State of Interoperability

Comprehensive insights from healthcare leaders about health data exchange

When it comes to health data, we’re at a crossroads.

Since the passage of the 21st Century Cures Act and the Trusted Exchange Framework and Common Agreement (TEFCA), the directive has been clear — health information must be shared electronically with trusted parties.

But how are healthcare organizations shifting in response to the legislation? How do decision-makers across the industry feel about health information sharing in the context of the incentives that drive their businesses?

We surveyed executives across the healthcare ecosystem to find out.

We surveyed over 130 senior healthcare executives with decision-making authority.

Part 1

Health Systems
40 CIOs and CMIOs at top 50 health systems

Part 2

EHRs
25 VPs of Platform at top 20 EHR companies

Part 3

Digital Health
36 venture-backed digital health product VPs and CTOs

Part 4

Diagnostic Labs
31 VPs and CIOs at diagnostic vendors

Download the full report to guide your data strategy.

Advances in interoperability are resulting in major strategic shifts across many healthcare stakeholders, including provider organizations, EHRs, and digital health companies. We surveyed key decision-makers to:

Understand how CIOs are navigating new regulations
Discover emerging use-cases for leveraging clinical data
Learn about issues related to patient data access and data quality

Select a Section

Part 1

Health Systems

The success of national health information exchange relies on broad participation from health systems, which produce the data that the rest of the ecosystem relies on. How are health systems accommodating the push for broader data exchange, and what are the obstacles that prevent progress?

Who did we survey?

40 CIO and CMIOs
Top 50 health systems

Health systems participate in health information exchanges (HIEs) to help providers get data faster.

Additional reasons for participating in an HIE

Maintaining a competitive advantage in their market (60%)
Reducing administrative costs associated with EHR data retrieval (55%)
Avoiding penalties associated with information blocking (50%)

Nearly every health system said they participate in HIEs to help providers get data faster.

94% Cited easier data retrieval as the primary reason for participating in an HIE.

Health system CIOs support the Trusted Exchange Framework and Common Agreement (TEFCA) — but not without reservations.

91%

Were supportive of TEFCA

58%

Expressed the need for more protection and guardrails around the data.

23% already comply with TEFCA standards.

68% are working to comply with TEFCA standards.

A majority of health systems are working to comply with TEFCA in anticipation of reimbursement changes.

Most health systems support sharing patient data for purposes beyond treatment.

58% Support broad health information sharing for multiple permitted purposes, including individual access and payment and operations.

29% Support sharing data for Individual Access Services, enabling consumers to retrieve their health records.

13% Will only share the minimum amount of data necessary to comply with regulatory demands.

Concerns about data security and patient privacy persist, regarding TEFCA.

75% Reported data privacy and security as their primary concern.

65% Anticipate an additional burden on their IT staff.

Health system respondents were mixed about the quality of the data received through health information exchanges.

2% found the data to be perfect or near perfect quality
38% found the data to be good quality
50% found the data to be OK quality — some duplicative, incomplete, or junk data
8% found the data to be bad quality — lots of duplicative, incomplete, or junk data
2% found the data to be very bad quality — nearly all duplicative, incomplete or junk data

A majority of health systems respondents use data from health information exchanges to inform patient care.

Supporting patient care or related visits 83%
Analyzing chronic disease burden or a particular patient population 55%
Identifying patients who may be due for care (i.e., annual wellness screening) 50%
Business intelligence purposes 28%
Identifying patients who may be eligible for clinical trials 20%

Download the full report to guide your data strategy.

Part 2

EHRs

Electronic health records (EHRs) are central to unlocking true interoperability. In light of an evolving regulatory landscape, EHR product executives are re-evaluating their data exchange strategy. Here's what we found.

Who did we survey?

25 VPs of Platform
Top 20 EHRs

Most EHRs participate in HIEs to make it easier for providers to retrieve medical records from third parties.

Improve the provider experience of retrieving external medical records 55%
Comply with government mandates and avoid information blocking penalties 36%
Aggregate more data and commercialize the dataset 5%
Stay competitive in the EHR landscape 5%
Upsell new functionality to provider customers 5%

A majority of EHR respondents participate in CommonWell Health Alliance.

56% participate in CommonWell Health Alliance.

EHRs are interested in accessing non-traditional data types, like historical diagnostic data.

Most EHRs want to surface novel data types to providers at the point of care.

80% of EHR respondents want to make it easier for providers to get complete clinical records from third-parties.

Digital health executives want access to claims data, pharmacy data, and other novel data types.

Claims 58%
Patient-reported outcomes 42%
Pharmacy 39%
Diagnostics/Imaging 36%
SDOH 28%

Part 3

Digital Health

Many venture-backed startups have grown rapidly with the rise of value-based care models, requiring data to fuel their business models. By leaning away from commercial EHRs and towards custom platforms, new opportunities and challenges arise.

Who did we survey?

36 Product VPs and CTOs
Venture-backed healthcare startups

Most digital health companies use HIE data to deliver patient care, but the list of use cases is expanding.

Delivering care for chronic conditions 61%
Delivering primary care 50%
Patient onboarding 44%
Screening patients before clinical visits 39%
Population analysis 39%
Longitudinal tracking after clinical visit 31%
Clinical research 19%

Digital health companies have multiple ways to retrieve EHR data.

EMR integration, connected by a third party 33%
Direct EMR integrations, built in-house 25%
Our internal staff retrieve charts or clinical information manually 22%
Direct integration with a health information exchange 22%
Patient-mediated or consent-based retrieval 19%

The data isn’t perfect.

Incompleteness and gaps in the data are persistent problems for patient data retrieved through national networks.

Lacking specific kinds of health data (medications, progress notes, labs, etc.) 36%
Issues relating to duplicative and junk data 25%
Not receiving data from specific clinical sites of interest 16%

Part 4

Diagnostic Labs

Diagnostic labs pose a unique challenge for achieving interoperability goals. There is debate in the community whether data from labs is subject to the same data sharing regulations as EHR data. Our findings show that labs continue to lag behind as participants in health information sharing.

Who did we survey?

31 VPs and CIOs
Diagnostic labs

Labs aren’t interested in sharing data, yet.

39% Already share lab information with HIEs to comply with regulations.
26% Said data sharing was not a priority and they were unfamiliar with efforts from ONC to incentivize data sharing.
22% Are evaluating ways to share diagnostic information more broadly.
10% Believe regulations do not impact diagnostic labs.

Labs want access to EHR data on the patients they serve.

Respondents overwhelmingly indicated that they would benefit from real-time access to complete, identifiable patient data.

Identifying patient testing needs and/or gaps in care 55%
Development of new tests 52%
Reducing the administrative burden associated with reimbursement 45%
Outcomes research to establish efficacy of testing 39%
Business planning and operation purposes 32%