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Get Independent Advice
Get Independent Advice
    April 23, 2019

    Gagging care-providers is a setback to interoperability


    Closeup portrait clueless senior health care professional doctor with stethoscope, has no answer, doesn't know right diagnosis standing in hospital hallway isolated clinic office windows background.

    Imagine, if you will, a cure-all drug. A chemical compound that the government says you must use. The feds don’t care where you get it – you can get a generic tablet (cheap) or a quick-dissolve lozenge (expensive) – just as long as you have it … and show that you’re using it.

    A doctor using that drug may notice that patients are showing adverse reactions. That doctor may want to share his or her concerns with another doctor. Consider the untold numbers of children who would have been born to mothers who continued to be treated for pregnancy-related nausea with thalidomide – a drug tied to devastating birth defects – if medical professionals in the early 1960's hadn’t been allowed to share their findings with their peers.

    And yet, virtually all of the (don’t forget: government-mandated) “cure-all” manufacturers have made doctors sign agreements that prohibit them from discussing the drug or sharing any information about it with anyone else.

    Bound by technicalities

    “Oh, come on; that’s preposterous. Science broadly, and medicine more specifically, has been predicated since the ancient Greeks on the free sharing of information, particularly when it comes to patient-safety matters.”

    Sadly, the introductory scenario is not preposterous at all. It is exactly the current situation with electronic health records (EHRs): the government-mandated IT elixir for what had “ailed” the medical community.

    Healthcare professionals who use the many disparate systems are bound by non-disclosure agreements (or “gag clauses”) that prevent them from sharing their observations about shortcomings in the systems. It is disconcerting (and perhaps marginally understandable) that EHR vendors included such language in the purchase agreements; however, it is stupefying that healthcare organizations would sign contracts that bind their clinicians’ hands from sharing knowledge with peers.

    Here is an oft-cited complaint: Confusing interfaces – extensive scrolling to find the right dosage for a man of a certain weight, for instance – used to order something as simple as an over-the-counter painkiller. It doesn’t take an active imagination to recognize how it would be easy for a caregiver to get confused in navigating that same interface for more complicated tasks.

    Take action to help restrict gag clauses

    There is a need to protect intellectual property. However, that need should never trump patient safety. Further, such protectionism flies in the face of EHRs’ original intent, which was the free flow of medical information; i.e., interoperability.

    It is heartening, then, to know that the U.S. Department of Health and Human Services’ Office of the National Coordinator (ONC) of Health Information Technology is proposing changes (top of page 2) that would restrict EHR vendors’ ability to implement and enforce “gag clauses.” The government is soliciting comments on the proposed rule change through May 3.

    Take the time to read the proposal and reach out to the ONC in support of these positive changes. We cannot afford to let proprietary pride stand in the way of using IT to help seamlessly deliver the very best patient-centric healthcare

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