Interoperability is the Key to Healthcare’s Next Breakthrough
Better Outcomes, Competitive Advantage, and the Next Big Investment
📌 This article is part of my "5 Healthcare Trends to Watch and Act On" series.
In this series, I’m breaking down five key healthcare trends shaping 2025—why they matter, how they’re impacting the industry, and what healthcare leaders should do next.
💡 Explore the Full Series:
🏠 Overview: 5 Healthcare Trends to Watch and Act On
1️⃣ Trend 1: Data Security Becomes a Competitive Advantage
2️⃣ Trend 2: Data Interoperability Becomes the Backbone of Healthcare (You’re here)
3️⃣ Trend 3: Advanced Risk Stratification and Predictive Analytics
4️⃣ Trend 4: Addressing Health Equity Through Social Determinants of Health
5️⃣ Trend 5: Value-Based Care (VBC) Drives Innovation
Healthcare is drowning in fragmented data. Claims, clinical records, lab results, pharmacy data, and social determinants of health (SDoH) exist in separate systems and formats that do not communicate effectively. The result is inefficiencies, missed opportunities, and care gaps that impact patients, health plans, and businesses alike.
For years, the industry has pinned its hopes on standards like Fast Healthcare Interoperability Resources (FHIR), believing a universal format could fix healthcare’s data-sharing problem. But the reality is that standards alone will not solve interoperability. Healthcare data is messy. Legacy systems persist. Real-world interoperability requires more than just a shared language. It demands active translation, validation, integration, and action.
The real winners will not be the organizations that simply ingest and move data across the healthcare ecosystem. The competitive advantage lies in making sense of it.
Interoperability requires vendors who can work with fragmented, unstructured, and outdated formats because someone needs to translate, validate, and contextualize all that information. AI will help automate parts of this process, but human expertise is still essential to refine insights, ensure accuracy, and drive meaningful action.
For health plans, this means ensuring their data is not just accessible but actually useful. It unlocks potentially decades of data that may have been unformatted or lost to obsolescence. For vendors, it means proving how they turn fragmented information into insights that improve outcomes rather than using "actionable insights" as another overused marketing phrase. For investors, it means backing companies that treat interoperability as a competitive advantage, helping harvest new insights from previously unactionable data. The companies that get this right are like desalination firms turning ocean water into an unlimited source of fresh water.
Organizations that solve interoperability challenges will not just streamline operations. They will improve patient outcomes, enhance member engagement, and unlock massive growth opportunities.
Health Tech Vendors
Health plans want more than API integrations. They need vendors that seamlessly fit into and improve their data ecosystem. Vendors who eliminate integration headaches and prevent future pain will win more business.
To stand out, vendors should:
Solve real-world data complexity by supporting a variety of formats and legacy systems, rather than relying solely on modern standards like APIs or FHIR.
Prioritize seamless implementation to reduce friction for health plans and providers.
Deliver real-time insights and trends (using technology and humans) instead of static dashboards.
Vendors who can take fragmented data and create new insights will strengthen their position in the market and become long-term partners to health plans.
Health Plans
Data interoperability is critical for health plans looking to improve outcomes and control costs. The ability to aggregate and act on data can drive better member engagement and operational efficiencies.
To stay ahead, health plans should:
Integrate claims, clinical, and SDoH data to create a more comprehensive view of each member.
Use AI-driven analytics to identify high-risk members and intervene before costly health events occur.
Ensure vendor partnerships support interoperability requirements to maximize the value of their technology investments.
Plans that can fully utilize their many data streams (and historical data) will better anticipate and respond to the needs of their membership, leading to improved member retention, higher enrollments, and reductions in unnecessary spending.
Private Equity & Venture Capital
Investors looking for scalable health tech companies should strongly consider those that embed interoperability into their core capabilities.
To maximize value, investors should:
Prioritize solutions that connect payors, providers, and members rather than creating additional data silos.
Invest in platforms leveraging interoperability to power AI-driven decision-making.
Focus on companies offering interoperability-as-a-service to reduce integration costs for health plans and vendors.
Companies that make interoperability a foundational part of their solutions will see bigger moats, higher valuations, and long-term growth potential.
The Road Ahead
Interoperability is no longer a complicated technical feature. It is a key that unlocks innovation, efficiency, and growth in healthcare.
Health plans that implement effective data-sharing strategies will improve member outcomes and reduce costs. Vendors that build seamless integration into their solutions will become essential partners. Investors who back companies solving interoperability challenges will see stronger returns.
The future of healthcare will be defined by those who can unlock the full value of the data and utilize it to make faster, better decisions.
🔥 If you liked what you’ve read, there’s more where that came from.
This article is part of my "5 Healthcare Trends to Watch and Act On" series, where I break down the biggest shifts shaping 2025. If you want to see all five trends at a glance and dive into the ones that matter most to you, check out the full overview here.
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