Texas AG sues Epic over health data, 'monopolizing' EHR industry

Texas Attorney General Ken Paxton has filed a lawsuit against Epic Systems, alleging the EHR vendor "monopolizes" the EHR industry and restricts parental access to minors' patient portal accounts.

At the heart of the lawsuit is the issue of health data exchange. The lawsuit alleges Epic does not enable adequate health data exchange, which has allowed the company to gain significant market share.

"For decades, Epic has amassed control over patient data by locking up hospitals into Epic's EHR, which in turn allowed Epic to insert itself as gatekeeper over the underlying patient data," the lawsuit states. "Epic controls who can access this data, when they can access it, and the terms by which they can access it -- despite the simple fact that it is the hospitals' and patients' data, not Epic's."

Indeed, Epic Systems houses medical records for more than 325 million patients, including tens of millions of Texans, the lawsuit says. This amounts to 90% of all U.S. citizens' records.

Other alleged anticompetitive behaviors include limited interoperability with non-Epic EHRs and imposing penalties for customers that switch into any overlapping competitor applications.

The lawsuit contends that these behaviors don't just harm the EHR industry as a whole, but the patients receiving care themselves.

Electronic health records are essential to providing quality patient care. Without access to those records, healthcare providers are sometimes limited in what they can do to treat a patient and, in some cases, can make medical errors. The Texas Attorney General's lawsuit alleges that Epic Systems does not enable adequate patient data exchange.

In a statement received via email, Epic Systems outlined its current data exchange capabilities.

"The action taken by Texas is flawed and misguided by its failure to understand both Epic's business model and position in the market and the enormous contributions our company has made to our nation's healthcare system illustrated by products like MyChart -- software that tens of millions of Americans depend on every day," according to an Epic spokesperson.

"Every month, we improve quality of care by helping providers see a more comprehensive picture of their patient through over 725 million record exchanges -- more than any other electronic health records vendor -- and over half of these are with non-Epic systems. Health systems using Epic shared information with almost 1,000 patient-facing apps 2 billion times in the past year."

In addition to taking on alleged anticompetitive behavior, the lawsuit addresses issues with minor patient portal accounts.

The lawsuit says Epic Systems designs patient portal accounts for minor children to obscure certain information from parents. Specifically, it alleges that Epic's patient portal accounts automatically block parents from seeing medication lists, treatment notes and provider messages once a child turns 12 years old.

According to Paxton, this violates Texas Health & Safety Code § 183.00, granting parents complete and unrestricted access to their children's medical records.

"We will not allow woke corporations to undermine the sacred rights of parents to protect and oversee their kids' medical well-being," Paxton said in a press release about the lawsuit. "This lawsuit aims to ensure that Texans can readily obtain access to these records and benefit from the lower costs and innovation that come from a truly competitive electronic health records market."

Epic Systems said it does not dictate parental access to its MyChart patient portal.

"Epic does not determine parental access to children's medical records," the Epic spokesperson said. "Decisions about parental access to children's medical records are made by doctors and health systems, not by Epic."

Sara Heath has reported news related to patient engagement and health equity since 2015.