{"id":169729,"date":"2026-06-30T09:20:03","date_gmt":"2026-06-30T13:20:03","guid":{"rendered":"https:\/\/healthit.gov\/data\/?post_type=data-brief&#038;p=169729"},"modified":"2026-06-30T09:20:04","modified_gmt":"2026-06-30T13:20:04","slug":"trends-in-health-information-organizations-experiences-of-perceived-information-blocking-2019-2025","status":"publish","type":"data-brief","link":"https:\/\/healthit.gov\/data\/data-briefs\/trends-in-health-information-organizations-experiences-of-perceived-information-blocking-2019-2025\/","title":{"rendered":"Trends in State, Local, and Regional Health Information Organizations\u2019 Experiences of Perceived Information Blocking, 2019-2025"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">State, local, and regional health information organizations (HIOs), including HIEs and emerging Health Data Utilities (HDUs), provide health information exchange services to member organizations, who range from hospitals and doctor\u2019s offices to behavioral health clinics and nursing facilities.(<a href=\"#h-references\">1<\/a>) Because HIOs enable interoperable exchange between healthcare organizations, they are uniquely positioned to directly observe and share their insights on various practices that they perceive to be possible information blocking, including practices of developers of certified health IT, health care providers, and other networks. This data brief presents results from the 2019, 2023, and 2025 National Survey of Health Information Organizations to measure the overall incidence of practices that HIOs perceive may constitute information blocking. The applicability date of the information blocking regulations occurred in April 2021.(<a href=\"#h-references\">2<\/a>) 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 window into HIOs\u2019 experiences about how other entities, like hospitals and health systems or developers of certified health IT, may have engaged in potential information blocking. The data brief provides additional context and understanding of the variation in behaviors that cause friction in the exchange of electronic health information.<\/p>\n\n\n\n<h2 id=\"h-highlights\" class=\"wp-block-heading\">Highlights<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>The percentage of HIOs reporting any instance of potential information blocking across any actor (developer, hospital and health system, HIO, network) decreased from 2019 to 2025.<\/li>\n\n\n\n<li>The prevalence of types of potential information blocking practices declined between 2019 and 2025 (though business-related practices that may constitute potential information blocking are still relatively high).<\/li>\n\n\n\n<li>Potential information blocking is not widespread but instead engaged in by a smaller group of actors.<\/li>\n\n\n\n<li>The share of HIOs that report routinely experiencing potential information blocking by developers of certified health IT and hospitals and health systems has remained consistent from 2019 to 2025.<\/li>\n\n\n\n<li>Most HIOs reported that potential information blocking has either a great or moderate impact on information exchange.<\/li>\n<\/ul>\n\n\n\n<h2 id=\"h-the-percentage-of-hios-reporting-potential-information-blocking-across-any-actor-decreased-from-2019-to-2025\" class=\"wp-block-heading\">The percentage of HIOs reporting potential information blocking across any actor decreased from 2019 to 2025.<\/h2>\n\n\n\n<h4 id=\"h-findings\" class=\"wp-block-heading\">Findings<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Seventy-one percent of HIOs reported experiencing any instance of potential information blocking in 2025, down from 91% in 2019.<\/li>\n\n\n\n<li>HIOs most commonly reported developers of certified health IT as the actor engaging in potential information blocking.<\/li>\n\n\n\n<li>Half of HIOs reported hospitals and health systems engaging in any type of potential information blocking, a decrease from 2023.<\/li>\n\n\n\n<li>Few HIOs reported other HIOs\/HDUs and national networks engaging in any type of potential information blocking.<\/li>\n<\/ul>\n\n\n\n<p style=\"padding-top:0;padding-right:0;padding-bottom:50;padding-left:0;font-size:20px\"><strong>Figure 1:<\/strong> Percent of HIOs that reported an entity sometimes or routinely engaged in potential information blocking, 2019-2025.