Health IT Research & Analysis
Quick Stats

Trends in Hospital Leaders’ Perceptions of Information Blocking

Last Updated

February 2026

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In 2025, 19% of hospitals perceived an instance of possible information blocking by any actor, an over 50% decrease since 2021. The applicability date of the information blocking regulations occurred in April 2021. The American Hospital Association Health Information Technology Supplement Survey fielded in 2021, 2022, 2023 and 2025 included questions on hospital leaders’ perceptions of practices that may constitute information blocking. While identification of whether a practice (an act or omission) constituted information blocking depends on the unique facts and circumstances of the practice, these data can provide a sense of the perception of key stakeholders.

Percent of Hospitals that Perceived Each Actor Engaged in Possible Information Blocking

 2021202220232025
Healthcare Providers36%12%*9%*13%*
State, regional, and/or local health information exchange19%20%15%*8%*
Developers of Certified Health IT (e.g. Enterprise EHR vendors)17%22%*12%*9%*
National Networks7%6%4%*3%
Any Actor42%32%*27%*19%*

Note: Hospitals that did not respond or indicated “don’t know” to each question are excluded from the numerator and denominator of each measure.
* denotes a statistically significant year-over-year difference at p<0.05. 

The survey also includes three questions on how healthcare providers engaged in practices that may be perceived as information blocking. Strategic affiliations, which are described as promoting alternative, proprietary approaches to information exchange or exchanging only within a referral network or with preferred referral partners, was the most common type of practice in 2023 but decreased significantly by nearly half in 2025. Only 6% of hospitals reported other health care providers refused to exchange patient information.

Percent of Hospitals that Perceived Healthcare Providers Engaged in Three Types of Possible Information Blocking

 2021202220232025
Artificial technical, process, or resource barriers (n=4,045)35%20%*19%14%*
Refusal to exchange patient information (n=4,011)26%15%*9%*6%*
Strategic Affiliations (n=3,951)32%29%22%*12%*

Note: Indicates % Often or Sometimes engaging in each method. Hospitals that did not respond or indicated don’t know to each question are excluded from each measure.
* denotes a statistically significant year-over-year difference at p<0.05. 

The survey also includes four questions on how EHR developers engaged in practices that may be perceived as information blocking. In all years, price was listed as the most common type of perceived information blocking by EHR developers and remained statistically unchanged in 2025, compared to 2023. Note that for consistency with prior surveys, this question asks specifically about “Enterprise EHR vendors”.

Percent of Hospitals that Perceived EHR Developers Engaged in Four Types of Possible Information Blocking

 2021202220232025
Price, including unreasonable fees28%29%24%*22%
Contract language to discourage exchange of patient information20%23%*21%*16%*
Artificial technical, process, or resource barriers19%19%16%*12%*
Refusal to exchange patient information10%16%*11%*7%*

Note: Indicates % Often or Sometimes engaging in each method. Hospitals that did not respond or indicated don’t know to each question are excluded from each measure.
* denotes a statistically significant year-over-year difference at p<0.05. 

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Data are from the American Hospital Association (AHA) Information Technology (IT) Supplement to the AHA Annual Survey. Since 2008, ONC has partnered with the AHA to measure the adoption and use of health IT in U.S. hospitals.

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.

This quick stat presents results from the 2020, 2022, and 2023 AHA IT Supplements. Due to pandemic-related delays, the 2020 survey was not fielded on time and was fielded from April 2021 to September 2021. Since the IT supplement survey instructed respondents to answer questions as of the day the survey is completed, we refer to responses to the 2020 IT supplement survey as measuring hospitals in 2021.  The 2022 survey was fielded from July 2022 to December 2022, and the 2023 survey was fielded from March 2023 to August 2023.

The response rate for non-federal acute care hospitals was 50 percent in 2022, 54 percent in 2022, and 58 percent in 2023. Overall, 2,092 hospitals responded to the information blocking questions in 2021, 2,446 responded in 2022, and 2,419 responded in 2023. A logistic regression model was used to predict the propensity of survey response as a function of hospital characteristics, including size, ownership, teaching status, system membership, and availability of a cardiac intensive care unit, urban status, and region. Hospital-level weights were derived by the inverse of the predicted propensity.

In 2021, the survey included the question “To what extent have you observed the following stakeholders engaging in information blocking behaviors?” and asked about four actors, 1) Developers of Certified Health IT (e.g., Enterprise EHR vendors), 2, Healthcare Providers, 3) National Networks (e.g., CommonWell, eHealth Exchange) 4) State, regional, and/or local health information exchanges. The four actor types identified in the survey correspond to categories of actors defined in 45 CFR 171.102 for purposes of the information blocking regulations as follows: Those in the survey’s type (1) would likely fall into the health IT developer of certified health IT definition; those in type (2) would likely fall into the health care provider definition; and those in types (3) and (4) would likely fall into the health information network or health information exchange definition.

The 2022 and 2023 Surveys included the same question but did not ask about healthcare providers in that question set. Instead, a separate question asked, “To what extent have you observed healthcare providers engaging in information blocking behaviors?”

In all three years, the survey included two sets of questions on specific types of information blocking. The first question asked, “In what form(s) have you observed or experienced information blocking by Enterprise EHR vendor(s)?” and listed four types: 1) Price; 2) Contract language; 3) Artificial technical, process or resource barriers; and 4) Refusal, with additional examples of each. The survey further asked, “In what form(s) have you observed or experienced information blocking by healthcare providers?” and listed three types: 1) Artificial technical, process or resource barriers; 2) Refusal; and 3) Strategic affiliations.

For all items above, Respondents could report Often/Routinely, Sometimes, Never/Rarely and Don’t know. For this quick stat, responses were dichotomized as either Often/Routine or Sometimes versus Never/Rarely, with hospitals reporting “Don’t Know” or not responding to that specific question omitted.