The Fund supports several networks of state health policymakers to help identify, inspire, and inform policy leaders.
The Fund identifies and shares policy ideas and analysis on topics important to state health policymakers, particularly on issues related to state leadership, primary care, aging, and total costs of care.
Keep up with news and updates from the Milbank Memorial Fund. And read the latest blogs from our thought leaders, including Fund President Christopher F. Koller.
The Fund publishes The Milbank Quarterly, as well as reports, issues briefs, and case studies on topics important to health policy leaders.
The Milbank Memorial Fund is an endowed operating foundation that publishes The Milbank Quarterly, commissions projects, and convenes state health policy decision makers on issues they identify as important to population health.
Back to The Milbank Quarterly
Context: Congress has raised concerns about providers and electronic health record (EHR) vendors knowingly engaging in business practices that interfere with electronic health information exchange (HIE). Such “information blocking” is presumed to occur because providers and vendors reap financial benefits, but these practices harm public good and substantially limit the value to be gained from EHR adoption. Crafting a policy response has been difficult because, beyond anecdotes, there is no data that captures the extent of information blocking.
Methods: We conducted a national survey of leaders ofHIE efforts who work to enable HIE across provider organizations. We asked them about the frequency of information blocking, its specific forms, and the effectiveness of various policy strategies to address it.We received responses from 60 individuals (57% response rate).We calculated descriptive statistics across responses.
Findings: Half of respondents reported that EHR vendors routinely engage in information blocking, and 25% of respondents reported that hospitals and health systems routinely do so. Among EHR vendors, the most common form of information blocking was deploying products with limited interoperability. Among hospitals and health systems, the most common form was coercing providers to adopt particular EHR or HIE technology. Increasing transparency of EHR vendor business practices and product performance, stronger financial incentives for providers to share information, and making information blocking illegal were perceived as the most effective policy remedies.
Conclusions: Information blocking appears to be real and fairly widespread. Policymakers have some existing levers that can be used to curb information blocking and help information flow to where it is needed to improve patient care. However, because information blocking is largely legal today, a strong response will involve new legislation and associated enforcement actions.
Author(s): Julia Adler-Milstein and Eric Pfeifer
Keywords: electronic health records, interoperability, health policy, incentives.
Read on Wiley Online Library
Volume 95, Issue 1 (pages 117–135) DOI: 10.1111/1468-0009.12247 Published in 2017
Get the Latest from the Milbank Memorial Fund
The Milbank Quarterly’s multidisciplinary approach and commitment to applying the best empirical research to practical policymaking offers in-depth assessments of the social, economic, historical, legal, and ethical dimensions of health and health care policy.