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large is-resized\"><img loading=\"lazy\" decoding=\"async\" height=\"647\" width=\"1024\" src=\"https:\/\/healthit.gov\/data\/wp-content\/uploads\/sites\/2\/2026\/06\/data-brief-85-figure-1.png?w=1024\" alt=\"Line chart showing the percentage of Health Information Organizations (HIOs) reporting that different actor types engaged in potential information blocking in 2019, 2023, and 2025. Developers of certified health IT decline from 91% to 62%; hospitals and health systems decline from 58% to 49%; national networks decline slightly (9% to 7%); HIOs\/HDUs increase from 15% to 20%; and the overall \u2018any actor\u2019 measure decreases from 91% to 71%.\" class=\"wp-image-169860\" style=\"aspect-ratio:1.7181846783073778;width:1024px;height:auto\" srcset=\"https:\/\/healthit.gov\/data\/wp-content\/uploads\/sites\/2\/2026\/06\/data-brief-85-figure-1.png 2280w, https:\/\/healthit.gov\/data\/wp-content\/uploads\/sites\/2\/2026\/06\/data-brief-85-figure-1.png?resize=300,190 300w, https:\/\/healthit.gov\/data\/wp-content\/uploads\/sites\/2\/2026\/06\/data-brief-85-figure-1.png?resize=768,485 768w, https:\/\/healthit.gov\/data\/wp-content\/uploads\/sites\/2\/2026\/06\/data-brief-85-figure-1.png?resize=1024,647 1024w, https:\/\/healthit.gov\/data\/wp-content\/uploads\/sites\/2\/2026\/06\/data-brief-85-figure-1.png?resize=1536,971 1536w, https:\/\/healthit.gov\/data\/wp-content\/uploads\/sites\/2\/2026\/06\/data-brief-85-figure-1.png?resize=2048,1294 2048w, https:\/\/healthit.gov\/data\/wp-content\/uploads\/sites\/2\/2026\/06\/data-brief-85-figure-1.png?resize=237,150 237w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><figcaption class=\"wp-element-caption\">Source: National Survey of Health Information Organizations, 2019, 2023 and 2025.<br>Notes: Estimates exclude missing responses. For 2025, N = 77 HIOs responded to the survey; n = 4 missing responses for the information blocking questions. For 2023, N = 76 HIOs responded to the survey; n = 8 missing responses for the information blocking questions. For 2019, N = 89 HIOs responded to the survey; n = 8 missing responses for the information blocking questions.<\/figcaption><\/figure>\n\n\n\n<h2 id=\"h-the-prevalence-of-types-of-potential-information-blocking-practices-declined-between-2019-and-2025-though-business-related-practices-that-may-constitute-potential-information-blocking-are-still-relatively-high\" class=\"wp-block-heading\">The prevalence of types of potential information blocking practices declined between 2019 and 2025 (though business-related practices that may constitute potential information blocking are still relatively high).<\/h2>\n\n\n\n<h4 id=\"h-findings-0\" class=\"wp-block-heading\">Findings<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>The share of HIOs that report that developers of certified health IT use fees and pricing to potentially block information exchange has decreased from 81% in 2019 to 59% in 2025; however, it remains the most reported potential information blocking practice.<\/li>\n\n\n\n<li>Nearly half of HIOs report that hospitals and health systems use strategic affiliations\u2014like ownership structures\u2014to potentially block information exchange, which is consistent between 2023 and 2025.<\/li>\n\n\n\n<li>For both entities, around 1 in 3 HIOs report at least some instances of outright refusal to exchange information.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\" style=\"font-size:20px\"><strong>Table 1:<\/strong> Percent of HIOs that reported developers of certified health IT and hospitals and health systems sometimes or routinely used types of practices they perceived as potential information blocking.<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><thead><tr><th class=\"has-text-align-left\" data-align=\"left\">Potential Information Blocking Practice<\/th><th class=\"has-text-align-center\" data-align=\"center\">2019<\/th><th class=\"has-text-align-center\" data-align=\"center\">2023<\/th><th class=\"has-text-align-center\" data-align=\"center\">2025<\/th><\/tr><\/thead><tbody><tr><td class=\"has-text-align-left\" data-align=\"left\" colspan=\"4\"><strong>Developer of Certified Health IT<\/strong><\/td><\/tr><tr><td class=\"has-text-align-left\" data-align=\"left\">Price, unreasonable fees<\/td><td class=\"has-text-align-center\" data-align=\"center\">81%<\/td><td class=\"has-text-align-center\" data-align=\"center\">60%<\/td><td class=\"has-text-align-center\" data-align=\"center\">59%<\/td><\/tr><tr><td class=\"has-text-align-left\" data-align=\"left\">Artificial barriers<\/td><td class=\"has-text-align-center\" data-align=\"center\">65%<\/td><td class=\"has-text-align-center\" data-align=\"center\">49%<\/td><td class=\"has-text-align-center\" data-align=\"center\">40%<\/td><\/tr><tr><td class=\"has-text-align-left\" data-align=\"left\">Contract language<\/td><td