By NextBestFitMandatory data-sharing standards
Enforce FHIR APIs and ban information blocking.
Enforce existing standards now.
Review ledgerHow this path connects
Addresses
Records don't follow patientsThis path
Mandatory data-sharing standards
Concrete changes if chosen
What would actually have to change in law, agencies, payment rules, or systems.
- Enforce FHIR APIs
- Ban information blocking
Effects
Each effect has its own page: the evidence, the case that it is or isn't a real cost, and whom it affects.
What it fixes
- Records don't follow patients
Enforcing record-sharing interfaces and banning information blocking builds on existing law while retaining market competition.
What it creates or worsens
- Takes years, or money up front, before it pays off
Enforcing record-sharing standards is slow, and vendors may comply only minimally.
- Requires new or changing information systems
Record-sharing standards keep changing, requiring systems to adapt.
Who's affected
Who gains
- People with ongoing or specialist care needs
- Records don't follow patients: Incompatible records lose information across providers and cause repeated tests.
- Health administration and software vendors
- Records don't follow patients: Enforcing record-sharing interfaces and banning information blocking builds on existing law while retaining market competition.
Who loses
- Health administration and software vendors
- Records don't follow patients: Record-system lock-in benefits vendors.
- Hospitals, clinics, and care organizations
- Records don't follow patients: Fragmented records help keep patients within their systems.
Where it has been tried
- U.S. 21st Century Cures Act: Under the 21st Century Cures Act, ONC logged 2,450 possible claims of information blocking between April 2021 and mid-2026, with over 1,500 submitted by patients and 1,938 implicating healthcare providers.