By 2024, 99% of US non-federal acute care hospitals had a certified electronic health record. Adoption, the question that dominated the last decade, is largely settled. The open question is whether those records can talk to one another.
Progress, with a gap
In 2023, 70% of US hospitals could find, send, receive and integrate outside data, up from 46% in 2018. That is real progress. It also means three in ten hospitals still lack the full set, and size matters: 38% of small hospitals often or routinely exchanged data interoperably, against 53% of large ones.
Make the flow visible
A useful first step is simple. List every interface, who owns it and which clinical or administrative process depends on it. Many organisations find this harder than expected, and that difficulty is the finding.
Treat exceptions as clinical work
A failed message is a piece of unfinished care. It needs an owner, a route to resolution and a way of telling the people affected. Monitoring only helps if someone is responsible for acting on what it shows.
Let clinicians set the priorities
Clinicians can say which delays really matter. That guidance helps technical teams to prioritise, and it builds trust in the systems that carry information between departments.