class=\"has-text-align-center\" data-align=\"center\">51%<\/td><td class=\"has-text-align-center\" data-align=\"center\">43%<\/td><td class=\"has-text-align-center\" data-align=\"center\">30%<\/td><\/tr><tr><td class=\"has-text-align-left\" data-align=\"left\">Refusal<\/td><td class=\"has-text-align-center\" data-align=\"center\">52%<\/td><td class=\"has-text-align-center\" data-align=\"center\">32%<\/td><td class=\"has-text-align-center\" data-align=\"center\">27%<\/td><\/tr><tr><td class=\"has-text-align-left\" data-align=\"left\" colspan=\"4\"><strong>Hospitals and Health Systems<\/strong><\/td><\/tr><tr><td class=\"has-text-align-left\" data-align=\"left\">Strategic affiliations<\/td><td class=\"has-text-align-center\" data-align=\"center\">&#8212;<\/td><td class=\"has-text-align-center\" data-align=\"center\">45%<\/td><td class=\"has-text-align-center\" data-align=\"center\">42%<\/td><\/tr><tr><td class=\"has-text-align-left\" data-align=\"left\">Artificial barriers<\/td><td class=\"has-text-align-center\" data-align=\"center\">34%<\/td><td class=\"has-text-align-center\" data-align=\"center\">25%<\/td><td class=\"has-text-align-center\" data-align=\"center\">22%<\/td><\/tr><tr><td class=\"has-text-align-left\" data-align=\"left\">Refusal<\/td><td class=\"has-text-align-center\" data-align=\"center\">52%<\/td><td class=\"has-text-align-center\" data-align=\"center\">40%<\/td><td class=\"has-text-align-center\" data-align=\"center\">31%<\/td><\/tr><\/tbody><\/table><figcaption class=\"wp-element-caption\">\n    Source: National Survey of Health Information Organizations, 2019, 2023 and 2025. <br>\n    Notes: Estimates exclude missing responses. For 2025, N = 77 HIOs responded to the survey; n = 4 missing responses for the information blocking questions. For 2023, N = 76 HIOs responded to the survey; n = 8 missing responses for the information blocking questions. For 2019, N = 89 HIOs responded to the survey; n = 8 missing responses for the information blocking questions.\n  <\/figcaption><\/figure>\n\n\n\n<h2 id=\"h-among-hios-that-reported-experiencing-potential-information-blocking-most-indicated-these-were-not-widespread-practices-by-hospitals-and-developers\" class=\"wp-block-heading\">Among HIOs that reported experiencing potential information blocking, most indicated these were not widespread practices by hospitals and developers.<\/h2>\n\n\n\n<h4 id=\"h-findings-1\" class=\"wp-block-heading\">Findings<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Among HIOs that reported experiencing any potential information blocking, the share that indicated some, most, or all developers of certified health IT engaged in potential information blocking declined by almost half (from 55% to 27%) between 2019 and 2025.<\/li>\n\n\n\n<li>From 2019-2025, about the same share of HIOs\u20141 in 4\u2014reported that some, most, or all hospitals and health systems engaged in potential information blocking with some fluctuation across years.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\" style=\"font-size:20px\"><strong>Figure 2:<\/strong> Among HIOs reporting experiencing any potential information blocking, percent of HIOs that reported that few, some, or most hospitals and health systems and developers of certified health IT engaged in any potential information blocking, 2019-2025.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large is-resized\"><img loading=\"lazy\" decoding=\"async\" height=\"596\" width=\"1024\" src=\"https:\/\/healthit.gov\/data\/wp-content\/uploads\/sites\/2\/2026\/06\/data-brief-85-figure-2.png?w=1024\" alt=\"Two clustered bar charts showing, among HIOs that experienced any potential information blocking, the percentage reporting that few, some, or most\/all hospitals and health systems or developers engaged in blocking behavior in 2019, 2023, and 2025. Most responses indicate \u2018few\u2019 entities, with the share reporting \u2018most\/all\u2019 decreasing over time for both developers and hospitals.\" class=\"wp-image-169831\" style=\"aspect-ratio:1.7181846783073778;width:1024px;height:auto\" srcset=\"https:\/\/healthit.gov\/data\/wp-content\/uploads\/sites\/2\/2026\/06\/data-brief-85-figure-2.png 2324w, https:\/\/healthit.gov\/data\/wp-content\/uploads\/sites\/2\/2026\/06\/data-brief-85-figure-2.png?resize=300,175 300w, https:\/\/healthit.gov\/data\/wp-content\/uploads\/sites\/2\/2026\/06\/data-brief-85-figure-2.png?resize=768,447 768w, https:\/\/healthit.gov\/data\/wp-content\/uploads\/sites\/2\/2026\/06\/data-brief-85-figure-2.png?resize=1024,596 1024w, https:\/\/healthit.gov\/data\/wp-content\/uploads\/sites\/2\/2026\/06\/data-brief-85-figure-2.png?resize=1536,894 1536w, https:\/\/healthit.gov\/data\/wp-content\/uploads\/sites\/2\/2026\/06\/data-brief-85-figure-2.png?resize=2048,1192 2048w, https:\/\/healthit.gov\/data\/wp-content\/uploads\/sites\/2\/2026\/06\/data-brief-85-figure-2.png?resize=258,150 258w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><figcaption class=\"wp-element-caption\">Source: National Survey of Health Information Organizations, 2019, 2023 and 2025.