Epic, Other EHR Vendors Agree To Waive Record-Sharing Fees

By Joseph Conn


ehrAfter years of saddling their customers and outside firms with substantial fees for interfaces and other costs for interoperability, vendors of electronic health-record systems are now engaged in what looks like an interoperability price war.

The federal government probably had something to do with it, after firing a warning shot last week about healthcare “data blocking.”

In the run-up to this week’s Healthcare Information and Management System Society’s annual convention, Athenahealth, a co-founder of the CommonWell Health Alliance, leaked that it would be permanently absorbing its customers’ costs for interoperability via the alliance.

The announcement one-upped fellow CommonWell co-founder Cerner Corp., whose CEO, Neal Patterson, pledged last November that Cerner would eat its customers’ costs for participation in CommonWell at least through 2017.

The alliance is a 2-year-old consortium to develop a proprietary interoperability platform that was launched by five major vendors at the 2013 HIMSS show.

Four of the founders have now pledged to absorb providers’ usage costs, according to Jitin Asnaani, its new executive director, in an interview this week.

And now comes Epic Systems Corp., which is not part of CommonWell, with an announcement that it is dropping the fees it has been charging customers for data transfers between Epic customers and non-Epic customers through a module formerly called Care Elsewhere.

Those interoperability services with customers outside the Epic fold have since been bundled into Epic’s other interoperability module, Care Everywhere, Epic CEO Judy Faulkner said in an interview at the HIMSS conference. “We’re not going to charge for Care Everywhere for at least until 2020,” she said.

Previously, Epic customers sending clinical messages to a health information exchange were charged 20 cents each, while inbound messages from a non-Epic user cost $2.35 for that patient for a year, no matter how many messages were sent, she said.

“We thought it was cheaper” than the fees charged by other health information exchanges, she said. But the fees annoyed customers.

Last week, the Office of the National Coordinator for Health Information Technology issued a report to Congress saying that a variety of practices it dubs “information blocking” are common. But the ONC also says it can’t quantify the extent of the problem and is limited in its ability to respond to it.

The agency said it received about 60 unsolicited reports of information blocking in 2014. The practices include excessive costs for information-sharing; a lack of contract transparency for technology buyers, who may not appreciate the costs of sharing information; efforts by vendors to make it difficult to download information from EHRs and port their systems to competitors’ systems; and collusion between providers and vendors to prevent information from following to other software systems or healthcare providers.

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