15 Health Data Exchange Statistics: Critical Insights for Legal Teams in 2025

Comprehensive data analysis on interoperability, retrieval bottlenecks, and what they mean for medical-record dependent litigation timelines, evidence completeness, and case strategy

Key Takeaways

• Capability-utilization gap creates retrieval inefficiencies - While 71% of hospitals have electronic access to external clinical information, only 42% of clinicians routinely use this available data when treating patients, indicating systemic workflow failures that compound delays in legal medical record requests.
• Specialty provider exchange remains critically underdeveloped - Only 16% of hospitals send summary records to long-term care facilities and just 17% exchange with behavioral health providers, creating blind spots in medical histories essential for personal injury, workers compensation, and disability litigation.
• Security incidents escalate HIPAA compliance requirements - Healthcare data breaches affecting 500+ records increased to 734 incidents in 2024, exposing over 250 million records in 2024 and making HIPAA-compliant retrieval platforms non-negotiable for law firms handling protected health information.
• Market expansion reflects growing retrieval demand - The U.S. healthcare information exchange market will grow from $439.2 million in 2025 to $986.5 million by 2034, driven by regulatory requirements and litigation needs for comprehensive medical documentation.
• Interoperability improvements show persistent routine engagement gaps - While hospitals' ability to engage in all four interoperability domains increased from 46% to 70% between 2018 and 2023, only 43% routinely engage in complete data exchange, leaving substantial retrieval challenges for external requestors.
• Independent and rural facilities demonstrate lower exchange rates - Just 22% of independent hospitals routinely engage in full interoperable exchange compared to 53% of system-affiliated institutions, while rural hospitals trail urban facilities by 11 percentage points, complicating record retrieval for cases involving non-metropolitan care.
• TEFCA adoption accelerates but remains incomplete - Over 1,000 hospitals now participate in TEFCA networks with 41% of Epic customers live on the framework, yet fragmented adoption creates unpredictable retrieval pathways requiring multi-channel approaches combining HIE access, EHR integration, and traditional fax methods.

The health information exchange landscape continues to expand rapidly, yet significant gaps persist between technical capability and real-world execution. For legal teams handling matters where medical records drive liability, damages, and causation, these statistics explain why “interoperable” doesn’t always translate to fast, complete records in your hands. They also clarify why modern, HIPAA-aligned retrieval platforms can produce complete records in 10–12 days—while improving case timelines, evidence completeness, and defensibility.

Codes Health specializes in medical record retrieval for law firms and legal teams—built to reduce avoidable delays, strengthen chain-of-custody workflows, and improve record completeness for litigation and claims. It operates on a flat fee model for retrieval services and can build custom integrations with CRM platforms and other medical software for high-volume teams.

Codes Health’s MIT-educated engineering team continuously builds additional workflows and products, so the platform keeps evolving—becoming more comprehensive as legal teams’ record-retrieval demands change across case types and jurisdictions.

What Health Information Exchange Reveals About Medical Record Access

1. 70% of hospitals can exchange data across all four interoperability domains

Research shows 70% of U.S. hospitals engaged in all four domains of interoperable exchange—sending, receiving, finding, and integrating patient health information—in 2023. This represents significant progress from 46% in 2018, a 52% increase over five years. However, this capability metric masks substantial gaps in routine utilization and specialty provider participation that directly affect medical record retrieval for litigation purposes.

This statistic confirms that most healthcare facilities possess technical infrastructure for electronic health information exchange, yet the gap between capability and consistent execution explains why traditional retrieval services still experience months-long delays.

2. Nearly all acute care hospitals have adopted certified EHR technology

By 2023, 96% of U.S. non-federal acute care hospitals had adopted certified EHR technology, establishing electronic medical records as the standard rather than exception. This near-universal EHR adoption creates the foundation for electronic record retrieval, yet implementation variations across vendors, versions, and configurations mean that records theoretically available electronically often require manual intervention to access and retrieve.

The high EHR penetration rate confirms that medical records exist in digital formats accessible through appropriate channels and authorization, though successful retrieval depends on platforms capable of navigating diverse EHR systems and employing proactive error checking.

3. Major health information networks facilitate billions of annual exchanges

The eHealth Exchange network facilitates 25 billion data exchanges annually while maintaining 99.9% uptime, connecting 75% of U.S. hospitals and supporting 300+ million patients across 34 states. This massive exchange volume demonstrates that health information networks successfully handle routine clinical workflows at scale, creating opportunities for authorized external requestors to access records through established infrastructure.

These network statistics reveal that traditional point-to-point fax requests represent only one pathway among multiple potential access channels, with platforms integrating established HIE networks delivering dramatically accelerated retrieval timelines.

