The following is a guest article by Jonathan Bush, Founder and CEO at Zus Health

In 2016, the 21st Century Cures Act prohibited healthcare providers from blocking access to electronic health information. No more data hoarding. No more information black holes. It was great!

Except it didn’t quite work. Our analysis shows that roughly 40 percent of data still isn’t being shared in designated networks by those who “own” it. That means providers are still trying to deliver care using outdated, incomplete information.

When data flows freely, providers can see the full patient picture. They can more easily provide care that’s equitable and cost-effective, that delivers a great patient experience and excellent health outcomes, and that creates a great working environment for healthcare staff.

In other words, they can deliver on the goals of value-based care. So the question is: Why are some providers still keeping their data locked up?

The way I see it, this data defensiveness comes down to three things: tools, caution, and greed.

EHR Tools Create Data Silos

A handful of major players control most of the healthcare records in the country. On a micro, system-specific level, they have what we all want: accessible data.

But on a national level, their separate systems have created data silos.

The EHR tech that was seen as a breakthrough in the era of 2009’s HITECH Act is now a shortcoming. We need a solution that connects all data, regardless of its system of origin.

But many organizations are still reluctant to break down the walls of data silos. Let’s dig into why.

Liability Fears Drive Excessive Caution

Data liability is complicated. When one doctor requests data from another, the requesting doctor is liable for its proper use, security, and disclosure. But when a patient asks for the same data, the hospital is on the hook.

This liability has led to a strong bias: We need to “protect the patient” from their own data. And this bias runs on shaky assumptions.

The first: Healthcare executives assume that doctors won’t misinterpret a patient’s data, but of course they can. The second: Providers assume that patients and their loved ones will misread their data, but plenty of them don’t.

Caution isn’t bad, especially when dealing with sensitive data like someone’s health history. But when caution leads us to hoard data, progress stalls. At some point, the bigger risk isn’t sharing the data — it’s keeping it locked away.

Costly Overhead Drives Greed

There’s an old joke: Hospitals don’t have an Oedipus complex; they have an edifice complex. The problem isn’t their fathers — it’s their buildings.

Medical facilities are massively expensive to run. The bills start piling up before the care even begins. Healthcare executives want to keep as many heads in their beds as possible to help pay for their overhead. It’s a reasonable self-preservation instinct, but it’s anti-progress.

This instinct also affects data. When faced with the massive cost of purchasing a new EMR system, many healthcare organizations were promised that “owning the data” would become a profit center.

And for many, it has. Major medical centers now have revenue streams from selling de-identified data for research purposes. But data’s true value is not how much money it can make the hospital; it’s how much it can help the patient.

Healthcare organizations should act not as data owners but as data stewards.

Data Defensiveness Also Affects Payers

It’s not only providers who are hoarding data. Payers are also guilty.

Most payers share claims data in clunky Excel files that change month to month. They view their data as proprietary and only allow certain providers to access it under strict terms.

But here’s the deal: If payers want access to provider data, they have to reciprocate with as little friction as possible. They have to be data stewards, too.

Free-Flowing Data Makes Our Future Brighter

We must thank healthcare providers for their caution, forgive them for their tools, and persist in liberating the data they have.

The problem isn’t evil people running hospitals and intentionally blocking the exchange of data. In fact, it’s much more mundane. There are a lot of busy people who — thanks to real-world conditions in the medical field today — don’t have the time, energy, or financial incentives to enforce the data sharing mandate.

At Zus Health, we’ve found that once you get a hold of these data hoarders and make eye contact, they are nearly always willing to share. Then, we’re able to clean and organize the data and make it accessible to providers who need it to deliver value-based care.

Intentional or otherwise, data hoarding is a major issue in the healthcare industry. Without free-flowing data, providers can’t deliver longitudinal, coordinated care.

Once healthcare organizations understand the bright future that data sharing enables, they’ll release their teeth — and we’ll have what we need for better, value-based care.

About Jonathan Bush

Jonathan Bush is the Founder and CEO at Zus Health, a company building the first shared health data platform designed to accelerate healthcare data interoperability by providing easy-to-use patient data at the point of care. He sits on the board of Innovaccer, and is the co-founder and former CEO of athenahealth and former Executive Chairman of Firefly Health.