Let My Data Go: The Movement to End Information Blocking

I have previously written about the largely unintended consequence of data balkanization that arose from the laudable privacy protection elements of the Health Insurance Portability and Accountability Act (HIPAA). In recent years, the government has tried to counter the phenomenon of data balkanization by restricting so-called information blocking. Information blocking refers to practices by healthcare providers, health IT developers, or health information exchanges when these actors know, or should know, that these practices are likely to interfere with the access, exchange, or use of electronic health information (EHI), unless required by law or covered by a regulatory exception. The 21st Century Cures Act (Cures Act) and subsequent HHS regulations make information sharing the expected norm, with specific exceptions for privacy, security, and technical infeasibility. Until recently, while penalties existed under the regulations, enforcement of information blocking requirements had not been significant.

There is emerging momentum towards addressing the inefficiencies caused by information blocking. Last month, the Office of the Inspector General of the Department of Health and Human Services (HHS OIG) and the Assistant Secretary for Technology Policy and Office of the National Coordinator for Health IT (AST/ONC) published an alert conveying that enforcement of anti-information-blocking regulations will be a high priority under the current administration (the Enforcement Alert). This enforcement priority is grounded in regulations that the Department of Health and Human Services (HHS) issued in 2020 and has been revising since. Although previous inadherence with those regulations has not resulted in meaningful sanctions, the Enforcement Alert indicates a new direction. Health IT developers and health information exchanges and networks (HIE/HINs) that improperly interfere with legally permissible access, exchange or use of electronic health information may be subject to civil monetary penalties up to $1 million per violation. Other potential sanctions include de-certification of certified electronic health record technology applications (CEHRTs). Moreover, the Centers for Medicare and Medicaid Services (CMS) has brought private companies together in promoting a health technology ecosystem, as reflected in a press July 30, 2025 press conference held by CMS. These efforts are meant to improve patient experience by, among other things, reducing paperwork and encouraging development of artificial intelligence-based virtual assistants. CMS has called on the private sector to commit to interoperability goals and adhere to a CMS Interoperability Framework for Data Access and Exchange through the voluntary Trusted Exchange Framework and Common Agreement (TEFCA).

In March 2025, the U.S. Court of Appeals for the Fourth Circuit affirmed a preliminary injunction against EHR vendor PointClickCare, finding that its actions likely constituted unfair competition in the form of information blocking under the Cures Act in Real Time Medical Systems, LLC v. PointClickCare. The Court concluded that blocking a competitor’s access to EHI was not justified by security or performance concerns and appeared motivated by competitive interests. The Fourth Circuit interpreted the information blocking regulations to favor requestors, signaling that information blocking claims may be raised based on state law. This case suggests that courts are willing to enforce information blocking rules and that vendors must document and apply exceptions consistently and in good faith.

AI-powered platforms can surface actionable insights from previously siloed data, enabling predictive care management, automated prior authorization, and personalized patient engagement. The potential value of interoperability and AI is no longer theoretical—it’s being realized in reduced readmissions, lower administrative costs, and improved patient outcomes across the country. Pearl Health welcomes government efforts to unencumber the flow of healthcare data by promoting uniform standards and reducing unwarranted information blocking, subject, of course, to continued safeguards for patients and their protected health information (PHI). If data were used more effectively in the US healthcare sector, hundreds of billions of dollars in value could be unlocked each year.¹ That savings opportunity expands with technological breakthroughs, particularly with large language models, agentic artificial intelligence, and purpose built tools like the Pearl Platform. Surely today the value created and savings would be dramatically larger in light of data and artificial intelligence focused technologies like the Pearl Platform. With enforcement ramping up and the economic stakes higher than ever, now is the time for healthcare stakeholders to embrace interoperability—not just as a compliance requirement, but as a strategic imperative for better care, accelerated innovation and a more sustainable health system.

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