Ever have PHI accidentally land in the wrong inbox? In Black v. IEC Group, an employee emailed a spreadsheet containing patients’ health claims information to other plan members, and the patients sued. The Ninth Circuit allowed the case to proceed based on the alleged loss of confidentiality, even without identity theft or financial loss, showing how the wrong inbox can open the courthouse door.
TEFCA’s Individual Access Services (IAS) rules are getting an update! Effective August 3, 2026, the revised requirements aim to help patients obtain their health records while strengthening identity verification and secure access. What changes for apps gathering those records, and the providers and health plans releasing them? Here’s what you need to know, including which requirements take effect now and which come later.
Epic got GuardDog to heel. But the stipulated judgment does not close the book for healthcare providers whose patient records may have been pulled, or answer whether they have a reportable breach. With patient class actions already in play, “Epic handled it” is not an incident response plan.
Epic’s new lawsuit casts the company as the white knight protecting patient records from alleged data thieves. For a company already facing antitrust claims over its own data-access practices, that is quite a wardrobe change. But will this fight make health information exchange safer, or leave everyone else afraid to share?
On August 6, 2025, ONC unveiled the first public TEFCA Organizational Map, a tool that makes it possible to see which health systems are stepping into the national interoperability framework—and which are not. For some, this marks a milestone in transparency and progress; for others, it raises questions about strategy, governance, and whether more national data sharing is always a good thing. The uneven pace of adoption, particularly among Epic’s vast customer base, shows just how complicated the march into TEFCA has become.
Audacious Inquiry has filed a patent infringement suit against CRISP, Maryland’s state-designated HIE. At issue are core encounter notification and care coordination tools that providers nationwide rely on daily. With high-stakes infrastructure and TEFCA participation on the line, the outcome could reshape how HIEs balance public good with private innovation.
HHS has opened the door to one of the biggest questions in health information law: should the TEFCA exception to the information blocking rules stay or go? The May 16, 2025 RFI asks whether this carve-out encourages participation in TEFCA or instead creates confusion and double standards for networks like Carequality, which already impose requirements stricter than HIPAA. With comments due June 16, stakeholders have just days to weigh in on a decision that could reshape the balance between nationwide interoperability and local control.
Carequality’s new Version 3 Framework Policies add stricter requirements than HIPAA and could expose participants to Information Blocking risks. At the same time, TEFCA alignment creates a paradox: practices permitted under the new TEFCA Exception may still be questioned outside of TEFCA. This article unpacks the double standard—and what it means for HINs, HIEs, and nationwide interoperability.
Last week, I attended HIMSS 2025 in Las Vegas and came away with four big themes that stood out for me: the industry’s growing focus on Individual Access Services (IAS) and rock-solid identity verification, the push to expand non-treatment use cases for interoperability (like payment and healthcare operations), the urgent need for modernized consent management, and the overarching importance of trust to tie it all together. Yet of all these, for me, IAS is the real showstopper: if we don’t get identity and access right, the rest of our digital transformations—from AI-driven insights to cross-network data sharing—could quickly unravel. In today’s post, I want to zero in on IAS—where it fits into HIPAA’s right of access, where personal representatives enter the picture, and why it risks becoming a Trojan Horse for unauthorized data if we don’t take the proper safeguards.
On January 3, 2025, a significant lawsuit was filed against a state HIE. The case was brought by a former employee and whistleblower who alleges that the HIE permitted unauthorized access and use of PHI for research purposes in violation of federal and state law, as well as operational policies. Although the facts that are currently known to the public are not sufficient to conclude whether or not HIPAA’s standards applicable to research were met, this case has the potential to influence not only the immediate parties involved but also broader interpretations of HIPAA compliance and enforcement in research settings. At a minimum, the case serves as a reminder that HIEs should be taking proactive steps to ensure that their internal policies, data use agreements, and HIPAA BAAs explicitly address research-related and similar activities in compliance with federal and state laws, including HIPAA.
On December 27, 2024, the Office for Civil Rights (OCR) at the Department of Health and Human Services (HHS) decided it was time to give the HIPAA Security Rule a much-needed cybersecurity makeover—and let’s just say, it’s not just a light touch-up. These proposed changes mean stricter security rules, fewer loopholes, and a whole lot more paperwork for covered entities, business associates, and especially Health Information Exchanges (HIEs) and Health Information Networks (HINs).
Since TEFCA went live in December 2023, eight (8) organizations have been designated as Qualified Health Information Networks (QHINs). Each QHIN is a large information network that represents up to hundreds of HINs, health systems, public health agencies, payers, and IT vendors. Epic and Carequality recently announced that they would align their frameworks with TEFCA. TEFCA’s growth will be further supported by regulatory measures to incentivize network participation, such as the Information Blocking Rule.
The landscape of health IT regulation just took another significant leap forward. In the final days of 2024, federal regulators dropped two game-changing rules—HIT-2 and HTI-3—adding to the foundation set by HTI-1. Together, these regulations are reshaping how healthcare organizations approach interoperability, data sharing, and compliance in an era of rapidly evolving technology. But what do these latest rules really mean for healthcare providers, developers, and patients? Let’s break down the impact and key takeaways you need to know.
In a decision that will have lasting implications for interoperability and health information exchange, earlier this month Carequality issued its Final Resolution in the dispute between Epic and Particle Health. This follows months of deliberation, multiple rounds of evidence submission, and deep scrutiny of the rules governing data sharing. This latest resolution delivers much-needed clarity on several key concerns—but it also introduces fresh questions around enforcement, reciprocity, and how trusted exchange will continue to evolve.
A federal district judge has granted preliminary injunctive relief to Real Time Medical Systems, Inc. (“Real Time”) barring the defendant, PointClickCare (“PCC”), from deploying unsolvable CAPTCHAs that interfered with Real Time’s ability to access the data of its skilled nursing facility customers that utilized PCC. As Judge Xinis wrote in the opinion, “No evidence supports that PCC had any legitimate good faith use for wholly inscrutable CAPTCHAs which, by definition, blocked Real Time from getting the very records it needs to exist….But even more damning is the timing of such deployments, which support that PCC used those CAPTCHAs as a device to hamstring or eliminate Real Time as a competitor.” Keep reading for additional details regarding Real Time’s complaints against PointClickCare.
Update: On August 19, 2024, PointClickCare filed a Motion to Expedite Appeal with the United States Court of Appeals for the Fourth Circuit.