Information Blocking Regulation Drives EHR Openness and API Competition

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The author argues that the Information Blocking regulation functions not merely as punitive enforcement but as a 'deterrent'—a threat of being caught that reshapes behavior. This legal pressure is causing EHR vendors to proactively pursue openness. Specific examples include Epic relaunching its developer conference and listing proprietary APIs, alongside rewriting its vendor agreements. Furthermore, eClinicalWorks has been observed shipping FHIR APIs at a pace exceeding compliance requirements (e.g., full CRUD on programmatic e-prescribing data, various encounters, and observation records). These developments indicate skyrocketing investment in integration technology across the industry, making openness a core growth strategy. The author concludes that this regulation has transformed the challenge from a 'sprint' into an 'ultramarathon,' guiding the industry toward releasing capabilities that enable access, use, and exchange of all EHI (Electronic Health Information). In Japanese healthcare IT, where data linkage and standardization are critical challenges, ensuring interoperability through open APIs like FHIR is paramount. This article serves as a key example of how external regulatory pressure can drive technological advancement (specifically API exposure) toward achieving systemic openness.