Data startup Particle Health sues Epic over antitrust concerns

Photo: HIMSSMedia

Startup company Particle Health, an intelligent data platform that aggravates patient data and sends it to healthcare companies, has filed an antitrust lawsuit against Epic Systems saying the electronic health record giant is using its market position to quash competition in the payer platform sector.

Filed today in the U.S. District Court for the Southern District of New York, the lawsuit alleges that Epic violated the Sherman Act, which prevents unfair competition, by stopping Particle from entering into the still nascent payer platform market.

In addition to monetary damages, Particle is asking for a court order to make Epic stop its current practices.

"Epic Systems controls the medical information of nearly every American – meaning one private company has unchecked power over our healthcare," said Particle CEO Jason Prestinario. "Now, Epic is using that power to thwart an emerging industry intended to bring payers and providers into closer collaboration for better patient care."

WHAT'S THE IMPACT?

The emerging payer platform market is intended to make data analysis in healthcare more modern and attuned to patients' care needs. The goal of the payer platform market is to ditch old-fashioned, paper-based processes in favor of efficient, scalable systems that can predict patient risk, analyze records and assist with clinical care decisions.

The lawsuit alleges Epic took actions that stifled Particle's ability to exchange health information. Over the past six months, according to the suit, Epic cut off data access for Particle customers and flooded the company's support staff with security concerns Particle considered "baseless."

According to the lawsuit, Epic's "manipulation" of EHR access is already having negative consequences for doctors and patients. The complaint details how a network of community oncology practices has seen over 2,800 patients' quality of care harmed because clinical information was blocked.

This instance, said the complaint, "shows just how far Epic is willing to go to harm Particle: it is willing to cut its own customers off from vital patient data, risking the lives of the most vulnerable patients in the process."

Epic said in a statement that Particle's claims are "baseless."

"This lawsuit attempts to divert attention from the real issue: Particle's unlawful actions on the Carequality health information exchange network violated HIPAA privacy regulations," said Epic. "Particle's complaint mischaracterizes Carequality's decision, which in fact proposes banning Particle customers that were accessing patient data for impermissible purposes."

THE LARGER TREND

Earlier this year Epic's new Rev Cycle Partners Program added Impact Advisors, a healthcare management consulting firm. The partnership program is designed to help healthcare organizations optimize their use of Epic to improve revenue cycle outcomes. 

Impact Advisors is partnering with Epic to help improve revenue cycle outcomes for mutual customers. It will provide end-to-end, customized revenue cycle services to optimize clients' use of Epic.

Jeff Lagasse is editor of Healthcare Finance News.
Email: jlagasse@himss.org
Healthcare Finance News is a HIMSS Media publication.