1. RESEARCH POSTER PRESENTATION DESIGN © 2012
www.PosterPresentations.com
This poster introduces the topic of Information Blocking which hinders
the ONC’s ability to successfully implement a nationwide
interoperability network. This literature review focuses on the issue of
interoperability, Information Blocking barriers, solutions and proposed
strategies as well as the professional opinions and interpretations of the
ONC report by Karen DeSalvo (Acting Assistant Secretary for Health in
the U.S. Department of Health and Human Services), Matthews Burwell
(the 22nd United States Secretary of Health and Human Services), and
Ashley Thomas (Legal Fellow for the Office of Legal Affairs at Presence
Health in Chicago, IL). In conclusion, Information Blocking has not been
dealt with in a serious manner and continues to remain a road block to
our healthcare industry.
ABSTRACT
The future of healthcare information technology relies on achieving a
system of semantic interoperability, cooperation between vendors,
healthcare providers and associations. “In June 2014, the Office of the
National Coordinator for Health Information Technology (ONC) laid out
a vision for a future health IT ecosystem where electronic health
information is appropriately and readily available to empower
consumers, support clinical decision-making, inform population and
public health and value based payment, and advance science1”.
However, the current state of interoperability in the United State has
been hampered due to several barriers.
One of the major barriers that has impeded information exchange is the
phenomenon known as “Information Blocking.” “Information Blocking
occurs when persons or entities knowingly and unreasonably interfere
with the exchange or use of electronic information1”. Information
Blocking prevents physicians and healthcare organizations from
providing effective patient-centered care, enhancing healthcare quality
and efficiency, and advancing research and public health1.
INTRODUCTION
RESULTS DISCUSSION AND CONCLUSIONS
REFERENCES
ACKNOWLEDGMENTS
We would like to give a special thank you to the faculty and staff of the
UT Austin Health Informatics and Health IT Professional Education
program, and specifically to Dr. Leanne Field for her guidance, beneficial
feedback, and support in the development of this poster.
The University of Texas at Austin, Health Informatics and Health IT Professional Education Program , Summer 2016
Minh Nguyen, B.S in Biochemistry and
Arturo Gonzalez, B.S in Health Information Management
Health Care Connectivity for a Nation: Solutions to Information Blocking
METHODS
This project was completed with the guidance from Dr. Leanne Field.
We used Academic Search Complete and Google Scholar to locate
published articles for this poster. We searched the following keywords:
“information blocking,” “information exchange,” “interoperability
roadmap,” and “interoperability standardization.” We also reviewed
articles from the ONC and the American Health Information
Management Association Body of Knowledge (AHIMA) websites.
1. The Office of the National Coordinator for Health Information Technology (ONC), Report to
Congress, (April 2015). Retrieved June 24 from
http://www.healthit.gov/sites/default/files/reports/info_blocking_040915.pdf.
2. Office of the National Coordinator for Health Information Technology. (2015b). Connecting health
and care for the nation: A shared nationwide interoperability roadmap. Retrieved from
https://www.healthit.gov/sites/default/files/hie-interoperability/nationwide-interoperability-
roadmap-final-version-1.0.pdf
3. Dvorak, K. (2015, April 28). ONC's Karen DeSalvo outlines 3 steps to interoperability. Retrieved
June 24, 2016, from http://www.fiercehealthcare.com/it/onc-s-karen-desalvo-outlines-3-steps-to-
interoperability
4. LIVE FROM HIMSS16: HHS Secretary Mathews Burwell Announces Major Industry Commitments
to Data-Sharing, Consumer Access, Interoperability. (2016, February 29). Retrieved June 24, 2016,
from http://www.healthcare-informatics.com/article/live-himss-hhs-secretary-mathews-burwell-
announces-major-industry-commitments-data-sharing#.V2Rs3Vea068.gmail
5. HIMSS Conference. (2016, February 29). Retrieved June 29, 2016, from
http://www.hhs.gov/about/leadership/secretary/speeches/2016/himss-conference.html
6. Thomas, A. (2015). American Bar Association. On Lock Down: Health Information Blocking as a
Barrier to Interoperability. Retrieved July 19, 2016, from
http://www.americanbar.org/publications/aba_health_esource/2014-2015/july/lockdown.html
CONTACT INFORMATION
PURPOSE
The purpose of this research project was to investigate the origins of
information blocking and to assess proposed solutions and strategies to
mitigate this major barrier to nationwide health information exchange.
“Unlocking data is a key part of our efforts to transform healthcare system
that works better for all Americans.”
