5 Interoperability Challenges Limiting Healthcare Data Exchange

For more than a decade, healthcare leaders have pursued the goal of seamless health information exchange. While significant progress has been made through advancing standards, TEFCA, and information blocking regulations, healthcare interoperability remains an ongoing journey.

Recent findings from the Office of the National Coordinator for Health Information Technology (ONC) highlight several persistent obstacles that continue to shape healthcare data exchange. Below are five key takeaways from the latest industry research.

1. Inconsistent adoption of interoperability standards– The healthcare industry has made substantial strides toward consistent data exchange, but fragmented adoption of modern interoperability standards prevents truly seamless exchange. While some systems support newer FHIR standards and advanced API functionality, others still rely on legacy architectures with limited interoperability capabilities. As a result, patient information may technically be exchangeable but not always accessible, reducing its clinical value. To address these challenges, the ONC continues to advance nationwide interoperability through initiatives such as the U.S. Core Data for Interoperability (USCDI), Health IT Certification requirements, and ongoing standards development efforts.
2. Financial and resource constraints– Interoperability requires ongoing investments in technology, cybersecurity, integration, staff training, and workflow optimization. Many healthcare organizations continue to balance modernization efforts against competing operational and financial priorities. Beyond implementation costs, organizations must also dedicate resources to maintaining interfaces, managing data governance, supporting regulatory requirements, and keeping pace with evolving interoperability standards. The ONC recognizes that these various resource constraints make it challenging to prioritize interoperability.
3. Information blocking and data accessibility– Although federal regulations now prohibit information blocking, healthcare organizations continue to navigate questions around data sharing, governance, consent, and compliance. The ONC has increased its focus on information blocking oversight while promoting greater transparency and patient access to health information. The industry’s challenge is shifting from whether information can be shared to how organizations can share it securely and efficiently.
4. Administrative and regulatory burden– Providers continue to cite documentation requirements, reporting obligations, and compliance activities as contributors to clinician burnout and operational inefficiency. While CMS and ONC have implemented measures intended to reduce burden and simplify interoperability participation, healthcare organizations still face significant administrative workloads associated with quality reporting, data governance, and regulatory compliance.
5. Expanding participation across the care continuum– Interoperability progress has been strong among larger hospitals and health systems, but gaps remain across behavioral health, public health, rural healthcare, and community-based providers. Recent research has shown that some care settings continue to lag in electronic health information exchange due to factors such as workforce limitations, technology disparities, privacy concerns, and budget constraints. As a result, many providers rely on external technology partners or interoperability platforms to simplify connectivity and reduce the burden of managing complex interfaces.

Today, the healthcare industry has stronger standards, nationwide exchange frameworks like TEFCA, expanding patient access capabilities, and increased regulatory support for data sharing. Yet significant interoperability challenges remain. Healthcare organizations that proactively optimize their EHR platforms, strengthen data governance, and invest in integration solutions will be best positioned to deliver more connected, patient-centered care.

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