List three factors that explain why health information exchanges have had difficulty achieving economic sustainability.

What will be an ideal response?

Answers may vary. Potential options include: 1. competing HIT organizations are trying to establish themselves as the principal source of exchange services; 2. competing hospital systems are unwilling to share data with each other; 3. providers do not want patient data kept in a central database; 4. the technologies involved are cumbersome and expensive; 5. interfacing between EHRs and HIEs continues to be a challenge; and 6. privacy and security are issues.