Interoperability has been a priority in healthcare for decades, but for many organizations, the journey remains unfinished. In a webinar hosted by Becker’s Healthcare and featuring leaders from across the industry, panelists examined the persistent gaps in data exchange and what it will take to move from fragmented connections to truly scalable, usable interoperability.
Panelists included Steven Travers, PhD, vice president and CIO at Broward Health (Fort Lauderdale, Fla.); Lauren M. Smith, MD, chief medical officer at Cook County Health (Chicago); Amy Roberts, director of health information systems and information technology at Raleigh (N.C.) Neurology Associates; and Sam Lambson, vice president of product management at athenahealth.
Below are key takeaways from their discussion.
‘Connected’ doesn’t mean usable
Ask any of the panelists where interoperability is falling short, and the answer is consistent: it isn’t that data can’t be exchanged but whether what arrives is usable. Too often, it’s fragmented, malformed, or incomplete.
Mr. Lambson described the core problem as one of usability, not connectivity. “The gap really isn’t whether data itself can move, but whether it arrives in a usable, actionable way at the point of care,” he said.
Ms. Roberts described the day-to-day frustration at the practice level: clinicians often receive too much information, but still not the detail they need. “I can’t tell you how many times doctors will come to my office and say, ‘I just needed to see what I need to see. I don’t want all the other stuff.’ And then, ‘oh, by the way, you didn’t send me the one thing I needed.’ So how do we do better? When we talk about it being fragmented, yes, we’re connecting, we’re talking. Now we need to talk the same language,” she said.
For Cook County Health, the consequences are both clinical and financial. Dr. Smith described how incomplete records don’t just slow care — they force redundancy. “We’re repeating labs and imaging and consultations because we don’t have access to that whole patient record at the time that we need it,” she said. That creates waste that health systems under fiscal pressure simply cannot sustain.
Distributed care is straining the old model and leaving smaller players behind
As care continues to shift into ambulatory and community settings, the limitations of legacy integration models are becoming harder to ignore.
Mr. Lambson described a counterintuitive dynamic: care moves out of traditional hospital settings, and the cost of each individual connection rises. As a result, large anchor organizations often prioritize only their highest-volume partners — which could pull focus from exchanges with some home care, hospice, palliative care and smaller independent providers outside of the exchange.
Dr. Travers sees this playing out at Broward Health, where integrating community partners like food banks and social determinants of health-focused organizations has required manual data movement, as those organizations sit outside the established exchange infrastructure. The underlying issue, he argued, is structural.
“We’ve got to move away from that hub-and-spoke model where our health system is the center of the universe and everything flows through here, to where we’re more of an internet type of model where we have everything networked together,” Dr. Travers said.
Achieving this, he said, means retiring legacy HL7 point-to-point connections in favor of FHIR-based web services, where organizations can share data regardless of which EHR they’re on, rather than managing a growing tangle of bilateral integrations.
Standards-based network connectivity is the path forward
The appetite for building and maintaining point-to-point integrations is fading. In a focus group athenahealth conducted with large health systems, Mr. Lambson said the common theme was exhaustion — the maintenance burden, the cost of individual interfaces and the coordination required to connect every ambulatory clinic in a network has become unsustainable.
The more durable path, he argued, is standards-based network infrastructure. TEFCA, which athenahealth moved 100% of its eligible providers onto last year, creates a “network of networks” that offers broad connectivity through a single connection. The 360X standard for closed-loop referral communication represents a similar opportunity.
Ms. Roberts said Raleigh Neurology Associates is actively pursuing that model in partnership with athenahealth. The practice has already significantly cut its reliance on fax by shifting to electronic direct messaging, and early 360X pilots are showing real promise. “I want that patient that goes from the hospital to that specialty clinic to have that referral loop closed and that communication to be constant,” she said.
Clinician-centered design and clear metrics are what make interoperability stick
Even the strongest connectivity strategy can stall if it doesn’t work for clinicians.
Dr. Smith was direct about what it takes to drive adoption among a workforce already stretched thin: “If it’s less clicks, you will get the clinicians to do it,” she said.
She pointed to two metrics every organization should be tracking as interoperability improves: pajama time, or documentation completed at home after hours, and resource utilization, particularly reductions in redundant imaging and labs. Cook County Health hasn’t yet fully quantified resource utilization but sees it as essential.
Ms. Roberts said her team uses similar operational metrics, including staff touches per referral, referral leakage and provider time, to build a concrete internal case for continued investment. On the solution side, Mr. Lambson said athenahealth’s alpha and beta testing program helps validate new functionality with clinician cohorts before broader deployment, ensuring the platform works in real-world care settings.
“Interoperability isn’t just about connections and connectivity,” he said. “It’s about creating a usable, scaled data flow that supports better care for clinicians and for patients. The next chapter is all about coordination.”
That shift — from connection to coordination — is what will determine whether interoperability remains a technical promise or becomes a practical reality in everyday care.
To watch the full conversation, view the webinar recording here.
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