Many hospitals have adopted systems for interoperable patient data exchange and are connected to national networks. However, ONC has consistently found that rates of interoperable exchange for smaller, rural, and independent hospitals have notably lagged behind other hospitals. For example, in both 2017 and 2021, rural hospitals were 23 percentage points less likely to engage in interoperable exchange compared to urban hospitals. In a recent study, ONC explored this digital divide to better understand the relationship between interoperable exchange and measures of hospitals that served populations that have been marginalized.

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