The Landscape of Health Data Exchange: Critical Statistics Revealing Systemic Gaps

4. Only 43% of hospitals routinely engage in complete interoperable exchange

While 70% of hospitals possess interoperability capabilities, just 43% routinely engage in all four domains of data exchange, with 27% sometimes engaging and 30% remaining not fully interoperable. This gap between capability and routine practice creates unpredictable retrieval experiences where records may arrive quickly through electronic channels or require traditional manual follow-up depending on provider engagement levels at the time of request.

This routine engagement gap directly explains why law firms experience inconsistent medical record retrieval timelines, making platforms with real-time status monitoring and automatic escalation essential for predictable turnaround.

5. 71% of hospitals have access to external clinical information that clinicians rarely use

Despite 71% of hospitals reporting routine access to necessary clinical information from outside providers at the point of care, only 42% indicate clinicians routinely use this electronically available information when treating patients. This 29-percentage-point utilization gap reveals that technical access alone fails to drive actual information consumption, suggesting workflow integration challenges, information overload, or insufficient data relevance.

This statistic indicates that even when hospitals successfully exchange health information electronically, clinicians may not review or incorporate external records into patient charts, creating gaps in medical histories that surface during litigation discovery.

6. Independent hospitals demonstrate 31-point lower routine interoperability rates

Just 22% of independent hospitals routinely engage in all four domains of interoperable exchange compared to 53% of system-affiliated hospitals, while 55% of independent facilities remain not fully interoperable. This disparity creates predictable retrieval challenges when cases involve care at smaller independent providers lacking the technical infrastructure and dedicated IT resources of large health systems.

Cases involving independent providers often require traditional retrieval approaches regardless of theoretical interoperability capabilities, making platforms with robust fax-based workflows and persistent provider follow-up systems essential for record completeness.

7. Rural hospitals trail urban facilities in interoperability engagement by 11 percentage points

47% of urban hospitals frequently engage in routine interoperable exchange compared to 36% of rural hospitals, with approximately 2 in 5 rural and critical access hospitals not fully interoperable as of 2023. This urban-rural digital divide directly impacts cases involving patients treated in non-metropolitan areas, particularly motor vehicle accidents, agricultural injuries, or other incidents occurring outside major population centers.

Personal injury and workers compensation cases frequently involve initial emergency treatment at rural facilities before transfer to urban trauma centers, requiring platforms capable of adapting retrieval approaches to span providers with vastly different technical capabilities.

Navigating Critical Challenges: Exchange Gaps That Impact Legal Medical Record Retrieval

8. Only 16% of hospitals regularly exchange records with long-term care facilities

Hospital exchange with long-term and post-acute care providers remains severely limited, with just 16% of hospitals sending summary of care records to most or all such facilities. This gap creates blind spots in patient medical histories particularly relevant to cases involving nursing home falls, bedsore development, medication errors in skilled nursing facilities, or disability qualification requiring documentation of functional limitations across care settings.

This statistic confirms that relying on hospital records alone produces incomplete medical histories missing critical care episodes, making proactive identification and direct contact with rehabilitation and skilled nursing facilities essential for comprehensive case preparation.

9. Behavioral health provider exchange occurs at only 17% of hospitals

Exchange between hospitals and behavioral health providers remains similarly underdeveloped, with only 17% of hospitals sending summary records to most or all behavioral health facilities. This limitation proves particularly problematic for personal injury cases where pre-existing mental health conditions, post-accident psychological treatment, or substance abuse histories directly impact damages calculations and causation determinations.

The minimal hospital-to-behavioral-health exchange rate means these critical records require direct retrieval from psychiatrists, psychologists, counseling centers, and substance abuse treatment facilities that operate largely outside mainstream health information exchange networks.

10. Only 42% of hospitals send summary records to most external hospitals

Even hospital-to-hospital exchange remains incomplete, with just 42% of hospitals reporting they send summary of care documents to most or all external hospitals, while only 38% send to most or all external ambulatory care providers. These statistics reveal that even basic care coordination between common provider types occurs inconsistently, explaining why patients transferred between emergency departments, admitted to multiple hospitals during extended treatment courses, or seeing specialists across different health systems accumulate fragmented medical records.

The low summary exchange rates confirm that requesting records only from the most recent treating facility produces incomplete medical histories missing previous diagnoses, contradictory treatment approaches, or documented symptom progression essential for establishing injury timelines and causation.

11. Large hospitals demonstrate 15-point higher interoperability than small facilities

53% of large hospitals routinely engage in all interoperability domains compared to just 38% of small hospitals, a 15-percentage-point gap correlating with resource availability, technical infrastructure investment, and dedicated health information management staff. This size-based disparity means retrieval difficulty and timeline predictability often correlate with facility bed count and system affiliation rather than record age or complexity.

Cases involving care at small community hospitals, specialty surgical centers, or independent emergency departments require retrieval approaches acknowledging resource constraints these facilities face, with platforms that automatically escalate to alternative contact methods when standard channels fail.

