Experiences with information blocking in the United States: a national survey of hospitals

“Data and Methods


We used data from the American Hospital Association (AHA) IT [information technology] Supplement Survey fielded between April and September 2021, an annual survey of hospitals on their IT capabilities and experiences. The AHA IT supplement is sent to Chief Information Officers and completed by those individuals or their delegates. [..] We combined this data with information on hospital characteristics from the 2020 AHA Annual Survey, the most recent year available. [..]

Perceived information blocking

[..] For health IT developers, hospitals were asked if they had experienced information blocking via price; contractual language; artificial technical, process or resource barriers; and refusal to exchange patient information (for instance, refusing to exchange patient information with competitors). For healthcare providers, hospitals were asked if they had experienced information blocking through artificial technical, process or resource barriers; refusal; or strategic affiliations. [..]


[..] Overall, 42% of responding hospitals indicated perceiving that at least 1 of the 4 actors (health IT developers, healthcare providers, national networks, and state, regional and/or local health information exchanges) either sometimes or often engaged in information blocking. [..]


[..] These data indicate the importance of continued stakeholder education on the information blocking regulations to facilitate compliance and continued collaborative efforts to reduce barriers to exchanging health information.

[..] claims submitted to ONC’s Report Information Blocking Portal, in which the plurality of claims appeared to have been submitted by patients, and the plurality of claims cited health care providers as possibly blocking information. Because patients engage more often with health care providers (a category of information blocking “actor” that includes hospitals) than with health IT developers or health information exchanges, they may be more likely to perceive health care providers (including hospitals) as information blocking. In contrast, health information exchanges work to provide services for healthcare providers—and many health information exchanges have achieved sustainability through the support of hospitals that are inclined to share information—but can perceive health IT developers as competitors or impediments to growth. [..]

In multivariable analysis, for-profit hospitals were almost 3 times as likely to report experiencing information blocking from other healthcare providers than were nonprofit hospitals. We speculate that health care providers may have been reluctant to share information with for-profit hospitals because of concerns about their approach to practice or competitive orientation. One possibility is that for-profit hospitals are more likely to report perceived information blocking because their more aggressive approach towards obtaining information from other entities. Notably, the share of the market dominated by for-profit hospitals was not correlated with rates of perceived information blocking, which might indicate that our finding is not driven by the information sharing (ie, sending or making available) related behavior of for-profit hospitals.”

Full article, J Everson, D Healy and V Patel. Journal of the American Medical Informatics Association, 2023.4.8