Real Time Medical Systems has asked a federal judge to force the nation’s largest post-acute EHR provider to keep its clients’ data accessible, saying information blocking “will cause needless patient suffering, including otherwise-preventable hospitalizations and deaths.”
PointClickCare last week fired back, arguing that it has integrated with about 1,900 other companies to share data via “stable and secure access” that protects patients’ electronic health information.
In a June 7 court filing, attorneys for the EHR provider called Real Time’s request for an injunction that would open up skilled nursing patients’ data on the PCC platform “unprecedented and dangerous.” The company said the changes Real Time wants would make it vulnerable to attacks from automated bots, and not just those it alleges are being used by Real Time.
“Data integrity is a matter of life and death,” PCC argued. “Allowing bots to launch unlimited high-volume queries to a healthcare database, as RTMS desires, would damage PointClickCare’s system by (1) causing delays and outages that harm the patients who rely on it; and (2) permitting malicious actors to deploy bots to damage or manipulate patient data.”
The case pits a growing analytics firm against the behemoth EHR provider, which has previously reported its electronic health record system is used by 70% of US skilled nursing facilities. PointClickCare offers some analytics tools and has made several acquisitions since 2020 aimed at growing those capabilities.
Information blocking concerns
The plaintiff alleges PointClickCare has blocked access to certain patient information to gain a competitive advantage in the analytics arena, though Real Time regained access following its injunction request. Without permanent relief — and no way to know what will be blocked or when — the Maryland-based company predicted it could collapse.
“Real Time will be unable to fulfill its contractual obligations to the nursing facilities, will be forced out of business and will ultimately cease to exist as a business before this lawsuit reaches a verdict — thereby allowing PCC to advance its competitive service to Real Time’s nursing facilities upon Real Time’s forced departure from the marketplace,” read a motion for an injunction filed in the US District Court for the District of Maryland.
In an interview with McKnight’s Long-Term Care News Wednesday, Real Time’s founder and its lead attorney argued the information blocking began sporadically in 2022 but became more common by late 2023. In that period, Real Time had been selected to deliver analytics support to the state of Maryland over PCC’s emerging analytics arm, Real Time Founder Scott Rifkin said. The company filed suit in January and moved for the injunction following a new round of alleged information blocking in mid-May.
“Most EMR companies work great with us,” Rifkin told McKnight’s, noting partnerships with at least 10 other electronic records providers. “PointClickCare used to work fine with us. Then they started producing products that compete with us. Suddenly, they couldn’t give us the data anymore, and they upfront told us that.”
Need data to intervene for patients
Real Time uses EHR data to identify areas where nursing homes can improve outcomes, such as by detecting early signs of infectious disease, automating antibiotic surveillance, reducing hospital readmissions and coordinating care.
Rifkin said the move to prevent routine queries into patient data technically owned by patients ran counter to the 21st Century CURES Act requirements to increase interoperability.
A spokeswoman for PCC said Wednesday company officials do not comment on matters before the court. But she said the company “remains committed to enhancing the interoperability of our technology and this continues to be a central focus for us.”
In its latest filing, PCC said it had blocked Real Time’s access because “unauthorized or improper access threatens … critical stability.” It argues that giving Real Time “unfettered access” would violate its legal agreements with skilled nursing providers, give the company “preferential treatment” over other vendors, and breach federal security obligations.
“PointClickCare’s system was not designed for, and cannot securely handle, RTMS’s high-volume bot usage. Such usage can cripple PointClickCare’s system, risking lives,” the company wrote.
But Real Time lead counsel Celeste Bruce, a partner with Rifkin Weiner Livingston, said PCC was hiding behind exceptions built into the CURES Act. The company’s reliance on CAPTCHA, which prompts users to prove they are human with mini tests, had already forced Real Time staff to enter queries manually.
Even then, Bruce said, the CAPTCHA images are indecipherable and make data inaccessible. She and Rifkin also noted Real Time’s IP address would be visible to PCC, and that Real Time holds a HITRUST certification demonstrating its own commitment to secure technologies.
She likened the case to a David vs. Goliath battle, noting that few other post-acute vendors want to take on a titan in the industry.
But information-blocking itself is becoming a hot-button legal issue as courts take a closer look at companies’ responsibilities to secure and share data they might not actually own. A similar case is proceeding in California, where analytics firm Intus Care is suing RTZ Associates, a leading provider of case management and care coordination software for PACE programs.
In Maryland, a hearing on Real Time’s injunction request is set for June 24.