- Sylvia Matthews Burwell
Sylvia Mary Mathews Burwell is the current US Secretary of Health and Human
Services (HHS) since 2014. Previously she was the Director of the White House Office
of Management and Budget from 2013 to 2014.
Three new federal commitments
proposed by the US Secretary of HHS
Matthews Burwell4:
Enhance consumer access
Restrict Information Blocking
Implement nationally recognized
standards and policies
Information Blocking: Origins, Proposed Solutions and Strategies
In February 2016, the US Secretary of HHS,
Sylvia Matthews Burwell proposed four critical
pathways towards a Nationwide Interoperability
Roadmap :
• Demand interoperability
• Speak the same language
• Private and secure data moving
• Work together to unblock data
Origins Possible Solutions Proposed Strategies
Healthcare vendors and
providers restrict individuals’
access to their electronic health
information.
Promote the coordination between Federal Agencies and
the ONC to investigate and take action against healthcare
vendors and providers that participate in Information
Blocking.
Continue public and private sector collaboration to develop
and drive the consistent use of standards and standards-
based technologies that enable interoperability.
Work with Standards Developing Organizations to develop
more robust technical testing tools to enforce ONC HIT
certification rule.
Charging prices or fees for
services such as data exchange,
portability and interfaces,
making electronic health
information cost prohibitive.
Promote greater transparency in certified health IT
products and services in the market place by engaging
vendors to be more reliable and open about their health IT
products and their exchange capability.
Foster a business, clinical, cultural, and regulatory
environment that is conducive to the exchange of electronic
health information for improved health care quality and
efficiency.
Promote competition and innovation in the health IT
market place to discourage the imposition of charges and
fees by healthcare vendors.
Establish governance rules for the sharing of protected
health information and its open exchange to prevent
providers and vendors from imposing costs or fees that
would make HIE cost-prohibitive.
Intentionally creating health IT
in non-standard ways that are
likely to increase the complexity
of electronic HIE.
Work with CMS to coordinate health care payment
incentives and leverage other market drivers to reward
interoperability and exchange and discourage information
blocking.
Clarify requirements and expectations for secure and trusted
exchange of electronic health information, consistent with
privacy protections and individuals’ preferences, across
states, networks, and entities.
Intentionally creating an
environment that encourages
fraud and abuse in the use of
Information Blocking.
Improve the collaboration between the ONC and the Office
of Civil Rights (OCR) to establish and enforce policies and
national laws that would prevent and penalize those
participating in intentional Information Blocking .
Establish effective rules and mechanisms of engagement and
governance for electronic health information exchange.
Art Gonzalez, B.S in Health Information Management: artg23336@gmail.com
Minh Nguyen, B.S in Biochemistry: minhnhat231194@utexas.edu
Currently, Information Blocking remains an ongoing and unresolved
issue because multiple entities continue to contribute to the gravity of
the problem.
FOUR MAJOR ORIGINS OF INFORMATION BLOCKING:
• Vendors and providers restrict access to health information.
• Vendors charge prices for health information exchange
services.
• Vendors create non-standard ways that make the
interoperability more complex.
• Vendors and providers create an environment that encourages
fraud and abuse.
THE PROMISE OF THE NEW FEDERAL ROADMAP
In order to stop Information Blocking, the US Secretary of HHS, Sylvia
Matthews Burwell has proposed the following:
• Three Federal Commitments
• Four Critical Pathways to nationwide interoperability
Along with the Secretary’s promise, several major health IT vendors,
healthcare systems, and healthcare professional associations have
agreed to participate in the these initiatives.
ACTION THAT MUST BE TAKEN NOW!
The time to act is now. The future of healthcare industry is hampered
heavily by the issue of Information Blocking. Federal, state, and local
organizations must come together and implement new policies and laws
to prevent Information Blocking.
Information Blocking: A Roadmap Forward
HHS’s announcement of healthcare vendors, systems and professional associations that have agreed
to participate in the Nationwide Interoperability Roadmap:
 Ascension Health
 Johns Hopkins Medical
 Community Health
Systems
 Trinity Health
 Greenway
 Athenahealth
 Allscripts
 Cerner
 Epic
 American Academy of Family Physicians (AAFP)
 American College of Physicians (ACP)
 American Medical Association (AMA)
 American Hospital Association (AHA)
Table 1: Origin, solutions and strategies to combat Information Blocking1
Table 2: Vision for a Nationwide Interoperability Roadmap5 Table 3: Selected entities participating in the Nationwide Interoperability Roadmap4