FTC, ONC put vendors on notice

Healthy competition is good; data hoarding is not
By Mike Miliard
11:04 AM

The Federal Trade Commission has some news for health IT vendors whose zeal for competitive marketshare outweighs their willingness to share data: they're watching, and will step in where necessary.

[See also: FTC calls out data brokers on privacy]

"We are working with ONC staff to identify potential competition issues relating to health IT platforms and standards, market concentration, conduct by market participants, and the ability of health IT purchasers to make informed buying decisions," wrote FTC officials in a blog post this week.

Healthy competition "is central to improving health care quality and outcomes, reducing costs, and improving the consumer experience," write Tara Isa Koslov, of FTC's Office of Policy Planning; Markus Meier, of its Bureau of Competition and David R. Schmidt, of its Bureau of Economics.

[See also: Interoperability: supply and demand]

But as electronic health records and other new health information technology platforms are increasingly deployed by care providers hoping for efficiencies and care coordination, FTC sees "potential threats to competition from high switching costs, data lock-in, misguided standard-setting activities, and other features of health IT systems and platforms."

The blog post reminds vendors that "FTC is well-positioned to monitor competition in today’s burgeoning health IT marketplace – relying on our combined expertise in health care, technology, and health-related privacy and data security issues."

Together, FTC and ONC "will continue to pay close attention to developments in health IT markets," FTC officials say.

Meanwhile, in a companion post on HealthIT.gov, ONC officials note that while there are "plenty of reasons to be encouraged about ways that competition is working to deliver interoperable systems and services," there's also ample evidence that "health IT markets are not functioning as efficiently as they could be."

Jodi G. Daniel, director of ONC's Office of Policy, and policy analyst Karson Mahler say there are too many areas where bad business practices are hindering care improvement.

Top of the list? Too much opacity when it comes to comparing the effectiveness of health IT products, and too little "accurate and complete information about costs and limitations." Without those critical tools, providers are stymied from making informed choices among an enormous array of competitive products.

Poor interoperability among disparate technologies is another huge issue, of course. There's been plenty of innovation these past few years, but too much of it has been in "walled gardens," Daniel and Mahler write.

"As market-based reforms shift provider incentives towards new care delivery models that reward quality and value, there is a risk that some providers may find themselves 'locked in' too rigid technologies or information sharing networks," they add – and it may be "prohibitively expensive to switch to new technologies that offer superior value, capabilities, and opportunities for delivering higher quality and more efficient care."

Even worse are business practices that intentionally inhibit healthcare data sharing. ONC has heard complaints about organizations that "restrict information exchange with users of other EHR products or HIE services," Daniel and Mahler write.

"Such conduct could include policies or practices that prevent or make it difficult to establish connections (or 'interfaces') to other systems. It could also include price or other contractual terms that limit 'data portability' in the event that a provider decides to switch to a different health IT vendor’s product."

Together with FTC, ONC "will continue to actively monitor health IT-related business practices that could impede progress towards interoperability or harm competition or consumers," they write. "Wherever possible, we will use our authorities and coordinate with other agencies to promote transparency in health IT markets, empower purchasers to make better decisions, and eliminate barriers to competition and innovation."

 

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