<br>Notes: Estimates exclude missing responses. For 2025, N = 77 HIOs responded to the survey; n = 4 missing responses for the information blocking questions; n = 45 HIOs reported any information blocking by a developer of certified health IT; n = 35 HIOs reported any information blocking by hospitals and health systems. For 2023, N = 76 HIOs responded to the survey; n = 8 missing responses for the information blocking questions; n = 49 HIOs reported any information blocking by a developer of certified health IT; n = 39 HIOs reported any information blocking by hospitals and health systems. For 2019, N = 89 HIOs responded to the survey; n = 8 missing responses for the information blocking questions; n = 74 HIOs reported any information blocking by a developer of certified health IT; n = 47 HIOs reported any information blocking by hospitals and health systems.<\/figcaption><\/figure>\n\n\n\n<h2 id=\"h-the-share-of-hios-reporting-routinely-experiencing-potential-information-blocking-by-developers-of-certified-health-it-and-hospitals-and-health-systems-has-not-decreased-from-2019-to-2025\" class=\"wp-block-heading\">The share of HIOs reporting routinely experiencing potential information blocking by developers of certified health IT and hospitals and health systems has not decreased from 2019 to 2025.<\/h2>\n\n\n\n<h4 id=\"h-findings-2\" class=\"wp-block-heading\">Findings<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>From 2019-2025, about 1 in 3 HIOs who experienced potential information blocking by a developer of certified health IT reported the behavior was routine.<\/li>\n\n\n\n<li>From 2019-2025, about 1 in 5 HIOs who experienced potential information blocking by a hospital and health system reported the behavior was routine.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\" style=\"font-size:20px\"><strong>Figure 3:<\/strong> Among developers of certified health IT and hospitals and health systems who engaged in potential information blocking, the percent of HIOs that reported the entity routinely engaged in that behavior.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" height=\"599\" width=\"1024\" src=\"https:\/\/healthit.gov\/data\/wp-content\/uploads\/sites\/2\/2026\/06\/data-brief-85-figure-3.png?w=1024\" alt=\"Line chart showing the share of HIOs that reported routine information blocking behavior among entities that were perceived to block information. For developers of certified health IT, about 30% report routine blocking consistently from 2019 to 2025. For hospitals and health systems, roughly 13\u201318% report routine blocking across the same years.\" class=\"wp-image-169832\" srcset=\"https:\/\/healthit.gov\/data\/wp-content\/uploads\/sites\/2\/2026\/06\/data-brief-85-figure-3.png 2101w, https:\/\/healthit.gov\/data\/wp-content\/uploads\/sites\/2\/2026\/06\/data-brief-85-figure-3.png?resize=300,175 300w, https:\/\/healthit.gov\/data\/wp-content\/uploads\/sites\/2\/2026\/06\/data-brief-85-figure-3.png?resize=768,449 768w, https:\/\/healthit.gov\/data\/wp-content\/uploads\/sites\/2\/2026\/06\/data-brief-85-figure-3.png?resize=1024,599 1024w, https:\/\/healthit.gov\/data\/wp-content\/uploads\/sites\/2\/2026\/06\/data-brief-85-figure-3.png?resize=1536,898 1536w, https:\/\/healthit.gov\/data\/wp-content\/uploads\/sites\/2\/2026\/06\/data-brief-85-figure-3.png?resize=2048,1198 2048w, https:\/\/healthit.gov\/data\/wp-content\/uploads\/sites\/2\/2026\/06\/data-brief-85-figure-3.png?resize=256,150 256w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><figcaption class=\"wp-element-caption\">Source: National Survey of Health Information Organizations, 2019, 2023 and 2025.<br>Notes: Estimates exclude missing responses. For 2025, N = 77 HIOs responded to the survey; n = 4 missing responses for the information blocking questions; n = 45 HIOs reported any information blocking by a developer of certified health IT; n = 35 HIOs reported any information blocking by hospitals and health systems. For 2023, N = 76 HIOs responded to the survey; n = 8 missing responses for the information blocking questions; n = 49 HIOs reported any information blocking by a developer of certified health IT; n = 39 HIOs reported any information blocking by hospitals and health systems. For 2019, N = 89 HIOs responded to the survey; n = 8 missing responses for the information blocking questions; n = 74 HIOs reported any information blocking by a developer of certified health IT; n = 47 HIOs reported any information blocking by hospitals and health systems.