Q2'25 Health IT Interoperability and Litigation Updates with Brendan Keeler
This is part of our executive insights series where Elion CEO Bobby Guelich speaks with healthcare leaders about their tech priorities and learnings. For more, become a member and sign up for our email list.
Name: Brendan Keeler
Role: Interoperability Practice Lead
Organization: HTD Health
When we spoke earlier this year, there were a number of important interoperability court cases underway. What is important for people to know now?
We’re headed into an action-packed summer with respect to each of these cases:
Particle Health v. Epic: We’re waiting on a pivotal ruling: Does the judge dismiss it or send it into discovery? If it goes to discovery, both sides can subpoena documents that could be quite damning in either direction. We got our last filing at the end of March; if this turns out to be a fast docket the decision could drop any day.
CureIS v. Epic: This is the next new and high-profile case. CureIS sold Medicaid-enrollment software to GE/IDX hospitals; when those sites migrated to Epic, CureIS says Epic lied about having equivalent functionality, blocked API access, and even stole trade secrets. It’s filed by the same law firm that is representing Particle, but the fact pattern is closer to Real-Time Medical Systems v. PointClickCare. Epic’s motion to dismiss is due early July; if CureIS survives, it becomes the template for every app that feels boxed out by an EHR.
Real-Time Medical Systems v. PointClickCare: This has already been sent back from appeals, so it’s gone back to the district court and now the actual case begins. We’ll see a new motion to dismiss from PCC, which should contain stronger, hardened arguments.
Intus Care v. RTZ: All the really interesting discovery is coming in late summer.
Obviously all of this matters a lot as precedent for future information blocking claims. Taking a step back, what’s your sense of how common information blocking is today?
It continues to be a real issue. Roughly 2,000 unprocessed information blocking complaints are sitting in ONC’s portal—patients against providers, apps against EHRs—and none of them have had any enforcement so far. But this week some complainants got follow-up emails, so it looks like things are starting to move. Even the perception of enforcement will spike filings, especially B2B claims, so I would expect to see more start to occur.
CMS just dropped that big RFI. What’s it all about?
At this point, CMS and HHS largely have their tech people in place. Now they’ve released this RFI that asks a very broad swath of questions that will be relevant to any digital health innovator. Every single person, patient, provider, digital health application, payer, or value-based care organization with an interest in healthcare technology should comment. They explicitly are asking for input on digital health priorities for this administration so they can move very fast on it.
Based on that, what’s your sense of their stance compared to the previous administration?
The agenda I can distill from it:
Fraud, waste, abuse—how can tech actually reduce it?
True patient access and consumerization of healthcare.
Doubling down on information blocking, rather than shying away or deregulating there.
Despite early rumors that TEFCA might be scrapped, I’m convinced HHS technologists will keep TEFCA, and morph it to fit the administration’s prerogative. Congressionally authorized levers are too valuable to abandon when driving nationwide health-tech policy.
What impacts do you predict on the certified EHR program?
I'd be really surprised if they don't essentially take it from an EHR certification program to an API certification program, predicating CMS money on having APIs and interoperability components. I’d bet they focus deregulation on prioritizing EHR inputs and outputs, and drop the old “what’s on the screen” workflow checks.
Anything else you expect to see with this administration?
ASTP is still up in limbo. I expect it will not be cut completely, but reduced in scope and treated more like the enforcer for CMS as opposed to the decider.
Editor’s Note: Since our conversation with Brendan, Dr. Thomas Keane was announced as the new leader for the agency, reinforcing the assumption that while the agency’s scope may shift, it is likely to continue to exist during the current administration.