The march toward health information exchange across care settings is a slow one.

"It's relatively simple for providers within a hospital using a single EHR to share information about their patients. The real challenge and expense is getting dozens of different systems to talk to each other," Jennifer Covich Bordenick, CEO of eHealth Initiatives noted last week in announcing the group's 10th annual survey of health information exchanges.

Of the 199 survey respondents, three-quarters reported that they had to build multiple interfaces between different systems in order to exchange data. That's both time-consuming and expensive, the report points out.

The report isn't all doom and gloom, though. Survey respondents were optimistic about the future and sustainability of exchanges, which would be a welcome change from the fits and starts of previous attempts, such as RHIOs.

Assuming the industry continues to make progress on standards and real data exchange, however, there's a growing concern over an age-old problem in health care: liability. For instance: Who owns the data? Who takes action on data? Can a doctor take action on a test that she didn't order, but sees the results? What happens if she does, or doesn't act?

Last month, we ran an interview on this topic that my colleague Susan Hoppszallern conducted with Linda Reed, R.N., vice president of behavioral and integrative medicine and CIO at Atlantic Health System. Reed is one of the most insightful CIOs out there and Atlantic Health is on the forefront of information exchange and clinical integration. I encourage you to take five minutes out of your day to watch the interview. It is sure to spur some meaningful conversations as you and your team march toward a more integrated delivery model.

What are your thoughts? Comment below or on Twitter