<\/figcaption><\/figure>\n\n\n\n<h2 id=\"h-most-hios-reported-that-potential-information-blocking-has-either-a-great-or-moderate-impact-on-information-exchange\" class=\"wp-block-heading\">Most HIOs reported that potential information blocking has either a great or moderate impact on information exchange.<\/h2>\n\n\n\n<h4 id=\"h-findings-3\" class=\"wp-block-heading\">Findings<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>In 2025, among HIOs that experienced potential information blocking by hospitals and health systems or developers of certified health IT, about 1 in 5 reported the behaviors had a great impact on information exchange.<\/li>\n\n\n\n<li>Although the reported impact is increasingly moderate, the share of HIOs that reported potential information blocking had minimal or no impact is unchanged between 2023 and 2025.<\/li>\n\n\n\n<li>A higher share of HIOs reported that potential information blocking by hospitals and health systems had a somewhat greater impact on information exchange (i.e., missing patient health information) than certified health IT developers (22% vs. 17%).<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\" style=\"font-size:20px\"><strong>Figure 4:<\/strong> Percent of HIOs who reported that experiencing potential information blocking affected the missingness of patient health information and their ability to provide health information exchange services to members.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" height=\"625\" width=\"1024\" src=\"https:\/\/healthit.gov\/data\/wp-content\/uploads\/sites\/2\/2026\/06\/data-brief-85-figure-4.png?w=1024\" alt=\"Clustered bar chart showing how HIOs rated the impact of potential information blocking by hospitals and health systems and by developers of certified health IT in 2023 and 2025. Categories include \u2018Greatly,\u2019 \u2018Moderately,\u2019 and \u2018Minimally.\u2019 In both years, most HIOs report a moderate impact, with smaller shares reporting great or minimal impact.\" class=\"wp-image-169833\" srcset=\"https:\/\/healthit.gov\/data\/wp-content\/uploads\/sites\/2\/2026\/06\/data-brief-85-figure-4.png 2236w, https:\/\/healthit.gov\/data\/wp-content\/uploads\/sites\/2\/2026\/06\/data-brief-85-figure-4.png?resize=300,183 300w, https:\/\/healthit.gov\/data\/wp-content\/uploads\/sites\/2\/2026\/06\/data-brief-85-figure-4.png?resize=768,468 768w, https:\/\/healthit.gov\/data\/wp-content\/uploads\/sites\/2\/2026\/06\/data-brief-85-figure-4.png?resize=1024,625 1024w, https:\/\/healthit.gov\/data\/wp-content\/uploads\/sites\/2\/2026\/06\/data-brief-85-figure-4.png?resize=1536,937 1536w, https:\/\/healthit.gov\/data\/wp-content\/uploads\/sites\/2\/2026\/06\/data-brief-85-figure-4.png?resize=2048,1249 2048w, https:\/\/healthit.gov\/data\/wp-content\/uploads\/sites\/2\/2026\/06\/data-brief-85-figure-4.png?resize=246,150 246w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><figcaption class=\"wp-element-caption\">Source: National Survey of Health Information Organizations, 2019, 2023 and 2025.<br>Notes: The denominator varies by the number of respondents who reported any information blocking by hospitals or health systems and\/or developers of certified health IT. In 2023, n = 32 HIOs reported any information blocking by a hospital or health system and n = 39 HIOs reported any information blocking by a developer of certified health IT. In 2025, n = 32 HIOs reported any information blocking by a hospital or health system and n = 35 HIOs reported any information blocking by a developer of certified health IT.<\/figcaption><\/figure>\n\n\n\n<h2 id=\"h-summary\" class=\"wp-block-heading\">Summary<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">State, local, and regional health information organizations (HIOs) have long played a crucial role in mediating exchange at the regional, state, and local level, enabling disparate health care, social service, and other entities to connect and exchange information on shared patients and clients. Their role in connecting these entities for different purposes and via different technologies gives them unique insight into how potential information blocking practices affect their operations and prevent more robust information access and exchange. Data collected via the National Survey of Health Information Organizations for years 2019, 2023, and 2025 provide insights into how perceptions of information blocking by HIOs have changed since ONC information blocking regulations went into effect in 2021.