Benefits and Challenges of Interoperability in Healthcare 2026

A consistent subtheme related to the importance of relationships with the EHR vendor to support interoperability emerged. Efforts to develop SDoH data standards, such as the Gravity Project , were raised as opportunities to improve the interoperability of SDoH data. These providers described collecting SDoH data in discrete data fields but also noted that the lack of standardization of SDoH data fields remains problematic and results in questionable data quality and limited ability to combine data across sources.

ATriple Aim refers to an approach to optimizing health system performance based on improving population health, enhancing the care experience, and reducing costs . Conversely, BHPs indicated that they were not participating in value-based purchasing programs to the same degree. Likewise, hospitals preferred to develop their own in-house population health analytics platforms rather than outsource this function to HIEs. A critical driver for interoperability among hospitals was their participation in value-based payment programs and population health initiatives.

Some key informants felt that this policy was incongruent with new information blocking rules as part of the 21CCA. Despite the general recognition of the policy’s good intentions, it was viewed as negatively impacting clinical care. Hospitals also felt the costs of interoperability, such as establishing admission, discharge, and transfer feeds or registry reporting, fall predominantly on hospitals, yet there are no corresponding changes to reimbursement. Hospitals felt that there was room for a greater policy push for managed care plans to initiate value-based payment contracts and distribute incentives to providers.

Main challenges of interoperability in healthcare

Interoperability is a critical component of the healthcare sector, yet challenges of interoperability still prevent its adoption and implementation. Although policy initiatives to expand interoperability existed, they were often misaligned to operational needs and may not be sufficient to overcome market forces. Our findings suggest that despite the ubiquity of data and applications, seamless interoperability into a comprehensive medical record, both within and across providers, remains out of reach. Similarly, the study only included Ohio stakeholders, which minimizes variation in the policy environment healthcare interoperability challenges and may limit generalizability. Moreover, the API approach has the potential to facilitate population health analytics using machine learning techniques .

Interoperability's next chapter: How health systems are reenvisioning connected care

However, questions persist about how well these efforts assist health care organizations in achieving interoperability. Finally, the regional HIEs also mentioned that TEFCA helps to establish standards but did not include any information about FHIR-based standards. The implications of information blocking were particularly notable during the pandemic when withheld information about addresses prevented HIE from tracking COVID-19 at the local level.

The challenges of interoperability in healthcare

Healthcare interoperability delivers measurable benefits across seven dimensions. Organizational interoperability encompasses the governance, policies, and workflows that enable data to flow effectively across organizational boundaries, with appropriate consent and use controls. Foundational interoperability is the ability to exchange data between two systems, with no specific structure required for the receiving system to interpret it. Healthcare interoperability is the ability of different clinical systems, devices, and applications to exchange and use patient data effectively across organizational boundaries.

• Interoperability addresses these information gaps directly, with measurable reductions in medication errors, duplicate imaging, and adverse drug events in healthcare systems that have implemented robust interoperability.
• Patients with access to their complete clinical record become more engaged in their care, manage chronic conditions more effectively, and catch potential issues earlier than patients with fragmented access to their records.
• Without interoperability, that record stays fragmented across many separate systems, and clinicians make decisions with incomplete information.
• In contrast, for BHPs, interoperability across applications was not discussed; instead, remarks focused on off-the-shelf EHR systems being misaligned to the specific requirements for BHPs, such as lacking additional protections for substance abuse data.

Streamlined clinical workflows and reduced administrative burden

Recent initiatives such as TEFCA that mandate sharing standardized sets of data and promote the use of FHIR APIs are expected to facilitate interoperability in the coming years . Likewise, the growing support for API-based data sharing can further support interoperable information exchange between dissimilar EHR vendors. Thus, our findings highlight a need for user-centric approaches in technology design and implementation to translate increased information access to use.