviors or altered contractual terms to better allow information-sharing in recent years, perhaps in anticipation of the information-blocking regulation. The second explanation is that perceptions of information blocking are related to the competitive dynamics of stakeholders. Hospital respondents were more likely than previous HIE respondents to perceive information blocking by other providers, perhaps because hospitals deal with healthcare providers more directly in circumstances where competition may be at play.
The survey also found that 19% of hospitals reported perceiving information-blocking practices by health IT developers. The data indicated that perceived information blocking by health IT developers is not inconsequential. Hospitals not using market-leading electronic health record (EHR) systems were more likely to indicate information blocking from health IT vendors. This finding is consistent with previous work that has shown that physicians using EHRs with lower market share were less likely to engage in interoperability. Developers with fewer customers likely need to spread the cost of enabling exchange over a smaller customer base and may therefore seek to minimize additional work to enable interoperability or to more aggressively maximize revenue for that work more.
Perceived Information Blocking by For-Profit Hospitals: The ONC survey found that for-profit hospitals were almost three times more likely to report experiencing information blocking from other healthcare providers than nonprofit hospitals. The researchers speculated that healthcare providers may have been reluctant to share information with for-profit hospitals because of concerns about their approach to practice or competitive orientation. They suggested that for-profit hospitals may be more likely to report perceived information blocking because of their more aggressive approach to obtaining information from other entities.