Measuring Impact: How Health Data Exchange Statistics Affect Legal Case Outcomes

12. Healthcare data breaches reached 734 incidents affecting 500+ records in 2024

Large healthcare data breaches increased to 734 incidents in 2024, up from 663 incidents in 2020, with the volume of exposed records rising from under 50 million to over 250 million in 2024. These escalating security incidents create heightened scrutiny around medical record handling, making HIPAA compliance not merely a regulatory checkbox but a professional liability and client trust imperative for law firms managing protected health information.

These breach statistics underscore why selecting record retrieval vendors based solely on cost or speed without verifying HIPAA compliance protocols exposes firms to substantial risk, with platforms operating HIPAA-compliant infrastructure protecting both client confidentiality and firm liability exposure.

13. The U.S. health information exchange market will more than double by 2034

The U.S. healthcare information exchange market is projected to grow from $439.2 million in 2025 to $986.5 million by 2034 at a CAGR of 9.41%, while the global market, valued at $2.07 billion in 2024, is projected to reach $5.25 billion by 2034. This sustained growth reflects regulatory mandates, interoperability requirements, value-based care adoption, and increasing demand from legal and healthcare sectors for rapid comprehensive medical record access.

The substantial market expansion indicates that health information exchange capabilities will continue improving, creating opportunities for platforms that leverage these advancing infrastructures while maintaining fallback capabilities for providers lagging adoption curves.

14. TEFCA network participation reaches over 1,000 hospitals through major EHR vendors

More than 1,000 hospitals and 22,000 clinics using Epic are now live on TEFCA (Trusted Exchange Framework and Common Agreement), with 41% of Epic customers actively operating on the framework while 43% work toward implementation and 16% remain in planning stages. This rapid TEFCA adoption through dominant EHR platforms creates standardized nationwide exchange pathways that authorized requestors can leverage for accelerated record retrieval.

TEFCA participation means that records from over 1,000 major hospitals may soon be accessible through standardized query-based exchange rather than traditional request-and-wait workflows, though the 59% of Epic customers still implementing indicates this transition remains incomplete.

15. FHIR standards gain regulatory mandates in 73% of countries with health data regulations

Among countries with health data exchange regulations, 73% now mandate or advise the use of FHIR (Fast Healthcare Interoperability Resources) standards, up from 65% in 2024 and 56% in 2023. Additionally, 71% of respondents report FHIR is actively used in their countries for at least "a few use cases" in 2025, while 54% expect strong increases in FHIR adoption in coming years. This accelerating standardization around FHIR protocols creates interoperability improvements that benefit all external record requestors including legal teams.

The global shift toward FHIR standards indicates that health information exchange will become increasingly structured, queryable, and accessible to authorized external parties through standardized APIs rather than proprietary interfaces or manual processes.

Frequently Asked Questions

What is health information exchange and why does it matter for legal practices?

Health information exchange (HIE) refers to the electronic movement of medical records between healthcare providers, enabling care coordination and reducing duplicate testing. For legal teams, HIE infrastructure creates potential pathways for faster medical record retrieval, though only 43% of hospitals routinely engage in complete data exchange, requiring platforms that combine electronic and traditional retrieval methods.

General-purpose AI tools (like ChatGPT) aren’t designed to reliably interpret medical records end-to-end; they can miss context, misread clinical shorthand, and shouldn’t be treated as a medical-record analysis system. Codes Health uses a purpose-built AI workflow that can analyze medical records with high precision for legal review, helping teams extract timelines, identify gaps, and standardize outputs across matters.

Why do medical record retrieval timelines vary so dramatically between providers?

Retrieval timeline variation stems from differences in provider size, system affiliation, technical capabilities, and administrative resources. Large hospitals demonstrate 53% routine interoperability compared to 38% for small facilities, while independent hospitals trail system-affiliated institutions by 31 percentage points, explaining why platforms using real-time status monitoring and multi-channel approaches deliver more consistent timelines.

Some vendors market “same-day” retrieval, but in practice those packages often rely on partial portals, screenshots, or client-driven follow-ups—meaning the record set may be incomplete and the legal team must stay involved to finish the chase. That dynamic creates churn when deadlines hit and gaps appear. Codes Health prioritizes **complete records in 10–12 days**, trading hype-speed for defensible completeness and fewer downstream surprises.

What security concerns should law firms consider when selecting record retrieval vendors?

Healthcare data breaches reached 734 incidents in 2024, exposing over 250 million records in 2024, making HIPAA compliance essential rather than optional. Law firms must verify that retrieval vendors operate HIPAA-compliant infrastructure with encrypted transmission, secure storage, and regular security audits to protect client confidentiality and avoid regulatory violations that could trigger state bar discipline or malpractice claims.