When I first started in the Health IT industry 20+ years ago, paper was having a heyday and fax was King. Over the years, we’ve made the monumental shift from faxing clinical documents to electronic data exchange between similar EHRs and wide-spread electronic data exchange among unique EHR systems. As I try to wrap my head around the reality that 2021 is almost over, I’m compelled to reflect on the progress we as an industry have made last year and share some observations about the journey we still have to look forward to.

My first takeaway: I believe we finally answered the key question of “What is the likelihood of seamless interoperability?”

Simply put, we have passed the point of no return; health systems will be connected. We may change how and we may have more types of data shared, but it will be a connected health care ecosystem. We still have much to do, but it is clear that wide-scale interoperability in health care is feasible and doesn’t have to be overly expensive.

My second takeaway: The industry as a whole speaks about interoperability differently now, and these differences are important. Now, it is about adoption and use, not just about access.

While provider-to-provider connectivity is high, usage is not as high as it could be. The fact that we shared a billion clinical documents last year across the CommonWell network alone is a significant statistic. But I still hear stories of providers who struggle with how to use their system to get to the data they need, and similarly, those who aren’t even aware their system still isn’t sharing everything it can.

So, what is in store for next year, as I dust off my crystal ball?

I think we will see a more concerted effort to connect and activate adoption across the Ps: Providers, Patients, Payers and Public Health. We have come a long way when it comes to sharing between two entities from the same P, but we run into more challenges once we cross them.

The ONC has shared its intent to get Public Health more connected to Providers, and many of us are focused on making it easier for patients to plug into the existing networks to get the same secure access providers have. However, the reality is the existing trust networks were initially designed for Provider-to-Provider exchange.

To improve our ability to cross the Ps, we need more than technical changes; there are policy, regulatory and trust issues to work through. Data moves at the speed of trust, and experience shows you first trust those like you before you trust others.

One area that CommonWell has and will continue to prioritize in the coming year is exchange between Provider to Patients. The technology pieces to improve the flow of data between these two Ps are there and work, but we have some adjustments to make to ensure they work smoothly together. I akin it to a Lego set. You can start with one Lego kit for Harry Potter’s flying car and one kit for a boat; toss away the instructions and used together, you can also build a pretty cool dragon.

I think we have the right pieces available to us at CommonWell, and we have proven experience breaking down traditional silos to build a pretty good-looking dragon, but we are still working to find that missing piece to make it breathe fire. Hmmm… maybe FHIR is the answer in 2022. 😊

What I do know is that CommonWell has a very strong roadmap to drive our vision forward and work alongside industry leaders to ensure there are no more data silos when it comes to health care.


2022 is full of anticipation and will be a lot of effort, including the initial development of CommonWell as a Qualified Health Information Network (QHIN) as TEFCA is finally released as well as our focus on incorporating discrete data exchange via FHIR.

But for me it is not just about getting the technology right, which we of course must do. For me, it is about getting to a place in health care where every person can tap into the same network that providers use to obtain a patient’s complete health history. After all, who cares more about my data and my health than me?

Together, we got this far. Let’s keep building this dragon, together.