---
title: "HIT Perspectives June 2026: Operational Lag"
description: Optimize health IT investments and bridge the gap between data exchange and operational value for improved healthcare outcomes. Business transformation > tech alone.
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---
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# Optimizing Health IT. For Good
Point-of-Care Partners delivers deep expertise through a 360-degree perspective to help organizations navigate complexity and drive meaningful progress.
# HIT Perspectives
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### Subscribe
#### HIT Perspectives – June 2026
# Why Data Exchange Is Up…But Operational Impact Still Lags
| *[](https://www.linkedin.com/in/vcandelora/) By [Kendra Obrist](https://www.linkedin.com/in/kendraobrist/), Senior Consultant & Payer Interoperability Expert* | *[](https://www.linkedin.com/in/vcandelora/) By [Brian Dwyer](https://www.linkedin.com/in/brian-dwyer-a291191/), Business Strategy Lead* |
| --- | --- |
### Quick Summary
- **Interoperability Adoption:** Healthcare has largely solved connectivity, but many organizations still struggle to turn exchanged data into operational value.
- **Workflow Matters:** Data only creates efficiency when it is integrated directly into clinical and administrative workflows.
- **Data Quality Challenges:** Poorly curated, unstructured, or low-value data can create risk, reduce trust, and limit adoption.
- **Beyond APIs:** APIs are foundational, but automation requires governance, workflow redesign, and intelligent orchestration.
- **Proven Results:** Organizations pairing standards-based exchange with process transformation are reducing administrative burden and improving outcomes.
- **CMS Pledge Program:** Industry collaboration is helping identify practical implementation strategies and demonstrate real-world ROI.
- **Payer Opportunity:** As CMS-0057 compliance efforts mature, payers should focus on extracting value from new interoperability capabilities.
- **The Next Frontier:** Competitive advantage will come from usability, workflow integration, and measurable operational impact, not connectivity alone.
The healthcare industry has spent the past couple of decades focused on a singular, monumental task: building the pipes. Through massive investments in electronic health record (EHR) adoption, the establishment of national networks such as the Trusted Exchange Framework and Common Agreement (TEFCA), and the mandate for FHIR APIs, clinical data is more fluid than ever before.
Recent federal reporting establishes that the technical infrastructure for exchange is almost universally deployed. According to the Office of the National Coordinator for Health Information Technology (ONC), nearly all acute care hospitals have implemented certified EHR technology. However, having the capability to send or receive data does not mean it is being effectively utilized. ONC data reveals a stark disconnect: while basic connectivity is high, only [43% of US hospitals routinely engage in all four core domains of interoperable exchange](https://healthit.gov/data/data-briefs/interoperable-exchange-patient-health-information-among-us-hospitals-2023/)—sending, receiving, finding, and integrating external data.
Yet, for many healthcare leaders, there is a nagging sense of "interoperability unrealized." We have achieved technical connectivity but the anticipated operational return on investment (ROI)—reduced administrative burden, lower costs, and seamless care coordination—remains stubbornly out of reach.
If the data is flowing, why hasn’t the needle moved on operational impact? The answer lies in the gap between basic interoperability and true operationalization.
### The Friction in the Flow: Why Pipes Aren't Enough
The disconnect between data liquidity and operational value is rarely a failure of the technology itself. Instead, it is a combination of process, quality, and structural barriers.
1. **The Workflow-Technology Mismatch:** Many organizations have "bolted on" new data capabilities to legacy workflows. When a clinician or payer administrator leaves their primary workspace to view external data, or when data arrives as an unparsed PDF that requires manual review, the attempt to reduce friction has failed. High-speed data exchange into a low-speed, manual process results in a net-neutral impact on productivity.
2. **The Data Governance and Quality Gap:** Data is flowing, but is it "clean" and contextual enough to act upon? Research into healthcare exchange highlights "data bloat," in which the volume of exchanged information is high, but the clinical relevance is low. Without robust data governance and standardized input processes, organizations face a wave of high-volume, low-quality data. If a clinician doesn't trust the data's accuracy or finds it fragmented, they will revert to manual verification, eliminating any efficiency gains.
3. **The Barrier of Unstructured Silos:** While connectivity is nearly ubiquitous in acute hospital settings, critical gaps remain in the care continuum. An [ONC tracking report on behavioral health settings](https://healthit.gov/data/data-briefs/electronic-health-record-adoption-and-exchange-capabilities-among-substance-use-and-mental-health-treatment-facilities-2024/) highlights that significance beyond general medicine. For example, [state government mental health and substance use facilities suffer from low adoption rates](https://hitconsultant.net/2026/04/20/onc-data-behavioral-health-ehr-adoption-hie-interoperability/), with 51% still relying on a combination of EHRs and paper charts. This lack of digital integration creates substantial blind spots for care coordination and payer evaluations, leaving high-value behavioral health data siloed from the rest of the ecosystem.