(<a href=\"#h-references\">2<\/a>) The data show that like survey data for hospitals, experiences of perceived information blocking have decreased since passage of the 21st Century Cures Act.(<a href=\"#h-references\">3<\/a>) Between 2019 and 2025, the percentage of HIOs that experienced any instance of potential information blocking decreased from 91% to 71%. Developers of certified health IT were most commonly reported by HIOs to be engaging in potential information blocking, but the percentage of HIOs that reported potential information blocking by developers decreased from 91% in 2019 to 62% in 2025. Conversely, fewer than 60% of HIOs reported any instance of potential information blocking by hospitals and health systems in 2019, but in 2025, the share has only decreased to 49%, a modest change. However, these rates consider all forms and frequencies of potential information blocking. The forms of potential information blocking HIOs report may provide a deeper understanding of HIOs\u2019 experiences.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Knowing the forms potential information blocking take can be helpful to better craft policy and enforcement actions to deter such practices. The findings show that developers and providers potentially use specific business, market, or other organizational constructs to not share information, rather than just refusing to provide information. Across all years, HIOs reported that developers of certified health IT most commonly used pricing and unreasonable fees to block information flow. In contrast, HIOs reported that hospitals and health systems used strategic affiliations, like organization or ownership structures, to avoid sharing information. This may suggest where efforts might be prioritized to continue to deter information blocking.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Data also show that even though most HIOs report experiencing possible information blocking, a majority of HIOs that experienced potential information blocking indicated that these practices and behaviors are not widespread among hospitals and health systems or developers of certified health IT. Many HIOs, therefore, experienced potential information blocking but increasingly by a smaller group of entities. Furthermore, among those entities who do engage in activities that could potentially constitute information blocking, a consistent share of HIOs reported these specific entities do so routinely. Taken together, this may signal that fewer specific entities may be engaged in potential information blocking, and some share of those entities are consistently doing so routinely.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">It&#8217;s unknown from the data who these specific entities that are potentially engaged in frequent potential information blocking are. Ongoing work by ONC to encourage reports of information blocking to HHS and educate the community about forms of blocking behaviors may improve awareness and deter these actions in the future.(<a href=\"#h-references\">4<\/a>) However, as shown in <a href=\"#h-appendix\">Appendix Table 1<\/a>, we find that few HIOs make such reports when they do experience potential information blocking. Engagement with the HIO and HDU communities to better understand their experiences and challenges deterring information blocking may also lead to improvements and greater trust in the reporting and investigation process. Although fewer HIOs experience any potential information blocking in 2025, compared to before information blocking regulations went into effect, certain forms of potential information blocking and possibly bad actors remain a barrier to information exchange facilitated and mediated by HIOs and HDUs. Those potential bad actors may have an outsize effect. Most HIOs report that information blocking greatly or moderately affects the missingness of patient health information and operation of information exchange services. Based on these analyses, deterring the small group of actors who may be engaging in potential information blocking practices including those related to business, market, or other organizational constructs to not share information could make a substantial impact on improving information exchange activity among HIOs and HDUs.