Number of Methods Used by Hospitals to Obtain External Information

Data are from the American Hospital Association (AHA) Information Technology (IT) Survey. Since 2008, ONC has partnered with the AHA to measure the adoption and use of health IT in U.S. hospitals. ONC helps fund the IT Survey to track hospital adoption and use of EHRs and the exchange of clinical data.

The chief executive officer of each U.S. hospital was invited to participate in the survey regardless of AHA membership status. The person most knowledgeable about the hospital’s health IT (typically the chief information officer) was requested to provide the information via a mail survey or secure online site. Non-respondents received follow-up mailings and phone calls to encourage response.

The 2019 survey was fielded from January 2020 to June 2020. Due to pandemic-related delays, the 2020 survey was fielded April 2021 to September 2021 and is referred to here as 2021 data. The 2022 survey was fielded from July 2022 to December 2022, the 2023 survey was fielded from March 2023 to August 2023, and the 2025 survey was fielded from April 2025 to October 2025.

This quick stat reports data from non-federal, general acute care hospitals in the 50 United States and District of Columbia. 2,645 responded in 2019 (59% response rate), 2,364 hospitals responded in 2021 (54% response rate), 2,541 responded in 2022 (58% response rate),  2,547 hospitals responded in 2023 (58% response rate), 2,351 hospitals responded in 2025 (55% response rate).

This figure shows the mean number of “All methods,” “Electronic methods,” and “Network-based methods” hospitals often used to obtain (query or receive) patient health information from outside sources. All methods include 9 different methods: mail or fax, eFax, provider portals that allow you to view records in another organizations’ EHR (“portals”), interface connection between EHR systems (“interfaces”), access to other organizations’ EHR system using login credentials (“direct access”), health information service providers that enable messaging via DIRECT protocol  (“HISPs”), regional state or local health information exchange organization (“HIEs”), EHR vendor-based network that enables exchange with vendor’s other users (“vendor networks”), and national networks that enable exchange across different EHR vendors (“national networks”). Electronic methods include 7 different methods: portals, interfaces, direct access, HISPs, HIE, vendor networks, and national networks. Network-based methods include 3 different methods: HIEs, vendor networks, and national networks.