Understanding Information Blocking in Healthcare: Its Effects on Data Sharing and Strategies to Promote Interoperability

In modern healthcare, effective data sharing is essential for delivering quality patient care. Healthcare systems need to communicate and exchange information promptly to improve treatment results, coordinate care, and enhance the patient experience. However, information blocking is a major barrier to achieving interoperability in the U.S. healthcare system. This article discusses the implications of information blocking, its effects on data sharing, and strategies to promote interoperability.

What is Information Blocking?

Information blocking refers to actions by healthcare providers, health IT developers, and health information exchanges that intentionally obstruct access to, exchange of, or use of electronic health information (EHI). This interference can lead to fragmented care and missed opportunities for timely interventions, driving up healthcare costs. The 21st Century Cures Act established clear definitions and constraints regarding information blocking, mandating that EHI should be shared routinely among healthcare actors.

The Cures Act identifies three groups involved in information blocking: healthcare providers, health IT developers, and health information exchanges. Each group has its own knowledge standards that outline what is considered reasonable or unreasonable practice under the law. For example, health IT developers must recognize potential interferences, while healthcare providers must identify when their practices become unreasonable.

Impacts of Information Blocking on Healthcare Providers and Patients

Information blocking can negatively affect both providers and patients. One immediate consequence is the inability to share essential health information, disrupting care coordination. When providers cannot access complete patient records, they may order unnecessary tests or treatments, resulting in higher costs and delayed care.

Data from the Office of the National Coordinator for Health Information Technology (ONC) shows that almost half (48%) of hospitals share data with other organizations but do not receive any information back. This gap in interconnection contributes to disjointed patient care. Without critical context, providers may recommend unnecessary procedures, which can cost the healthcare system billions annually.

The administrative burdens resulting from information blocking can also contribute to physician burnout. Many physicians report spending nearly 49% of their time on clerical tasks, especially entering data into electronic health records (EHRs). This clerical workload reduces the time available for patient interactions, potentially leading to a lack of engagement and job dissatisfaction.

Patients are affected as well. An increasing number of patients want immediate access to their medical records. A 2021 report revealed that 42% of hospitals noted information blocking practices, highlighting a broader trend of frustration among patients seeking timely access to their health information.

Barriers to Interoperability

Achieving interoperability in healthcare is challenging because persistent barriers undermine the goal. Key barriers include:

• Lack of Standardization: Different EHR systems and varying standards create confusion and hinder seamless communication.
• Data Silos: Many healthcare organizations maintain isolated systems, which can limit information sharing due to competitive motives or technical limitations.
• Cost Constraints: Implementing interoperable systems often requires significant financial investment. Many small practices struggle with the costs associated with EHR implementations, which can range from $15,000 to $70,000 per provider. This financial gap affects the care quality across different institutions.
• Regulatory Challenges: The complexity of regulations surrounding health data sharing can create hurdles. Providers often face difficulties in understanding compliance requirements, which can affect their willingness to adopt interoperable systems.
• Misalignment of Incentives: Current incentives tend to focus more on EHR adoption than on interoperability, which can lead providers to prioritize their proprietary systems over collaborative efforts.

These barriers lead to a fragmented healthcare system where the goal of interoperability remains elusive.

Strategies to Promote Interoperability

To address the challenges posed by information blocking, healthcare organizations can adopt several strategies to enhance interoperability:

• Adoption of Common Standards: The industry should standardize formats for data exchange, such as HL7 Fast Healthcare Interoperability Resources (FHIR), to improve data sharing.
• Collaborative Partnerships: Engaging with various healthcare entities can promote data sharing. Collaborative agreements can define how shared information will be managed and establish a culture of trust.
• Incentivizing Interoperable Systems: Regulatory agencies can create incentives for health IT developers to prioritize interoperability in their products. Grants for developing collaborative platforms can drive progress.
• Implementation of APIs: The requirement for CMS-regulated payers to offer access via secure application programming interfaces (APIs) is a positive step. Encouraging the use of APIs can streamline health data exchange.
• Education and Training: Educating healthcare providers about the benefits of interoperability and providing them with necessary skills is crucial. Training programs can demonstrate how shared data improves clinical outcomes.

The Role of AI in Addressing Workflow Barriers

Utilizing AI for Enhanced Data Sharing

The integration of artificial intelligence (AI) and automation in healthcare can significantly improve data sharing and interoperability. AI can streamline administrative workflows and alleviate the clerical burden on providers. AI-driven solutions can automate tasks like data entry and scheduling, allowing physicians to focus more on patient care.

Moreover, AI can enhance clinical decision support systems by integrating data from various sources. By analyzing data efficiently, AI can inform providers about potential concerns and necessary follow-ups. Automatic data aggregation can help mitigate the effects of information blocking by ensuring that providers have access to a comprehensive view of each patient’s history, no matter the originating EHR system.

AI can also help identify patterns indicating information blocking across healthcare organizations. By recognizing these trends, stakeholders can target efforts to address barriers and promote collaboration.

The Future of Information Sharing in U.S. Healthcare

As patient demand for timely access to medical records grows, the future of healthcare in the U.S. must prioritize interoperability. There is a clear need for policy adjustments to eliminate information blocking and encourage cooperative data sharing.

Initiatives like the 21st Century Cures Act and the Interoperability and Patient Access Final Rule are critical for improving the healthcare system. As regulations evolve alongside technology, proactive engagement from providers, IT managers, and administrators will be necessary. Regular updates on regulatory requirements and best practices are essential for preparing for future changes.

By supporting transparency in electronic health information exchanges and fostering collaboration and partnerships, stakeholders can navigate the challenges of information blocking. The goal is to achieve a more integrated and effective healthcare system for everyone.

Promoting interoperability is crucial for improving patient care. As organizations work to remove the barriers created by information blocking, the shared aim should be a healthcare system that values accessible and actionable health information. This effort toward efficient data sharing and communication can ultimately lead to better patient outcomes and satisfaction.