<\/p>\n\n\n\n<h2 id=\"h-definitions\" class=\"wp-block-heading\">Definitions<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Health Information Exchange Organization (HIO): <\/strong>Local, regional, and state organizations operating in the United States that supported live electronic health information exchange across unaffiliated entities. This does not include local proprietary or enterprise networks. These organizations may be referred to as HIEs, as well, but their meaning and organizational role remain the same.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Health Data Utility (HDU)<\/strong>: Nonprofit organization designed to serve as a public-good infrastructure for secure, statewide health data exchange. Governed by diverse stakeholders and often designated by the state, an HDU supports both public and private sector needs by ensuring access to high-quality, integrated health data in accordance with federal and state privacy laws.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Information Blocking<\/strong>: A practice by an \u201cactor,\u201d undertaken with requisite knowledge, that is likely to interfere with the access, exchange, or use of electronic health information (EHI), except as required by law or specified in an information blocking exception. See the official government website for more information: <a href=\"https:\/\/healthit.gov\/information-blocking\/\" data-wpel-link=\"internal\">https:\/\/healthit.gov\/information-blocking\/<\/a>.<\/p>\n\n\n\n<h2 id=\"h-data-sources-and-methods\" class=\"wp-block-heading\">Data Sources and Methods<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Data are from the National Survey of Health Information Organizations (HIOs). Since 2019, ONC has partnered with the University of California, San Francisco (UCSF) and the Civitas Networks for Health to track the existence and operations of state, regional, and\/or local health information exchange organizations. The data are from the 2019, 2023, and 2025 national surveys. The 2019 survey was fielded from May 2019 to February 2020. In 2019, 106 organizations met inclusion criteria and 89 responded (84% response rate). The 2023 survey was fielded from January to July 2023. In 2023, 90 identified HIOs met the inclusion criteria and 76 responded (84% response rate). The 2025 survey was fielded from January to July 2025. In 2025, 87 identified HIOs met the inclusion criteria and 77 responded (86% response rate).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Statistics are unweighted and exclude missing responses.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Copies of the survey instruments are available on healthit.gov: <a href=\"https:\/\/healthit.gov\/data\/about\/#health-information-organization-survey\" data-wpel-link=\"internal\">https:\/\/healthit.gov\/data\/about\/#health-information-organization-survey<\/a>.<\/p>\n\n\n\n<h2 id=\"h-data-availability\" class=\"wp-block-heading\">Data Availability<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Data is available upon request. Please contact&nbsp;<a href=\"mailto:ONC_Data@hhs.gov\">ONC_Data@hhs.gov<\/a>.<\/p>\n\n\n\n<h2 id=\"h-references\" class=\"wp-block-heading\">References<\/h2>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Consortium of State and Regional Interoperability. The CSRI Health Data Utility Capability Model. Available from: <a href=\"https:\/\/thecsri.org\/the-csri-health-data-utility-capability-model\/\" data-wpel-link=\"external\" target=\"_blank\" rel=\"external noopener noreferrer\" class=\"wpel-processed wpel-icon-right\">https:\/\/thecsri.org\/the-csri-health-data-utility-capability-model\/<i class=\"wpel-icon fa fa-external-link\" aria-hidden=\"true\"><\/i><\/a>. Accessed: February 25, 2026.<\/li>\n\n\n\n<li>Information Blocking and the ONC Health IT Certification Program: Extension of Compliance Dates and Timeframes in Response to the COVID-19 Public Health Emergency (85 FR 70064). 2020. Available from: <a href=\"https:\/\/www.federalregister.gov\/documents\/2020\/11\/04\/2020-24376\/information-blocking-and-the-onc-health-it-certification-program-extension-of-compliance-dates-and#p-69\" data-wpel-link=\"external\" target=\"_blank\" rel=\"external noopener noreferrer\" class=\"wpel-processed wpel-icon-right\">https:\/\/www.federalregister.gov\/documents\/2020\/11\/04\/2020-24376\/information-blocking-and-the-onc-health-it-certification-program-extension-of-compliance-dates-and#p-69<i class=\"wpel-icon fa fa-external-link\" aria-hidden=\"true\"><\/i><\/a>. Accessed: February 25, 2026.