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Who’s Blocking Health IT Interoperability? April 28, 2015

Since January 2015, there has been a flurry of information on healthcare IT concerns published by government and industry, in large part as a result of Congressional pressure. Congress is holding both public and private sectors to task for the lack of progress in achieving the interoperable health IT infrastructure it envisaged by the passing of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009. To date, Congress has appropriated over $28 billion in Electronic Health Record (EHR) incentive payments funneled through Medicare and Medicaid to health care professionals and hospitals participating in the Meaningful Use program, as certified by the Office of the National Coordinator for Health Information Technology (ONC). Despite this investment, Congress believes that the widespread and effective sharing of electronic health information across the health care continuum does not exist.

These efforts and additional actions needed to achieve the nation’s health IT goals are described in detail in the Federal Health IT Strategic Plan, 2015–2020[1]  released in 2014, and ONC’s draft Shared Nationwide Interoperability Roadmap[2], released for public comment on Jan 30, 2015. Comments were due April 3, 2015, and the final report will be published later in 2015.

Congress thinking that some of the lack of health IT interoperability might be the result of intentional health information blocking, in December 2014, passed legislation requiring ONC to produce a report, within 90 days, on the information blocking problem, and a strategy to address it. Congress also charged ONC to work with the HIT Policy Committee (HITPC) to address Congress’s separate detailed request for a report on barriers to interoperability within 12 months. That report “should cover the technical, operational and financial barriers to interoperability, the role of certification in advancing or hindering interoperability across various providers, as well as any other barriers identified by the Policy Committee.[3]”

ONC concluded after providing information on elements of a comprehensive information blocking report (39 pages) that: “While the evidence is in some respects limited, there is little doubt that information blocking is occurring and that it is interfering with the exchange of electronic health information.”  Table 1 (p. 10) of the report identifies Targeted Actions and strategies to address them, as well as gaps in current knowledge, programs and Authorities. ONC also concludes that Congressional intervention may be needed to address information blocking and achieve nationwide health information interoperability, e.g., an effective government mechanism.

Contributed by: Judy Fincher

[1] ONC, Federal Health IT Strategic Plan 2015-2020 (2014) (Draft), available at

[2] ONC, Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap Draft Version 1.0 (2015) (hereinafter “Roadmap”), available at

[3]  REPORT TO CONGRESS, APRIL 2015, Report on Health Information Blocking, April 9, 2015, ONC/HHS, p. 5, available at

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