Digital Health

Epic vs Particle: The Data Exchange Debate

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It probably would have been impossible to wander onto any of your healthcare newsfeeds last week and miss the drama unfolding between Epic and Particle.

If for some reason the solar eclipse blacked out your internet, the basic timeline looks like this:

  • April 8 – Rumors began circulating that Epic cut off data access to patient information platform Particle Health.
  • April 9 – Particle confirmed that Epic ceased responding to medical record requests through the Carequality network (updates ongoing).
  • April 10-11 – All hell broke loose.
  • April 11 – Epic released an Issue Notification detailing the issues and steps toward a resolution.
  • April 12 – Our shepherd through the dark forest of interoperability, Brendan “Health API Guy” Keeler, published a masterful breakdown of the situation and its downstream implications.

Without wading too far into the data exchange weeds, Particle “combines data from 270 million plus patients’ medical records by aggregating and unifying healthcare records from thousands of sources”… sources like Carequality.

  • Carequality is effectively one of the country’s largest health information networks, facilitating data exchange between qualified network members (i.e. Particle) who agree to only query patient data for “Permitted Purposes” such as Treatment, Health Care Operations, or Public Health Activities.
  • The problem at the heart of the Particle controversy arises due to the fact that Treatment is the only purpose that organizations like Epic are actually required to respond to, causing all sorts of companies to warp their true purposes to Treatment-shaped requests.

Epic’s Issue Notification went as far as specifically naming certain Particle customers that it felt violated the Treatment case, including a company named Integritort that was allegedly using the patient data to try and identify potential class action lawsuit participants.

  • Particle maintains that all of its partners directly support Treatment, and that “the ability for one implementor to decide, without evidence or even so much as a warning, to disconnect providers at massive scale, jeopardizes clinical operations for hundreds of thousands of patients as well as the trust that is so critical to a trust-based exchange.”

The Takeaway

Since we know a perfect takeaway when we see one, we’ll leave it to the Health API Guy to wrap up the story:

“The tactical actions and who’s right or wrong really isn’t that important. Instead, they can serve as a catalyst and accelerant for the change needed. These events occurred because fraud and abuse are happening because the status quo of the networks only working for Treatment leads to the worst possible incentives. Health data is needed by a broader set of stakeholders in order to serve the patient.”

In other words, now’s the time to make viable paths for other Permitted Purposes a reality.

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