Patient groups have criticized medical record vendors, like Epic and its chief rival Cerner , for failing to do enough to support health data interoperability. Both companies have stressed that they're doing more to fix the problem, although progress has been slow.

On the other side, patient advocates have spoken out in favor of the rules, which aim to make medical records accessible through application programming interfaces (APIs). The rules are also designed to make it easier for hospitals to share patient records with other medical offices or hospitals. That's been a big challenge for years , and studies have shown that it has a negative impact on patient's health.

The proposed rules have pit patient advocates against some doctor groups and companies, like Epic. Critics say they don't have enough provisions to protect patients' privacy. Epic's Faulkner has been vocal in her criticism of the rule, which she believes will result in app makers having access to patient data without consent.

The email, which was written by Epic CEO Judy Faulkner and addressed to CEOs and presidents of hospital systems, urges recipients to sign a letter alongside Epic that voices disapproval for rules the Department of Health and Human Services proposed in 2019. These rules aim to make it easy for patients to access their health information at no cost, and make it more challenging for companies to block access to that information.

Epic Systems, one of the largest medical records companies, emailed the chief executives of some of the largest hospitals in the U.S. on Wednesday, urging them to oppose proposed regulation designed to make it easier to share medical information.

The letter includes an urgent call to action. "HHS needs to hear from you so they understand that you feel these issues are important," it says. "Very little time is left."

It also notes that other "healthcare CEOs" have signed the email, which is addressed to HHS Secretary Alex Azar. The email also includes attachments with more information, including the letter that Faulkner hopes that the recipients will sign.

Epic confirmed that it sent the letter.

A spokesperson for the Office of the National Coordinator for Health IT, which sits under HHS, said by phone that a "lot of energy" went into to making that sure that the proposed rules support patient choice. "We want the public to have computational right of access to health information so they can have control over apps of their choosing," they said.

Former White House Chief Technology Officer Aneesh Chopra expressed frustration over Epic's move. "It is unfortunate to see this much effort placed at stalling the important, bipartisan progress we have made to open up health information -- at a minimum to consumers and institutions they trust."

Epic, which has remained private despite getting its start in the late 1970s, has some sway over its health system customers, who sometimes shell out upwards of a billion dollars to buy and deploy the software. The company recently notified some of its customers that it would no longer integrate with Google Cloud.

The largest technology companies, who could benefit from easier access to patient records so they could create products for the health industry, have largely stayed silent on the topic. Several of them, including Microsoft and Apple, have spoken out against practices in health care that make it challenging for providers to share medical records, and for patients to access their health data. But they have not issued statements on the data-blocking rules thus far.

Here's the letter, without names and contact information:

Subject: Your Help Needed on ONC Interoperability Rule Dear CEO / President: ONC's Proposed Rule could negatively affect patients and health care organizations. HHS needs to hear from you so they understand that you are feel these issues are important. Very little time is left. We are concerned that health care costs will rise, that care will suffer, and that patients and their family members will lose control of their confidential health information. Please review the attached information, and if you agree with these concerns, join other healthcare CEOs by signing the attached letter to HHS Secretary Alex Azar, with a copy to Director of the Domestic Policy Council Joe Grogan. We all fully support helping patients have access to their data. Your patients have been able to download their health information since 2010.

Your patients have been able to share their health information with anyone in the world that has internet since 2017.

Care Everywhere allows you to interoperate with other health systems and was developed years before Meaningful Use required interoperability.

Epic interoperates with thousands of third-party products/apps. Let's prevent the unintended consequences of this rule and make sure the final rule is a good one that is modified to help, not harm, healthcare organizations and patients. ONC may finalize the rule the first week of February, so we must get the message to them right away. Thanks for your help in this very important matter.﻿

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