Carequality, an interoperability network, released findings from a previous dispute between Epic Systems and startup Particle Health.
Carequality released the resolution Oct. 8 following Epic's push for the interoperability network to disclose the findings of its dispute with Particle Health, which had raised concerns about some of the company's data-sharing practices.
Twelve things to know about the released resolution:
- In March, Epic accused three Particle Health customers of submitting queries through Carequality, a nationwide health data exchange network connecting over 600,000 healthcare providers, 50,000 clinics and 4,200 hospitals. Epic alleged that these queries were falsely labeled as being for treatment purposes when, in fact, they were not.
- Epic had requested several actions against Particle Health, seeking to declare it a "Carequality Implementer" not in good standing and to prevent it from adding new connections. Epic also wanted to establish a process for Particle to regain good standing and re-onboard its current customers. Epic additionally demanded detailed records of each patient record accessed through Particle's system and confirmation of the deletion of any improperly obtained data.
- On May 3, Particle Health responded to Epic's claims and filed its own complaint against Epic. It accused Epic of suspending responses to treatment queries from several Particle connections without proper justification. Particle also alleged that Epic violated anti-discrimination rules by applying arbitrary criteria for suspending responses and failing to onboard new Particle connections in a timely manner while accepting others. Additionally, Particle accused Epic of bypassing the established dispute resolution process and making misleading public statements.
- Particle Health requested several actions from Epic, including the resumption of responses to all suspended queries and a revision of Epic's onboarding policies to ensure compliance with Carequality rules. Additionally, Particle sought recognition for certain queries as "treatment" queries, the appointment of its own representative to the Carequality steering committee and a denial of all of Epic's claims.
- In June 2024, Particle Health informed a panel of Carequality community members — who were reviewing claims between Epic and Particle Health regarding their participation in the network — that it had terminated its contracts with two of the companies in question.
- In the resolution, the Carequality panel prohibited the two former Particle Health customers from participating in Carequality for any allowed purposes, including treatment, for a duration of 12 months. This decision was made because the customers had submitted queries that were not intended for treatment purposes in certain instances. The panel also stated that after the suspension, these organizations could only rejoin Carequality with explicit approval from the steering committee.
- The third Particle Health customer brought into question was allowed to use Carequality to exchange information for treatment purposes, as this organization acted as a business associate for healthcare providers. Additionally, as part of the resolution, Particle Health agreed to obtain additional written documentation from this customer. This documentation aimed to ensure that the customer had the necessary records outlining its relationships with the healthcare providers it serves.
- In response to Particle Health's allegations that Epic violated Carequality's anti-discrimination rules by refusing to exchange data with certain customers, Epic committed to specific actions as part of the resolution. The company agreed to revise its policies to create clear, objective criteria for determining whether an organization is engaged in treatment. Additionally, Epic had to provide information to Carequality for the next six months to verify its compliance with these updated policies.
- "The Carequality steering committee resolution confirms that Particle Health customers improperly accessed individuals' medical records by falsely claiming to be treating them as patients," an Epic spokesperson told Becker's. "As a result, Particle has been placed under a corrective action plan. Three of its customers, including one that supplied records to class action law firms, have either been suspended from the network or are facing other sanctions. This resolution reaffirms that Epic and its customers took the necessary steps to protect patient privacy."
- "The increased transparency and clarity outlined in this statement — particularly as it calls on Epic to make changes for more open communication with the ecosystem — will benefit all participants and drive positive innovation for patient care," Particle Health CEO Jason Prestinario said in a statement shared with Becker's.
- This resolution comes as Particle Health filed a federal lawsuit in New York, accusing Epic of deliberately undermining its competing platform in violation of U.S. antitrust laws.
- Epic claims Particle's lawsuit is baseless.