Digital Health Data And Information Sharing: A New Frontier For Health Care Competition? - Lucia Savage Martin Gaynor Julie Adler-milstein

There are obvious benefits to having patients’ health information flow across health providers. Providers will have more complete information about patients’ health and treatment histories, allowing them to make better treatment recommendations, and avoid unnecessary and duplicative testing or treatment. This should result in better and more efficient treatment, and better health outcomes. Moreover, the federal government has provided substantial incentives for the exchange of health information. Since 2009, the federal government has spent more than $40 billion to ensure that most physicians and hospitals use electronic health records, and to incentivize the use of electronic health information and health information exchange (the enabling statute is the Health Information Technology for Clinical Health Act), and in 2016 authorized substantial fines for failing to share appropriate information. Yet, in spite of these incentives and the clear benefits to patients, the exchange of health information remains limited. There is evidence that this limited exchange in due in part to providers and platforms attempting to retain, rather than share, information (“information blocking”). In this article we examine legal and business reasons why health information may not be flowing. In particular, we discuss incentives providers and platforms can have for information blocking as a means to maintain or enhance their market position and thwart competition. Finally, we recommend steps to better understand whether the absence of information exchange, is due to information blocking that harms competition and consumers.

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