Particle Health, the data exchange and analytics company, filed a lawsuit filed Monday in the Southern District of New York alleging that Epic Systems is using its monopoly over electronic health records to block its provider customers from getting full patient medical records – and also barring the Particle platform from competing in the fledgling payer platform market. 

'Unchecked power'

Particle Health said in a statement sent to Healthcare IT News that it does not pursue the lawsuit lightly, but is suing in the name of preventing patient harm.

"When patient care is being harmed and powerful incumbents are stymying progress, we’re forced to do something," said Jason Prestinario, the company's CEO, in the statement.

Particle alleges Epic violated the Sherman Antitrust Act. It's seeking monetary damages and injunctive relief.

"After Epic’s clear abuse of power, we believe it is our responsibility to defend our mission, which drives innovation and ensures that patients receive an ethical and transparent quality of care," Prestinario also said Monday in a social media post. 

He added that the EHR giant – which holds health information for nearly every American – is using its dominance to "thwart an emerging industry" breaking down patient data silos notorious to healthcare," alleging that "one private company has unchecked power over our healthcare."

Particle claims, for example, that community oncology practices have seen the quality of care for more 2,800 patients compromised due to Epic blocking important clinical information to doctors who work on Epic’s EHR software. 

While Particle has attempted to deliver those records, the company said it explained in its complaint, Epic is willing to go to extreme lengths to edge out competition. 

"It is willing to cut its own customers off from vital patient data, risking the lives of the most vulnerable patients in the process," Particle said in a statement.

Epic's response

"Particle’s claims are baseless," an Epic spokesperson told Healthcare IT News by email Monday.

In March, Epic filed a formal dispute with Carequality – a nonprofit nationwide health information exchange – claiming that Particle was sharing patient data for purposes not authorized under privacy protection law, according to a statement on the latter's website. Particle denied wrongdoing and said it complied with all informal inquiries from Epic over several months.

"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," the Epic spokesperson said.

"Particle’s complaint mischaracterizes Carequality’s decision, which in fact proposes banning Particle customers that were accessing patient data for impermissible purposes." 

Particle also said that Epic not only cut off access to data, but filed "now-discredited complaints, and overwhelmed Particle’s support operations by stoking baseless security concerns."

Carequality, the clinical interoperability framework, said that since it is not a party in this lawsuit, it would not be appropriate to comment on ongoing litigation.

"What we can say is that Carequality is committed to the integrity and transparency of our interoperability framework," a spokesperson told Healthcare IT News by email Tuesday. 

"We feel confident in our independent and non-biased dispute resolution process, which considers all the information in meticulous detail to reach an outcome that preserves trust, improves our network and reaches the best outcome for our community. That process resulted in a resolution that is still being considered by the parties, and therefore, we will not comment on the specifics." 

Recent history of dispute

Particle Health, which, according to its website, aggregates, cleans and contextualizes clinical data to provide a clearer picture of patient health, has been in a dispute with Epic for nearly six months.

In April, the company's founder Troy Bannister confirmed that Epic stopped responding to requests for patient information on the Carequality framework from its customers.

"These partners were all reviewed by Carequality prior to onboarding and they are entitled to fair and transparent treatment by the network and other implementers," he said in a social media post.

"Carequality takes any dispute very seriously and is committed to maintaining the integrity of the dispute resolution process as well as trusted exchange within the framework," the interoperability framework responded in a statement on its website just days later.

But, "Carequality cannot comment on the existence of any dispute nor comment on the activities of implementers." 

Bannister said that despite Epic disconnecting providers on a "massive scale" without warning, Particle – a startup that received millions in investment in 2022 and 2020 would remain connected to the health information exchange framework.

"Our healthcare system stands at a crossroads," said Particle's Prestinario in a statement. "Timely and complete medical information is critical to effective care. Regrettably, Epic is hoarding the data, showing how it can rapidly seize control of all markets that depend on the clinical records that rightfully belong to patients."

"Epic’s software is open and interoperable, allowing healthcare organizations to easily share data under HIPAA and all relevant regulations," a spokesperson for the EHR company said by email. "Epic will continue to protect patient privacy and vigorously defend itself against Particle’s meritless claims."

This article was updated on September 24, 2024, with a statement from Carequality.

Andrea Fox is senior editor of Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a HIMSS Media publication.