Beyond lost efficiency, this data bloat introduces significant medical-legal liability for receiving organizations, particularly health systems. When an organization accepts massive, unstructured data payloads, such as a multi--gigabyte document dump, it assumes responsibility for the information buried within them. If a critical piece of clinical data, such as a borderline lab result or a vague finding in an imaging report, is buried deep within a massive file, the health system faces a "needle in a haystack" dilemma. From a legal standpoint, the argument is, *"You had the data; why didn't you act on it?"* Yet from the health system’s operational reality, it was a pile of unvetted information that was impossible to safely parse at the point of care.
Without clear data provenance, filtering, and trust, acceptance of external data becomes a risk rather than a clinical asset. This is not a recipe for building a usable trust network.
### Bridging the Gap: Moving Toward Operationalization
To move from simple connectivity to actual value, organizations must shift their focus toward three critical pillars:
### The Power of Shared Success: Proving the ROI of Operationalization
While macro-level statistics highlight systemic gaps, micro-level success stories offer the blueprint for bridging them. The industry has long suffered from a lack of public, quantifiable evidence demonstrating that interoperability investments can yield tangible business value. However, a growing body of public case studies proves that when organizations meaningfully align data quality, education, and process redesign, the ROI is substantial.
When trailblazing organizations choose to share both their successes and failures publicly, it injects confidence into the wider market. Healthcare leaders no longer have to operate in the dark, wondering if a process transformation will collapse under its own administrative weight.
### Real-World Blueprints for Success
The proof of this concept is already emerging across several high-profile implementations:
### Catalyzing the Industry: The CMS Pledge Program
Perhaps the most significant potential to promote widespread operational transparency lies in the Centers for Medicare and Medicaid Services ([CMS) Pledge Program](https://www.cms.gov/priorities/health-technology-ecosystem/overview/medicare-app-library). Initiated to catalyze industry action outside formal rulemaking, the program organizes participants across categories such as data networks, EHRs, payers, and health systems into a shared commitment to transform the digital ecosystem.
A critical milestone occurred recently at the [CMS Health Tech Ecosystem Live! Event,](https://www.cms.gov/newsroom/press-releases/cms-launches-first-wave-healthtech-ecosystem-tools-fast-tracking-fully-digital-patient-centered) an in-person event where pledge participants gathered to actively demonstrate their technology, present real-world functionality, and map out active collaborations. In hands-on workshops, participants didn't just showcase "cool new technology," they surfaced practical, real-world deployment challenges.
As the program progresses, the ultimate value of the CMS Pledge initiative will depend on participants' willingness to share their operational data publicly. If pledge participants intentionally track and publish their ROI metrics—explicitly detailing how they solved data quality governance and overhauled human workflows—they will provide the industry with a definitive roadmap. Demonstrating that these tools actively "kill the clipboard" and eliminate administrative waste shifts interoperability from a compliance-driven cost center to an undeniable operational strategy.
### The Strategic Outlook for Payers and Vendors
From a payer perspective, the failure to operationalize data exchange manifests as wasted spend and missed opportunities for process transformation. Without streamlined data, medical necessity reviews remain slow, administrative friction remains high, and process transformation goals are missed.
For vendors, the competitive landscape is shifting. Connectivity is now a baseline requirement; the new frontier is product usability vs mere connectivity. Vendors that can demonstrate how their products reduce "clicks," prevent clinician burnout, and integrate seamlessly into the user’s cognitive workflow will win the market.
### How to Connect All the Dots into Meaningful Action
Moving the needle on operational impact requires more than a technical roadmap. It requires an objective understanding of a specific organization's starting point; not just their tech stack but the knowledge base and skill set of staff, the efficacy of current processes, data silos that may still exist, and the internal ability to make changes vs the need to find a partner to fill skill gaps.
Payers across the board have made significant investments in interoperability pointed at compliance with CMS-0057F over the past several years. As we approach the second half of 2026 and payers near completion of this work, focus must turn to realizing value from this investment. Each of the required new APIs present a unique challenge when it comes to value realization.
- **Payer-to-Payer API:** No data flows into a new payer unless these new members authorize it and identify their prior payer. How will payers educate and encourage members to do this? When data is received from prior payers, what can (and will) payers do with it? How should it be incorporated with other member data? How can it be used for improving member experience and health? Can it help to improve operational efficiency?
- **Prior Authorization:** No value can accrue unless providers use the new API. How will payers educate their providers and encourage utilization? How can a digital understanding of coverage and prior authorization rules change behavior at the point of care? How can payers take advantage of other member health data to inform the process? How much of the determination process can be automated? What role can and should artificial intelligence play?
- **Provider Access API:** Will EHR vendors develop functionality to support this? If so, will providers adopt it? How can and should providers use this data? How can this capability help improve the member experience and health?
Point-of-Care Partners specializes in helping organizations navigate business transformation, operations, and processes related to interoperability investments by aligning technology with the realities of human workflow.
Our team can assist you with:
**Don’t just build the pipes—start realizing the value.** [Contact Point-of-Care Partners today](https://www.pocp.com/contact/) to learn how we can help you bridge the gap between interoperability and operational excellence.
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