Everson Jordan, Healy Daniel
Department of Health and Human Services, Office of the Assistant Secretary for Technology Policy, Washington, DC 20201, United States.
J Am Med Inform Assoc. 2025 Apr 1;32(4):665-674. doi: 10.1093/jamia/ocaf007.
To describe the prevalence of and trends in practices that interfere with the exchange of patient health information (potential information blocking) 2 years after implementation of information-blocking regulations.
Drawing from the American Hospital Association Information Technology (IT) Supplement and a national survey of health information organizations (HIOs), we described rates and methods of potential information blocking from these organizations' perspectives in 2023 and compared them to prior years.
Twenty-seven percent of hospitals sometimes or often observed potential information blocking by any actor in 2023, down from 42% in 2021 and 33% in 2022. Thirty percent of HIOs routinely observed potential information blocking by health IT developers, down from 50% in 2015. 13% of HIOs routinely observed potential information blocking by hospitals and health systems, down from 25% in 2015. According to both hospitals and HIOs, the most prevalent method of potential information blocking by developers in 2023 was through price, while the most prevalent by healthcare providers/health systems was by focusing exchange on strategic affiliations. Few hospitals and HIOs that experienced potential information blocking said that they had reported it to the Department of Health and Human Services.
Hospitals and HIOs perceived lower rates of potential information blocking in 2023 than in prior years indicating some impact of regulations addressing information blocking. However, both respondent types reported that substantial potential information blocking persisted in 2023 and negatively impacted the exchange of information.
While potential information-blocking practices have decreased, they have not been eliminated, indicating the value of continued and robust enforcement of information-blocking regulations.
描述信息封锁法规实施两年后干扰患者健康信息交换的行为(潜在信息封锁)的发生率及趋势。
借鉴美国医院协会信息技术补充资料以及对健康信息组织(HIO)的全国性调查,我们从这些组织的角度描述了2023年潜在信息封锁的发生率及方式,并与往年进行比较。
2023年,27%的医院有时或经常观察到任何行为主体存在潜在信息封锁情况,低于2021年的42%和2022年的33%。30%的健康信息组织经常观察到健康信息技术开发者存在潜在信息封锁情况,低于2015年的50%。13%的健康信息组织经常观察到医院和医疗系统存在潜在信息封锁情况,低于2015年的25%。根据医院和健康信息组织的反馈,2023年开发者最普遍的潜在信息封锁方式是通过价格,而医疗服务提供者/医疗系统最普遍的方式是将信息交换集中于战略联盟关系。很少有经历过潜在信息封锁的医院和健康信息组织表示他们已将此事报告给卫生与公众服务部。
医院和健康信息组织认为2023年潜在信息封锁的发生率低于往年,这表明解决信息封锁问题的法规产生了一定影响。然而,两类受访者均表示2023年仍存在大量潜在信息封锁情况,且对信息交换产生了负面影响。
虽然潜在信息封锁行为有所减少,但并未消除,这表明持续有力执行信息封锁法规具有重要意义。