Particle Provides an Update on Carequality Network

We are providing an update regarding our previous statement on April 9, 2024. At present, we are actively collaborating with Epic to get the remaining impacted customers–for whom there are no formal complaints–back online.

Particle Health is strongly committed to privacy and security. Our mission is to unlock the power of medical records in an intelligent platform that focuses health back on the patient. We have always responded rapidly and robustly to data-supported complaints through appropriate channels. There is no debate about this fact.

Maintaining trust and accountability is core to our mission and we build strong systemic protections for security and privacy into our platform. Particle Health customers commit to a rigorous onboarding process and must adhere to all standards as outlined in the Carequality framework in interactions with Particle Health or are immediately removed. If complaints are filed against any customer by other parties, we expect they will be managed through agreed upon channels and we assist in all legitimate investigations.

Multiple issues are being conflated in the timeline and information presented by Epic on April 10, 2024. We are responding to these publicly because the document in question was distributed publicly. Epic did not shut off Particle Health as an entity, nor did Carequality. We want you to know that Carequality has not suspended Particle's Health ability to participate in data exchange.

The emergent issue is that after filing an unrelated complaint on March 21, 2024 Epic stopped responding to data requests from a subset of customers of Particle Health, without a clearly stated reason or explanation (as addressed in our April 9, 2024 statement). We began addressing this issue immediately and alerted our impacted customers. In subsequent conversations we have made significant progress towards resolving this connectivity, with some customers already turned back on. We are continuing working collaboratively with Epic and remain committed to upholding our mission by standing up for our customers and supporting the legitimate use of health data exchanges. We appreciate Epic’s collaboration on this issue.

A separate and broader concern is that over a series of months, individuals at Epic thought certain customers of Particle Health ‘might be inaccurately representing the purpose associated with their record retrievals’ and extrapolated this to assert that Particle ‘might not be fulfilling its obligations as a Carequality implementer’ (from April 11, 2024 Epic letter, emphasis ours). We are happy to investigate the former and object strongly to the latter. We did not receive any formal complaints relating to these issues until March 21, 2024. Of note, section 5.3.3 of the Carequality Connection Agreement states that if there is a legitimate privacy or security concern - that an implementer must file a dispute within 30 days. This provision grants limited exemption from section 8 - which states that an Implementer is not allowed to limit exchange with another Implementer. Particle Health has, over the course of these months, worked collaboratively on all informal inquiries from Epic and intends to support our customers through the formal complaint process.

While we have followed all guidelines and consistently acted in good faith, there is, in fact, no standard reference to assess the definition of Treatment nor the application of the definition of treatment as it pertains to data requests. These definitions have become more difficult to delineate as care becomes more complicated with providers, payers, and payviders all merging in various large healthcare conglomerates. The growth of value based care continues to blur that line as well. We welcome this discussion. It’s in fact a discussion we have been actively having with Carequality for months.

Carequality helps facilitate consensus among stakeholders regarding the validity of a use case as a treatment purpose of use. As a health data community, we need to all come together to agree to a clear set of rules of the road so that we can avoid these kinds of potentially biased decision-making conflicts in the future. A cascade of inherently-biased entities (including Particle) making independent judgments on data access is orthogonal to the spirit of the Cures Act.