You know why I’m interested in the Particle v Epic EHR (electronic health record) systems lawsuit? It’s because … data. Say I’m thinking about this like, say, a plan sponsor and I want data so I can do better population health or do care navigation to help my members avoid downstream bad things or steer and tier to high-quality docs and point solutions and, and, and … For a full transcript of this episode, click here. If you enjoy this podcast, be sure to subscribe to the free weekly newsletter to be a member of the Relentless Tribe. To do anything that has anything to do with population health, I need data. And when I say data, we often think claims data as plan sponsors; and we think about getting it from carriers. But where does the claims data originate? Oh, right … the gleam in the eye of a lot of claims data is EHR data. Someone typed something into an EHR system that metamorphosized, ultimately, into a claim that wound up in a carrier’s dataset. Plan sponsors want the claims part of the claims data, obviously, to see prices; but they also want those underlying data elements that indicate the health of their members. Said another way, they want the insights gleaned from some clinician somewhere who typed something into an EHR system that turned into codes that drove claims. So, yeah … Particle v Epic. Particle was getting EHR data and passing it on to other parties, and we get into the what’s and the who’s and the commentary. But bottom line, what I wanted to get into today is this: Will this lawsuit result in more access to data for downstream entities who need it, or less? What are the implications here of Epic shutting down access to its EHR data to Particle and Particle filing an antitrust lawsuit saying Epic did this because Epic wanted to use their monopoly power here to advantage their own payer platform business? Oh, the plot thickens. Payer platform business? For an EHR system. What is that exactly? More intrigue. What’s going on there? Because, yeah, probably a lot of plan sponsors and patients are, I’m gonna say, unaware of this part of the equation as to what data the carriers seem to have and where are they getting it from and what things they may be doing with it that plan sponsors and/or members who are their customers may or may not be aware of. Knowledge is power here, especially in the fight over trying to get data out of carriers who won’t hand it over when the carriers themselves are getting that data through interoperability networks that potentially plan sponsors also qualify for. Chucking that in there as a point to ponder. This whole “I’m intrigued” bit here, though, was not rhetorical. I really am/was intrigued—so intrigued, as a matter of fact, that I called Brendan Keeler to come on the pod and talk this out with me. Brendan, by the way, has written a very detailed account of the Epic/Particle dustup. There is a part one and a part two. Before we kick in here, though, I did just want to make at least one point on background. First, so many, many people want to get their mitts on EHR data for good reasons and maybe not-so-good reasons from the standpoint of the patients whose personal health information is being fought over here. The basic rule is that to get EHR data, you have to be involved in the treatment of the patient. So, this is the current governance as it stands. You have to be involved in the treatment of the patient if you want EHR data. So involved in the treatment, actually, that you have to have your own treatment data to share back. This is called reciprocity, right? Like, how can you say that you’re treating a patient if then you don’t have any data as to that treatment? On-site clinics, by the way, are providing treatment—just saying, in case anybody is thinking the same thing I’m thinking right now. Okay, back to the lawsuit. The real kicker of this whole Particle v Epic and Epic cutting off Particle thing, as far as I’m concerned, is over the secondary use of said treatment data once someone gets it (ie, someone gets EHR data transmitted to them because they are doing something or other to treat the patient, but now they have that data). And at that point, is it a free-for-all what they do with it? Can they, I don’t know, sell it to anyone they want? Said another way, what if I realize I need EHR data for, I don’t know, I’m a lawyer trying to do lawyer things or I’m public health entity or whatever. It doesn’t matter. If I throw a medical professional in a room and cook up something this person is doing, that could be considered treatment if you squint at it. Tricky, right? Now I can get EHR data. So, yeah … there’s that motto “If you ain’t cheatin’, you ain’t tryin’,” which Pryce Ancona said, ironically, on Health Tech Nerds the other day; and I cracked up. But it’s so not funny. Because you have some people—maybe or maybe not—kind of violating, let’s just say, the spirit...
