ONC’s February 2026 brief shows that approximately nine in ten hospitals enabled patient access through an API, while much third-party exchange still relied on proprietary or non-standards-based methods. That is meaningful progress. It is also not the finish line: connectivity and clinical coherence are not the same thing.
The gap is not primarily a standards problem. It is an operating model problem. Information may be available and still arrive too late, in the wrong place, with unclear provenance, or without a workflow that tells a person what to do next.
The last mile is where value is decided
In healthcare, a data exchange capability becomes valuable when it changes a decision: a clinician sees a relevant history before ordering a test, a care manager spots a gap before a patient falls out of follow-up, or an operations leader can reconcile capacity across sites without stitching together five reports.
That requires more than an interface inventory. Leaders need to map:
- the decision the information is meant to support;
- the minimum context required for a person to trust it;
- the latency the workflow can tolerate;
- the ownership of data quality and exceptions;
- the point at which a human must review, explain, or override a recommendation.
ONC’s current hospital API brief adds the management question: who owns the information contract, what context is required for safe use, and how does a clinical or administrative team report that the exchange failed its purpose?
Design the clinical and administrative system together
Healthcare organizations often separate “clinical transformation” from “enterprise technology” until the handoff. That is where useful information loses context. A prior authorization workflow, for example, is simultaneously a clinical decision, an administrative process, a data exchange, a compliance boundary, and a patient experience.
The strategy should therefore start with the end-to-end service. Identify where work waits, where information is re-entered, and where accountability becomes ambiguous. Then design the data product, the workflow, and the change plan as one release.
The Global Enterprise view
We help healthcare leaders turn interoperability progress into operating advantage. Our experience across enterprise strategy, ITIL change management, AI advisory, and data foundations lets us work across the clinical, administrative, and technology boundaries that usually make these programs slow.
The question we ask is not “Can the systems exchange data?” It is “What will a better-informed person be able to do next, and what has to be true for that action to be safe?”