Despite progress in digitization, health data far too often remains siloed across systems and sectors.
For providers, data siloes can threaten patient safety and hinder care coordination by forcing clinicians to make decisions without complete, timely information from other settings of care. For patients, fragmented data increases the risk of disjointed care, avoidable errors, unnecessary tests, inappropriate procedures, and delays in receiving appropriate treatment.
Persistent gaps exist in healthcare interoperability. For example, while a majority of physicians surveyed in a JAMA Open Network study indicated being at least somewhat satisfied with access to outside information, just 23% stated that it was very easy to use outside information. Even fewer (8%), said that it was very easy to use information from different electronic health record (EHR) systems.
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Separately, a Black Book Research report ranked countries by “interoperability rates,” defined as the percentage of healthcare providers such as hospitals, clinics, pharmacies, laboratories, and general practitioners actively exchanging patient data through standardized digital systems. At 59.8%, the U.S. interoperability rate significantly lags international peers like Estonia (99.1%), Finland (98.9%), and Denmark (98.2%).
To enhance clinical care and improve outcomes, it is essential that the healthcare industry focus on safely and securely connecting its many “islands” of data, extending beyond traditional physician-centric EHRs to include dentistry, optometry, therapies, social services, public health, and device data.
Ultimately, by building broader, deeper, longitudinal datasets that enable a more complete view of individuals’ and populations’ health information, the healthcare industry can achieve the long-term vision for interoperability that drives value-based results.
The problem with missing and fragmented health data
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Ideally, clinicians would have access to high-quality, comprehensive data for every patient from pre-conception to post-mortem. However, the most relevant patient data for clinicians is generally recent information, because it provides a window into the patient’s current health and care needs.
Data that does not appear in EHRs can include a wide variety of information, such as exercise, sleep, activities, dental and behavioral health, nutrition, patient-reported symptoms and outcomes, as well as many critically important social determinants of health.
In some cases, this data has not yet been integrated into EHRs, in part, because it has only recently been digitized and has not traditionally been thought of as accessible or essential health information. In other instances, this non-EHR data has not been standardized into widely usable formats, such as HL7 FHIR, or included in the US Core Data for Interoperability (USCDI).
Dental data offers a strong case in point. Dental and medical records are notoriously non-interoperable, which creates barriers to holistic patient care, according to a report by Niam Yaraghi, a senior fellow with the Brookings Institution.
Limited interoperability in the dental industry results from separate record systems, restricted access at co-located facilities, and traditionally limited collaboration. Even where medical and dental services are offered together, just 42% of dental providers can enter information into patients’ general medical records via the health center’s EHR system.
Despite strong interest from dentists in accessing patients’ medical records, the path to dental interoperability is hindered by issues associated with ownership of records, technical challenges, and lack of financial incentives, according to the report.
Though just one example, the dental industry’s struggles with interoperability offer a window into the challenges with fragmented patient data that providers routinely encounter.
Breaking down barriers to interoperability
Strengthening expectations for data sharing and applying information blocking rules more broadly would help close these gaps and ensure that relevant data can flow securely and reliably to the people and systems that need it.
Recent federal initiatives reflect growing momentum toward a more connected system. CMS’ proposed ACCESS model, which encourages the use of wearable device data in care delivery, signals support for incorporating emerging sources of patient-generated information into clinical workflows.
Meanwhile, ONC continues to advance the technical foundation for interoperability through FHIR-based exchange, TEFCA implementation, and ongoing expansion of the USCDI. Together, these efforts pair a clear vision of what data should move with a robust framework for how that exchange could occur across diverse settings.
Ensuring equitable participation is equally essential. Areas like behavioral health, alternative/complementary medicine, and social care often hold information that meaningfully shapes patient outcomes, yet many lack interoperable systems or clear pathways to share data.
Addressing privacy concerns, supporting standards development initiatives such as the Gravity Project for SDOH data, and creating financial incentives for active participation can bring new participants into the interoperability ecosystem. These steps will allow the healthcare system to utilize richer, more complete datasets to enhance decision-making, care coordination, and value-based performance.
Conclusion
Healthcare cannot achieve its goals for quality, equity, and value without breaking down the persistent barriers that keep critical information siloed across sectors.
By expanding standards, strengthening policy initiatives, and ensuring that all data contributors, from dentists to device manufacturers, can participate in nationwide exchange frameworks, the industry can build more complete, multi-dimensional health records that truly support care.
Photo: Nuthawut Somsuk, Getty Images
Dr. Steven Lane is the Chief Medical Officer at Health Gorilla and a nationally recognized leader in health data interoperability. As a practicing primary care physician, he brings deep clinical insight to his work advancing nationwide health information exchange. From 2020 to 2024, Dr. Lane served as Chair of the Carequality Steering Committee, helping guide one of the nation's most influential interoperability frameworks. He has also served on federal advisory bodies such as the ONC’s Health Information Technology Advisory Committee (HITAC). At Health Gorilla, he bridges the gap between policy, technology, and frontline care to ensure that data exchange delivers real-world clinical impact.
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