■ n Participate in standards development.
As the need for interoperability increases, our reliance on solid standards that
achieve their intended purposes becomes
paramount. If you don’t trust your vendors
enough to represent your interests in the
standards community do it yourself!
■ n Insist that your vendors develop and
provide standards-based products. Standards help prevent vendor lock-in, even in
the world of large EHR systems.
■ n Educate decision makers about the
broader health data landscape and the
impact of current systems deployments on
the future direction of the LHS. Health IT
is at the core of what drives many enterprises and supports the clinical and research
missions directly. It must be thought of by
leadership as a strategic asset and managed
■ n Consider all your options when it comes
to health information exchange (HIE).
While vendor-based HIE may be strongly
encouraged by your EHR vendor as the
simplest way to achieve interoperability
with other organizations, there are usually other options – including community-or state-based systems – that may provide
more flexibility, serve a wider variety of
trading partners, and prevent your data
from feeling captive to any one vendor.
■ n Complain to ONC when you feel a vendor or another organization is unfairly or
unnecessarily blocking access to information. ONC must begin to build a stronger
base of data first to understand and then
to combat this problem.
■ n Organize with your colleagues –
through vendor user group forums, organizations like HIMSS, and other professional
or industrial membership groups – to present a more unified front to the vendor community to promote your interests in a more
interoperable future. JHIM
Noam H. Arzt, PhD, FHIMSS, is president of HLN
Consulting, LLC. He has been involved in healthcare
informatics projects for over twenty years, including
a focus on national interoperability planning. He can
be reached at firstname.lastname@example.org.
F GHTING INFORMATION BLOCKING IN THE EMERGING LEARNING HEALTH SYSTEM
3. “Shared Medical Systems Corporation
History”, Web, 19 February 2015 http://www.
6. Ibid., p. 17.
7. Ibid., p. 18.
9. “EHR Meaningful Use Market Share, Industry
View | 2014,” Web, 19 February 2015 http://www.
13. Joseph Conn, “Fee Frustrations: Connecting
EHR Systems Too Pricey, Providers Say,” Modern
Healthcare, 27 July 2013, Web, 19 February
14. “Experts Say Vendors Charge Excessive
Fees to Interface EHRs with Clinical Pathology
Laboratories, Other Providers, and Networks,”
Dark Daily, 4 October 2013, Web, 19 February
15. John Morrissey, “The battle over EHR patient
data: How to secure your access to patient data
when switching electronic health record vendors,”
Medical Economics, 21 October 2014, Web,
19 February 2015 http://medicaleconomics.
16. Niam Yaraghi, “Electronic Health Record
Vendors Take Patient Data Hostage: What Should
We Do?,“ Tech Tank: Improving Technology Policy,
The Brookings Institution, February 24, 2015,
Web, 37 March 2015 < http://www.brookings.edu/
17. Arthur Allen, “Sticker shock: Doctors say
transfer fees are blocking health reform,” Politico,
21. Office of the National Coordinator for Health
Information Technology, “Report to Congress:
Report on Health Information Blocking,” April
2015, Web, 13 April 2015 http://healthit.gov/sites/
22. Ibid., p. 11.
23. Ibid., p. 13.
24. Ibid., pp. 22-4.
25. Joseph Conn, “ACOs make progress in using
big data to improve care,” Modern Healthcare,
17 January 2015, Web, 19 February 2015 http://