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Appendix C: Background on the Market Landscape Pertaining To Exchange of Health Information

Lack of Uniform Data Standards

Lack of clear, universal technology and data standards is a key underpinning of existing market dynamics related to exchange of health information.118 Some standards for information sharing do exist, such as those developed by Health Level Seven International (commonly known as HL7), which provide a general framework for data sharing between health care applications but allow for a great deal of flexibility in how those standards are implemented.119 Other organizations and alliances have been created in recent years to improve interoperability between providers and systems, including the CommonWell Health Alliance, The Sequoia Project and the Care Connectivity Consortium, but there are no universal standards that all providers observe.120

Because universally accepted national standards do not exist and the standards that do exist allow significant room for interpretation, vendors develop systems and solutions according to their own design interests, typically charging providers additional fees to develop middleware and interfaces that enable connections between systems. If universal standards existed, providers might be able to more reliably procure technology that maximizes interoperability at a lower cost.