Interoperability has been a goal of the healthcare industry for decades, but the conversation is only now beginning to shift. The question is no longer whether systems connect; it’s whether those connections can scale, and whether they’re actually improving the experience for clinicians and patients. At a featured session during Becker’s 16th Annual Meeting, leaders from two complex health systems explored what it takes to move from fragmented data exchange to a network advantage — and a genuine way to help enhance access.
The session, titled “The network advantage: How scalable interoperability unlocks better patient and clinician experiences,” was moderated by Claire Aviles, director of product strategy at athenahealth. The company operates the largest connected ambulatory network in healthcare, where a single connection opens up data exchange across 170,000 clinicians.[1] Ms. Aviles was joined by leaders from two health systems within that network — both managing multi-EHR environments.
Here are four key takeaways from the session:
Note: Quotes have been edited for length and clarity.
1. Interoperability breaks down in operations, not technology
The panelists were candid: the technology to enable data exchange has existed for years. What’s lagged behind is the operational infrastructure to make it work.
“The barrier is operational workflows,” said Christoper Mack, senior director of strategic planning and patient access at Sutter Health (Sacramento, Calif.). At Sutter, which runs on a single primary EHR but manages 48 different systems across its network, centralizing the ambulatory referral function has been a prerequisite for meaningful interoperability gains. That work, Mr. Mack noted, requires physician leadership and a deliberate change management strategy — not just a technology deployment.
2. Ecosystem interoperability beats point-to-point at scale
Both health systems have moved away from direct, bilateral integrations in favor of network-based approaches. For Sutter, that philosophy is now baked into network strategy. Mr. Mack described a “scorecard of connectivity” that Sutter uses to hold its network partners accountable — measuring not just clinical outcomes and participation in shared initiatives, but whether and how partners are exchanging useful and relevant data in real time.
3. Closed-loop referrals offer a tangible proof point
One of the session’s most concrete examples was Sutter’s implementation of electronic referrals using 360X, a standard for closed-loop referrals running on DirectTrust. The 360X standard enables referring providers to send referrals electronically and track their status — whether accepted, declined or scheduled — rather than relying on fax or phone-based follow-up. The approach helps improve coordination between care teams, creating a more connected experience and making it easier for patients to access the care they need.
Sutter is among the first clinically integrated networks to implement 360X at scale, and athenahealth’s network presence in Northern California made it a natural partner. “It took us several years to even find a partner who was willing and able to,” Mr. Mack said. “The reason we chose athenahealth and athenahealth chose us is because it takes a willing partner.”
Ms. Aviles noted that surfacing the right referral options at the point of care, and ensuring incoming referrals are caught in a centralized, routable way, is central to how athenahealth is thinking about making interoperability function as intended.
4. The ROI is real — and so are the human stakes
Quantifying the return on interoperability investments can be challenging, but both health system leaders offered frameworks. One leader described measuring ROI similarly to how organizations evaluate AI tools: minutes saved per clinician interaction, multiplied across the care continuum.
Mr. Mack put it in the terms of meeting more patients’ needs: “When you convert somebody from traditional fax to direct messaging … [for us,] for every patient they sent prior to converting, it’s about five more patients.” That, he said, makes interoperability a strategic lever for both growth and creating a more seamless referral experience for patients and care teams.
Ms. Aviles grounded that in athenahealth’s broader mission. “If we don’t have the information at the point where it’s actually going to be useful, then what are we doing with all this technology?” It’s a question that shapes how athenahealth approaches network-based interoperability — prioritizing delivery of data within clinicians’ native workflows, at the moment it can drive action.
Beyond the numbers, speakers were clear about why this work matters personally. Mr. Mack reflected on navigating his mother’s care across many providers, repeatedly filling out the same clipboards and repeating histories that should have been available electronically.
“I think we have both a fiduciary responsibility and a care organization responsibility to do better,” he said.
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.
