Barriers to Obtaining and Using Interoperable Information
A 2024 study of non-federal acute care hospitals in the US found that fragmented, multi-vendor EHR environments remain the single biggest obstacle to health data interoperability — and the problem is disproportionately worse for smaller institutions.
Everson & Richwine — JAMIA 2024, PMC open access ↗What the Data Actually Shows
of hospitals encountered at least one major or minor barrier to health information exchange.
reported greater challenges exchanging data across different EHR vendor platforms — the #1 overall barrier.
experienced at least one major barrier to obtaining or using interoperable information.
more major barriers reported by small independent hospitals versus large system-affiliated institutions.
Source: Everson J, Richwine C. “Barriers to obtaining and using interoperable information among non-federal acute care hospitals.” J Am Med Inform Assoc. 2024. DOI: 10.1093/jamia/ocae263. View full study ↗
What Multi-Vendor Fragmentation Actually Costs
AI and analytics initiatives stall
When patient data lives across Epic, Cerner, Athena, and a dozen other vendors' systems, building a unified ML-ready dataset requires manual reconciliation at every step. Most health systems' AI roadmaps fail at the data layer before a single model ships.
Compliance becomes a manual burden
HIPAA audit trails, 21st Century Cures Act compliance, and FHIR mandate reporting all require complete, traceable data lineage across sources. Fragmented environments turn compliance into a full-time reconciliation job.
Small and independent hospitals are hit hardest
The study found small independent hospitals face more than twice as many major barriers as large system-affiliated institutions — a structural disadvantage that compounds over time as integration debt accumulates.
