The prevalence of information blocking within the digital health sector appears to be trending downward, though federal regulators warn that a subset of actors continues to restrict the flow of patient data frequently. According to the Office of the National Coordinator for Health Information Technology (ONC), while fewer health information exchanges and providers are engaging in practices that impede electronic health information access, the persistence of these barriers remains a focal point for federal oversight under the 21st Century Cures Act. The Cures Act, signed into law in December 2016, established clear prohibitions against practices likely to interfere with, prevent, or materially discourage the access, exchange, or use of electronic health information (U.S. Department of Health and Human Services, HealthIT.gov).
For patients and healthcare providers, the ability to seamlessly transfer medical records is a cornerstone of modern, efficient care. When systems are siloed—whether due to technical limitations or intentional business practices—the resulting gaps in a patient’s medical history can lead to diagnostic delays and redundant testing. The ONC’s ongoing monitoring efforts aim to ensure that the interoperability mandates outlined in the final rule published in May 2020 are upheld across the industry. While the raw count of reported incidents suggests improvement, the agency emphasizes that the quality and intent behind information-sharing practices remain under close scrutiny.
Understanding the Shift in Information Blocking Trends
The transition toward more open data exchange has been driven by both regulatory pressure and the maturation of health information technology standards. Organizations that previously relied on proprietary, closed-loop systems are increasingly adopting Fast Healthcare Interoperability Resources (FHIR) standards, which facilitate easier data exchange between disparate platforms. This shift is critical because, as the ONC has noted, the technical capability to share information is no longer the primary hurdle; rather, the challenge lies in the policies and business models that govern how that information is released.
Despite the overall reduction in reported impediments, the ONC’s monitoring indicates that certain entities maintain restrictive practices. These practices can manifest in various ways, such as charging exorbitant fees for data access, implementing overly complex security protocols that discourage requests, or failing to respond to legitimate requests for patient data in a timely manner. The agency continues to evaluate these behaviors against the definitions of “reasonable and necessary activities” permitted under the Code of Federal Regulations.
The Role of Federal Oversight and Compliance
The ONC, as part of the U.S. Department of Health and Human Services, plays a central role in investigating claims of information blocking. When a report is filed, officials assess whether the conduct meets the legal threshold for an information-blocking violation. This process is not merely about enforcing compliance; it is designed to foster a culture of transparency where patient data is treated as a portable asset that belongs to the individual, rather than the institution holding the records.
Healthcare providers and health information exchanges are now subject to clearer guidance regarding their obligations. The ONC’s guidance for healthcare providers clarifies that while security is paramount, it cannot be used as a blanket excuse to prevent the exchange of information. As the regulatory environment matures, the industry is seeing a clearer distinction between legitimate security concerns and anti-competitive behavior. Entities that fail to comply with these federal standards face potential penalties, which underscores the seriousness with which the federal government views the portability of health records.
What Happens Next for Digital Health Interoperability
The federal government is expected to continue its phased approach to enforcing information-blocking provisions. The next critical checkpoint involves the ongoing analysis of complaints submitted through the ONC’s public reporting portal, which provides the agency with real-world data on how systems are performing in clinical settings. This data informs future rulemaking and helps identify specific sectors or technologies where barriers remain most entrenched.
For patients, the primary benefit of these ongoing efforts is the increased availability of their own health data through patient portals and third-party applications. As the industry moves toward a more unified digital ecosystem, the expectation is that information blocking will become an outlier behavior. However, until full interoperability is achieved, patients are encouraged to monitor their own health information access and report suspected instances of blocking to the appropriate federal authorities.
We invite our readers to share their experiences with health information access in the comments section below. How has your ability to access medical records changed over the past few years? Your insights help us track the real-world impact of these shifting regulatory landscapes.