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

• Exponential data growth: Data is increasing at a very high rate due to modern advancements in technology.
• Privacy and security concerns: For example, the European Union's (EU) General Data Protection Regulation (GDPR) includes a "right to erasure" and places health data in a special category of personal data. This raises additional questions about the intersection of blockchain, encrypted data, and patient privacy.
• Patient engagement: This approach requires many participants and meticulous steps.
• Incentives: The biggest limitation is incentivizing institutions to build patient-facing data connections without financial motivation, which represents the difference between mere compliance and true interoperability.