Hands in the EHR Jar: Breaking Interoperability Barriers to Unlock Healthcare's Digital Goldmine

Healthcare data accounts for up to 30% of the world’s total data volume, yet reports suggest that as much as 97% of hospital data remains unused, trapped in silos across fragmented systems. Electronic Health Records (EHRs), the cornerstone of modern health IT infrastructure, were designed to centralize patient information and improve care coordination. But despite widespread adoption and advancing technology, the healthcare industry has yet to realize the full value of its digital assets. Persistent interoperability challenges keep this data locked away, limiting its potential to transform outcomes, streamline care, and inform innovation.

The Paradox of Progress: Healthcare’s Data Explosion vs. Locked Value

Healthcare data is growing at a staggering 36% annually. In the U.S., 88.2% of office-based physicians now use EHRs, and the global EHR market is projected to exceed $44 billion by 2034.  Despite this widespread adoption, health systems remain digitally fragmented. EHRs have simply replaced paper silos with digital ones, often segmented by hospital, department, vendor, or geography.

The scale of fragmentation is immense. A single hospital may rely on 10 different EHR vendors, a figure that rises to 16 when affiliated providers are included. The root problem isn't a lack of technology but a lack of interoperability. Inconsistent implementation of data standards undermines even well-intentioned efforts; messaging formats and exchange protocols differ not only between systems but within the same health network. As a result, there's a yawning gap between what’s technically possible and what’s routinely practiced: while 70% of hospitals say they exchange data occasionally, only 43% do so consistently.

Certain regulatory and structural complexity further exacerbates the challenge, especially in the U.S. The absence of a national patient identifier and the prevalence of a fragmented, multi-payer system create deep systemic barriers to data exchange. On top of this, economic hurdles, like high access fees for data, make it difficult for organizations to leverage healthcare data for purposes beyond direct clinical care.

Cracking the Surface: Innovation and Policy Momentum

Despite these longstanding barriers, new forces are accelerating progress. Technological innovations, evolving regulatory frameworks, and shifting economic incentives are pushing healthcare toward more effective interoperability.

Among the most promising developments is the increasing adoption of FHIR (Fast Healthcare Interoperability Resources) standards. A 2025 global survey found that 71% of respondents reported active FHIR use in their country, up from 66% in 2024. Expectations for national-scale interoperability via FHIR APIs are growing, with pilot projects already demonstrating faster care approvals and more seamless data flow.

Cloud-based platforms are also removing infrastructure hurdles, particularly for smaller organizations that previously couldn’t afford scalable solutions. The cloud-based EHR market is projected to grow to $82.5 billion by 2034, reflecting demand for more accessible systems. In fact, 83% of smaller organizations report that cloud-based EHR implementation is one of the most impactful business decisions that they have made recently. Meanwhile, AI is transforming how unstructured data is used, from algorithms that predict chronic disease risks with high accuracy to ambient scribes that alleviate clinician burnout. Blockchain, too, is gaining traction as a secure, decentralized ledger for data sharing, helping to reinforce stakeholder trust.

Regulatory momentum is building alongside these technologies. In the U.S., the Trusted Exchange Framework and Common Agreement (TEFCA) aims to create a unified governance structure for national health data exchange. Seven Qualified Health Information Networks (QHINs) are already live, enabling thousands of providers to participate. In the EU, the goal is for 100% of citizens to have access to their electronic health records by 2030.

Economic incentives are also aligning. AI-driven efficiencies could save the healthcare system hundreds of billions of dollars annually, creating strong business cases for data integration. Meanwhile, consumer expectations are evolving rapidly: patients increasingly demand digital experiences that mirror those in other industries, including transparent, portable access to their health information.

The Vendor Landscape: Who Controls the Keys

Three dominant EHR vendors are responding to the interoperability challenge in different ways:

• Epic Systems, which dominates the large hospital market, has committed to full participation in the TEFCA (Trusted Exchange Framework and Common Agreement) initiative. More than 1,000 hospitals and 22,000 clinics using Epic are now live on the network, with full rollout expected by the end of 2025.
  
  

• Oracle Health (formerly Cerner) is leveraging its cloud infrastructure to pursue QHIN (Qualified Health Information Network) status under TEFCA, positioning itself as a national data exchange enabler.
  
  

• Meditech, focused on mid-market hospitals, emphasizes "intelligent interoperability" through cloud-based systems that provide longitudinal patient views.
  
  

Consolidation among health systems around these leading vendors may further drive interoperability, while emerging players are succeeding through specialization. Companies like Veracyte, Tempus, and Flatiron Health focus on oncology and genomics data, demonstrating that niche value creation can thrive even when broader interoperability is slow to materialize.

Cross-Industry Demand: Who Wants Healthcare Data?

The appetite for healthcare data extends far beyond traditional healthcare boundaries. Life sciences and pharmaceutical companies represent the most obvious external demand, seeking real-world evidence from EHR data to accelerate drug development and demonstrate treatment effectiveness. Tech giants are increasingly active: Apple is partnering and integrating EHR data into Apple Health Records; Google is advancing AI and cloud tools for health systems; and Microsoft is offering interoperability solutions through Azure.

Payers and insurers use health data to predict demand and manage population risk. Government agencies rely on it for public health surveillance and resource allocation. Academic and clinical researchers need large, diverse datasets to run trials and generate evidence. Digital health startups developing AI diagnostics and precision medicine solutions rely heavily on access to clinical data for training and validation.

Who Will Share the Data: The Reality of Data Distribution

Despite the appetite, access remains uneven. Large, system-affiliated hospitals, often using standardized IT infrastructure, are the most active data sharers. Smaller, independent hospitals lag behind due to limited resources and technical complexity, reinforcing health equity concerns.

Large technology companies with substantial resources can potentially navigate this complexity by negotiating data partnerships, while established life sciences companies leverage regulatory expertise and existing healthcare relationships.

Perhaps most importantly, patients themselves are gaining new power over their data. TEFCA includes provisions for individuals to access and share their own health records across providers and approved apps, a major step toward shifting data ownership from institutions to individuals.

Acknowledging the Complex Realities Ahead

While these initiatives and growing appetite signal momentum, significant challenges remain. Technical complexity means many current solutions are narrow and case-specific rather than universally scalable. Moreover, the limited maturity of EHR systems in supporting AI adoption may hinder progress; despite health systems advancing their AI strategies, only 2% of CIOs consider their EHR platforms sufficiently mature for AI capabilities.

Security concerns also loom large; healthcare remains one of the most targeted industries for cyberattacks, with millions of patient records breached annually. Vendor lock-in further impedes progress, as many EHR vendors rely on proprietary formats and economic incentives that bind customers to their ecosystems, keeping these systems closed. Finally, clinician burnout driven by poor EHR usability continues to limit meaningful engagement with interoperability initiatives.

Conclusion: A Goldmine with Guarded Gates

The potential of healthcare’s digital goldmine is undeniable. With stronger policy enforcement, clearer standards, and scalable technologies, data integration could revolutionize care delivery, research, and population health.

But unlocking this value requires more than just technical solutions. It demands aligning policy with economics, empowering patients with real ownership, and building systems that clinicians actually want to use. Interoperability must move beyond a checkbox toward meaningful, actionable exchange; secure, seamless, and equitable.

To serve every stakeholder, including providers, patients, payers, life sciences, public agencies, and innovators, the future of data must be built on trust, usability, and shared benefit. Only then will healthcare’s vast digital assets truly become a force for system-wide transformation.