Health Gorilla’s 2023 State of Interoperability Report Finds that Data Quality and Sharing Among Healthcare Industry Stakeholders Remains a Key Challenge

Health Gorilla, a leading Health Information Network and interoperability provider, released its inaugural 2023 State of Interoperability report today to understand how healthcare decision-makers are approaching their clinical data strategies in light of patient privacy concerns and new federal regulations. The study, conducted in collaboration with Flexpa and the Health Management Academy, found that 60% of health systems report duplicative or incomplete data retrieved through health information exchanges, and 69% of digital health executives report gaps in their data.

The first annual State of Interoperability report offers comprehensive insights from more than 130 executive decision-makers across the healthcare ecosystem, including health systems, EHRs, digital health organizations and diagnostic labs, to discover emerging trends and perspectives on critical issues impacting healthcare data interoperability. These issues include patient data access and quality, participation in national exchanges, innovative use cases in digital health, new regulations and federal initiatives, and much more.

Among the findings:

  • Only 40% of health system executives believe the data retrieved through health information exchanges is “good or great” quality, and more than 50% of health system CIOs plan to spend 5-20% more on interoperability initiatives in 2023
  • EHRs want new data and data types: 80% want complete clinical data from other EHRs to enrich their own data
  • Digital health executives are eager for data to better serve patients, with 69% reporting gaps in their data and 61% sharing that their primary use for patient data is to deliver better care for chronic conditions, virtually or in-person

Additionally, the report found that:

  • The vast majority of health system CIOs are supportive of the Trusted Exchange Framework and Common Agreement (TEFCA), which seeks to set interoperability standards nationwide.
  • More than half (58%) of CIOs are supportive of sharing health information for purposes beyond treatment, including individual access services, payment and operations, and research.
  • Thirty-two percent of EHR executives are actively evaluating Qualified Health Information Networks (QHINs). Their choice will be influenced by a range of factors including an existing integration/relationship (76%), technology capabilities (60%), and pricing (56%).
  • Thirty-three percent of digital health organizations rely on a third-party intermediary vendor to access patient data from other EHRs. Respondents expressed interest in accessing additional data types, such as claims data (58%), patient-reported outcomes (42%), and pharmacy data (39%).
  • Twenty-six percent of lab respondents reported that data sharing was not a priority, and 10% believe that data sharing mandates do not apply to labs. However, 68 percent of labs do share data into health information exchanges, but 76% of them contribute only to regional exchanges.
Supporting Quotes

“The State of Interoperability report represents a significant contribution to the public understanding of healthcare data interoperability in the U.S. These insights supplement other efforts to quantify the progress of interoperability on the part of both government agencies and the industry. After reviewing the findings, it’s amazing to see how far we’ve come, and to see broad alignment across many different markets,” said Steven Lane, MD, MPH, Chief Medical Officer at Health Gorilla.

“Is interoperability a buzz word? Yes. Is it overused to the point of being nearly meaningless? Also yes. Despite those facts, does the State of Interoperability Report somehow manage to break through that wall of vendor marketing and provide data-driven analysis and insights that simply haven’t been put out before? Resoundingly yes. If you’re curious about what’s actually happening in the industry in regards to clinical data exchange and perception by various stakeholders, it’s not only one of the best resources out there; it’s arguably the only impartial, data-driven resource out there today,” said Brendan Keeler, Head of Product at Flexpa.

“It is encouraging to see that a majority of providers intend to dedicate resources to achieving interoperability, including participating in TEFCA for individual (patient) access to data. Enforcement of the information blocking rules is slow in coming – but it will come. Entities covered by the information blocking rules that take steps to be compliant in advance of enforcement will be well prepared for what is to come, and can start to realize the clear benefits from data exchange,” said Deven McGraw, Lead of Data Stewardship & Data Sharing at Invitae.

“It’s exciting to see that the market is aware of, and anticipating, exchange via TEFCA. In particular, the broad support for individual access as a permitted purpose, and a solid majority in support of exchange for payment and operations, is very encouraging,” said Dave Cassel, SVP of Customer Success and Operations at Health Gorilla and former Executive Director of Carequality.

“The report and survey data had a lot of really interesting nuggets – perspectives on TEFCA, how digital health companies currently get data, quality of the data available, etc. As interoperability becomes more and more real, this is a great snapshot into understanding how executives view different aspects of it today,” said Nikhil Krishnan, Founder of Out-Of-Pocket.

“Thanks to market adoption of national and regional data exchanges and the continued thrust of government initiatives – such as TEFCA, FHIR APIs, Information Blocking, Promoting Interoperability, and other recent CMS rules – the basis on which healthcare participants will make decisions is evolving. The State of Interoperability report highlights the magnitude of this change, and showcases the progress made by public-private collaboration,” said Jitin Asnaani, Board Member of Health Gorilla and former Executive Director of CommonWell Health Alliance.


Between November-December 2022, Health Gorilla, in collaboration with Flexpa and the Health Management Academy, surveyed the following groups:

  • Health systems: 40 CIOs and CMIOs at the top 50 health systems
  • EHRs: 25 executives (CEOs, CIOs, CTOs, COOs, CIMOs, VPs) at the top 20 EHRs
  • Digital health: 36 product VPs and CTOs at venture-backed health startups
  • Diagnostic Labs: 31 VPs and CIOs at diagnostic vendors, including the top 5 labs

Download the report for the full results here.

Founded in 2014, Health Gorilla is a National Health Information Network (HIN) and interoperability platform providing permitted access to actionable patient data. With enterprise-grade clinical data APIs and an unparalleled master patient index, the Health Gorilla network makes it easy for providers to pull their patient’s information from any clinical records system. For more information, visit or


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