<\/li>\n\n\n\n<li>Office of the National Coordinator for Health Information Technology. \u2018Trends in Hospital Leaders\u2019 Perceptions of Information Blocking\u2019 Health IT Quick Stat #65. Available from: <a href=\"https:\/\/healthit.gov\/data\/quickstats\/trends-in-hospital-leaders-perceptions-of-information-blocking\/\" data-wpel-link=\"internal\">https:\/\/healthit.gov\/data\/quickstats\/trends-in-hospital-leaders-perceptions-of-information-blocking\/<\/a>. Accessed: February 25, 2026.<\/li>\n\n\n\n<li>Office of the National Coordinator for Health Information Technology. \u2018Information Blocking Claims: By the Numbers,\u2019 Health IT Quick Stat #59. Available from: <a href=\"https:\/\/healthit.gov\/data\/quickstats\/information-blocking-claims-numbers\/\" data-wpel-link=\"internal\">https:\/\/healthit.gov\/data\/quickstats\/information-blocking-claims-numbers\/<\/a>. Accessed: February 25, 2026.<\/li>\n<\/ol>\n\n\n\n<h2 id=\"h-acknowledgments\" class=\"wp-block-heading\">Acknowledgments<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The authors are with the Office of the National Coordinator for Health Information Technology. The data brief was drafted under the direction of Mera Choi, Director of the Technical Strategy and Analysis Division, Vaishali Patel, Deputy Director of the Technical Strategy and Analysis Division, and Wesley Barker, Chief of the Data Analysis Branch with subject matter expertise from Rachel Nelson, Chief of the Compliance and Administration Branch.<\/p>\n\n\n\n<h2 id=\"h-suggested-citation\" class=\"wp-block-heading\">Suggested Citation<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Barker W, Healy D, Patel V. Trends in Health Information Organizations\u2019 Experiences of Perceived Information Blocking, 2019-2025. Office of the National Coordinator for Health Information Technology. Data Brief: 85. June 2026.<\/p>\n\n\n\n<h2 id=\"h-appendix\" class=\"wp-block-heading\">Appendix<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\" style=\"font-size:20px\"><strong>Appendix Table 1:<\/strong> Among HIOs that reported any instance of potential information blocking, percent of HIOs who reported those instances of potential information blocking to the ONC Information Blocking Portal, 2019-2025.<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><thead><tr><th class=\"has-text-align-center\" data-align=\"center\">Year<\/th><th class=\"has-text-align-center\" data-align=\"center\">Information blocking practices by developers<\/th><th class=\"has-text-align-center\" data-align=\"center\">Information blocking practices by hospitals and health systems<\/th><\/tr><\/thead><tbody><tr><td class=\"has-text-align-center\" data-align=\"center\">2025<\/td><td class=\"has-text-align-center\" data-align=\"center\">22%<\/td><td class=\"has-text-align-center\" data-align=\"center\">10%<\/td><\/tr><tr><td class=\"has-text-align-center\" data-align=\"center\">2023<\/td><td class=\"has-text-align-center\" data-align=\"center\">22%<\/td><td class=\"has-text-align-center\" data-align=\"center\">&#8212;<\/td><\/tr><tr><td class=\"has-text-align-center\" data-align=\"center\">2019<\/td><td class=\"has-text-align-center\" data-align=\"center\">&#8212;<\/td><td class=\"has-text-align-center\" data-align=\"center\">&#8212;<\/td><\/tr><\/tbody><\/table><figcaption class=\"wp-element-caption\">Source: National Survey of Health Information Organizations, 2023 and 2025. <br> Notes: A survey question asking about use of the ONC portal to report potential information blocking was first added in 2023.<\/figcaption><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>State, local, and regional health information organizations (HIOs), including HIEs and emerging Health Data Utilities [&hellip;]<\/p>\n","protected":false},"author":2800,"featured_media":0,"parent":0,"template":"","meta":{"_acf_changed":false,"_selected_menu":"","_show_breadcrumbs":"true","footnotes":""},"categories":[],"topics":[126,68,65],"class_list":["post-169729","data-brief","type-data-brief","status-publish","hentry","topics-data","topics-information-blocking","topics-interoperability"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.5 (Yoast SEO v28.5) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Trends in State, Local, and Regional Health Information Organizations\u2019 Experiences of Perceived Information Blocking, 2019-2025 - ONC Health IT Research &amp; Analysis<\/title>\n<meta name=\"description\" content=\"This data brief presents results from the 2019, 2023, and 2025 National Survey of Health Information Organizations to measure the overall incidence of practices that HIOs perceive may constitute information blocking. 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