Barriers to obtaining and using interoperable information among non-federal acute care hospitals

OBJECTIVE: To understand barriers to obtaining and using interoperable information at US hospitals. MATERIALS AND METHODS: Using 2023 nationally representative survey data on US hospitals (N = 2420), we examined major and minor barriers to exchanging information with other organizations, and how barriers vary by hospital characteristics and methods used to obtain information. Using a series of regression models, we examined how hospital experiences with barriers relate to routine use of information at responding hospitals. RESULTS: In 2023, most hospitals experienced at least one minor (81%) or major (62%) barrier to exchange, with the most common major barriers relating to different vendors and exchange partners' capabilities. Higher-resourced hospitals and those often using network-based exchange tended to experience more minor barriers whereas lower-resourced hospitals and those often using mail/fax or direct access to outside electronic health records experienced more major barriers. In multivariate regression, hospitals indicating "Patient matching" and "Costs to exchange" were a major or minor barrier had the strongest independent negative association with the likelihood of reporting providers at their hospital frequently use information from outside organizations. DISCUSSION: Despite progress in interoperable exchange, various barriers remain. The prevalence of barriers varied by hospital type and methods used, with barriers more often preventing exchange for lower-resourced hospitals and those using outdated exchange methods. CONCLUSION: While several technical and policy efforts are underway to address prevalent barriers, it will be important to monitor whether efforts are successful in ensuring information from outside organizations can be seamlessly exchanged and used to inform patient care.