Which barrier to health information exchange is NOT addressed by HITECH?

• A. There are few agreed-upon technical standards for health IT.
• B. The transfer of information between institutions is not secure.
• C. There are few statewide examples of health information exchange.
• D. Hospitals may lose competitive advantage if they exchange information with others.

Answer: (D)

The key idea here is understanding what HITECH was designed to remove as obstacles to exchanging health information. HITECH drives widespread use of health IT and the ability for different systems to talk to each other by pushing for interoperable technical standards, strengthening privacy and security protections, and supporting development of health information exchanges across states. Because its purpose is to enable and encourage sharing, it does not view collaborative data exchange as a barrier. In fact, it provides incentives and frameworks that make sharing safer and more feasible.

So the barrier about hospitals potentially losing competitive advantage by sharing information is not something HITECH targets. It’s more about the fear or perception of competitive harm, whereas HITECH aims to promote sharing to improve care, with safeguards and standards to address legitimate concerns.

The other options fit with what HITECH addresses: there were not enough standard approaches to health IT, which HITECH addresses through pushing interoperability; information transfers needed stronger security and privacy protections, which HITECH strengthens; and there were few statewide HIE examples, which HITECH funds and supports to build out.