The patient-driven approach to healthcare interoperability faces several limitations:

• Data is increasing exponentially, at a very high rate, with modern advancements in technology.
• Privacy and security concerns. For example, the European Union's (EU) recently adopted General Data Protection Regulation includes a “right to erasure” and places health data in a special category of personal data. This further raises additional questions about the intersection of blockchain, encrypted data, and patient privacy, particularly in the EU context.
• Patient engagement, which requires a lot of participants and meticulous steps.
• The biggest limitation is incentives: incentivizing institutions to build patient-facing data connections without financial motivation to do so will be challenging—the difference between compliance and true interoperability.