Overly burdensome expense in transferring data between systems also may hamper the ability of providers to switch vendors, Cronin said, and there are questions as to whether vendors are clear about the expense of extracting data from a system and transferring it to a new one.
“Was there adequate information shared at the time of purchase, did you know what you were getting into? Theoretically, you should be able to switch products in a market without so much disruption,” she said.
The American Medical Association has cited this concern as one of its top issues in the EHR market.
She also noted that there's “huge market dominance right now in the EHR vendor market.”
“What impact does that have on providers' inability to share and the pricing involved with that?” she asked. The FTC is interested in understanding whether there's monopolistic behavior in the health IT market, she elaborated.
Cronin did not mention any vendors by name. However, Epic is currently the largest provider by attestations in the EHR subsidy program, and Dr. Cristoph Lehmann, a professor of pediatrics at Vanderbilt University, noted in an interview that Epic is capturing more than half of new large hospital system contracts.
Asked for company response to the speech and the implied comments about Epic, an Epic spokesperson said in a statement, “In our experience working with others in HIT, we don't know of any vendors that aren't interested in sharing records across healthcare organizations to improve the care of patients. That's why we're working on standards. We exchange data today with all of the major HIT vendors as well as with many other certified EHR technologies.”
Some critics charge vendors design their systems so that only their applications and solutions can be used, a situation commonly called a “walled garden.”
“Clearly, we don't want the walled gardens—we never did,” Cronin said. “It's manifesting itself in the market and we need to do something about it.”
Despite the concerns cited by Cronin, she cautioned that more understanding and data is needed by both ONC and the FTC.
“There's anecdotal evidence but we don't have the kind of data (we need),” she said. And FTC is interested in knowing how standards-setting practices are impacting the market in general.
“If there is inappropriate behavior, what should we be doing about it?” she questioned.
Follow Darius Tahir on Twitter: @dariustahir
