Every year, there are roughly 33.5 million hospital admissions, 155 million emergency department visits, and hundreds of millions of outpatient encounters across the United States. At the same time, healthcare spending has reached $4.9 trillion annually. When patient data, especially for such a large number of healthcare consumers, is fragmented across multiple applications, vendors, and systems, the effect is exponential. It is multiplied across every encounter, every workflow, and every decision, impacting not only quality of care and the patient experience, but also hospital performance and the bottom line.
As a result, EHR interoperability is becoming central to how healthcare organizations think about sustainability, efficiency, and care delivery at scale. While industry conversations have traditionally focused on interoperability as only a regulatory requirement or technical milestone, the shift is becoming more apparent.
This shift is also reflected in how healthcare leaders are approaching their technology environments. In a 2026 CHIME survey, nearly 90% of healthcare CIOs reported that vendor consolidation is a priority within their interoperability strategy. There is broad alignment around the need to simplify environments and reduce fragmentation. At the same time, interoperability is still often being approached as something layered onto existing systems rather than a capability built into their EHR core.
Shifting Interoperability from Project to Infrastructure
Interoperability isn’t a new need or a new concept; for years, health system IT departments have advanced compatibility through interfaces, integrations, and incremental improvements. This approach wasn’t wrong; in fact, it has enabled meaningful progress for more than a decade, and has expanded the ability for healthcare organizations to exchange data across systems. But, each additional connection requires implementation, ongoing maintenance, governance, and costs. Over time, these connections and improvements have also introduced significant complexity to systems that can and should be simple.
That complexity has caused many health IT leaders to shift how they think about interoperability to the point that it is no longer viewed solely as a series of projects that somehow connect together. Instead, it is increasingly viewed as a continuous capability that must both be sustained and scaled. Despite this new focus on interoperability, only 16% of CHIME respondents reported that interoperability is capable through the core of their EHR system, highlighting the gap between strategic intent and architectural reality.
Data Says That the Roadblocks are Resulting in Dollar Signs
This dynamic isn’t about knowledge, skill, institutional support, or desire; instead, data points to cost. Healthcare leaders report that the financial burden of integration and ongoing maintenance remains a primary barrier to achieving interoperability at scale, and more than 47% of CHIME respondents cited cost as their biggest obstacle. Even as organizations invest in new technologies and standards, the underlying model can make it difficult to achieve progress without adding complexity.
Foundational Challenges are Keeping Interoperability at Bay
Cost may be the primary barrier slowing down interoperability for most health IT leaders, but it is not the only one. The foundational challenges of interoperability have remained consistent and it shows in the data. Vendor unwillingness and delays impact more than 42% of CHIME respondents working towards interoperability, lack of standardization stands in the way for 26% and IT staffing and internal resource constraints block the path for another 37%. In addition to these challenges, 47% of CHIME respondents ranked data silos and system fragmentation as a top concern when it comes to achieving interoperability.
These are not new issues, nor are they the result of a lack of effort. Instead, they reflect the way healthcare technology has evolved over time, typically in response to immediate needs rather than long-term architectural alignment with the hospital’s needs and goals.
The impact of these challenges becomes clearer when viewed at scale. Across millions of patient encounters each year, fragmented data can contribute to repeated testing, delays in information access, and increased administrative burden. These all contribute to increased financial pressure over time, a pressure made worse by the mounting cost of uncompensated care.
Since 2000, hospitals have provided nearly $745 billion in uncompensated care. While many factors contribute to this, inefficiencies tied to disconnected systems remain monumental to the broader equation.
Interoperability as an Enabler of Outcomes
Looking past these challenges, the direction forward is increasingly clear, Interoperability is about connecting systems to enable positive outcomes. In the CHIME survey, 58% of CIOs cited improved care coordination as the most important potential result of interoperability, while 37% pointed to patient safety improvements and cost reduction.
When interoperability functions as intended, it becomes part of the background, a silent partner that seamlessly supports the end goal for all clinicians and patients; the right data in the right hands at the right time. Clinicians need access to complete and timely information. Organizations can reduce duplication and streamline workflows. Patients experience more coordinated care across settings. In this way, interoperability facilitates essential infrastructure of all clinical decisions and outcomes.
The industry has already made significant progress: standards continue to evolve, technologies are advancing, and strategic alignment is stronger than it has been in the past. The next phase of interoperability builds on this progress by establishing these advancements as the foundational core of the EHR and supporting clinical delivery at the point of care.
As healthcare continues to evolve, the alignment between strategy and architecture will play an increasingly important role. Interoperability is required to be embedded, supported, and sustained as part of the core system. That is where the full value can be realized across the entire care continuum.
About Sandra Johnson
As Senior Vice President of Client Services, Sandra Johnson is responsible for delivering healthcare IT solutions and managing the customer experience to ensure CliniComp’s technology is continuously evolving to meet the changing needs within the healthcare community. Sandra oversees all aspects of the customer lifecycle including account & project management, application support, clinical services, cybersecurity, and learning & development for our global customer base.
