Welcome back to Care Decoded! In this episode, host Dr. Sunil Nihalani, CEO of Inferscience, sits down with interoperability expert Brendan Keeler, better known as the “health API guy.” Together, they tackle one of health tech’s biggest promises: interoperability. You’ll hear a down-to-earth exploration of what interoperability really looks like in practice, from the daunting challenges of connecting healthcare systems and sharing patient data, to the recent regulatory pushes trying to bridge the gaps.
Dr. Sunil Nihalani and Brendan Keeler dive into the evolution of healthcare data exchange, discuss the real progress and persisting pain points, and unpack both the tailwinds and headwinds shaping the future of seamless data sharing. With candid stories from the front lines and practical insights, this episode cuts through the industry buzz, spotlighting where we’re at and where we need to go to make interoperability meaningful for providers, patients, and everyone in between. If you care about the future of healthcare, data access, and smarter care, you won’t want to miss this conversation!
Timestamps:
00:00 "Healthcare, Consolidation, and Frustration"
03:57 "Progress and Continuous Improvement"
07:15 EHR Data Sharing Challenges
11:23 AI Modernizing EHRs and Visit Prep
15:59 "TEFCA Driving Patient Data Access"
18:03 "Boost for Tech-Enabled Care"
21:03 "Trust Strain Threatens Care Networks"
25:01 Illegal Loopholes Exploiting Patient Data
27:46 Identity Proofing vs Scribble Debate
31:42 "EPIC's Dominance in Vertical SaaS"
34:57 EHR Integration and Antitrust Rulings
39:04 EHRs, APIs, and Information Blocking
41:11 "Ubiquity Over Structured Data"
46:16 "Optimism Through AI and Interoperability"
47:40 "Driving Interoperability Through Advocacy"
Decoding Healthcare Interoperability: Insights from the Care Decoded Podcast
In a recent episode of Care Decoded, Dr. Sunil Nihalani and Brendan Keeler tackled one of the hottest topics in health tech: interoperability. With Brendan Keeler's vast experience leading integration efforts at major companies like Epic, Redox, Zeus Health, and Flexpath, this episode delivered a wealth of insights for providers, innovators, and anyone interested in the future of healthcare data exchange. Here, we break down the most compelling takeaways from their in-depth conversation.
The Journey Toward True Interoperability
The episode kicked off with Brendan Keeler sharing his personal journey into interoperability, emphasizing that his initial exposure to healthcare IT began at Epic. What stands out from his story is the idea that meaningful progress in interoperability has finally arrived. Over the last decade, networks like Carequality, CommonWell, and Health Exchange have enabled 75 to 80 percent of US providers to exchange clinical data. While not perfect, this is a monumental leap from where things stood ten years ago.
Why Interoperability Matters to Clinicians
Dr. Sunil Nihalani spoke to the daily frustrations many clinicians face: accessing complete medical histories across different systems remains a challenge. Even with the growth in networks and participation, users often encounter issues such as missing data and blank screens. Brendan Keeler noted that while the infrastructure exists, the quality, consistency, and depth of data vary considerably. Some Electronic Health Record (EHR) vendors share complete records, while others offer only basic patient summaries. Specialty-specific or niche EHRs often lag behind, sometimes not participating in these data exchanges at all.
Progress and Persistent Obstacles
Significant tailwinds are pushing the industry ahead. Regulatory advancements like TEFCA (Trusted Exchange Framework and Common Agreement) and new CMS programs are expanding access and use cases beyond traditional provider-to-provider exchange. For example, patients now benefit from identity-proofed digital routes to their data, making it easier than ever to access medical records without navigating multiple patient portals.
However, there are hurdles. Trust between network participants is fragile due to rising tensions around data use for non-treatment purposes, such as payment and legal requests. Brendan Keeler explained that implementation details and network effects impact everything from the reliability of data retrieval to patient-provider communication. He warns that if trust is lost, there is a risk that networks could unravel, slowing progress.
The Evolving Role of Major EHR Providers
Epic remains a central player in this space. While some view Epic as having too much influence, Brendan Keeler sees the situation as nuanced. Epic’s integrated approach gives it dominance among large health systems, but it is not unbeatable across all market segments. Importantly, regulatory pressure is forcing EHRs to open their APIs and support competition, paving the way for innovation.
Technology and Human Judgment: The Ideal Balance
The integration of AI tools is transforming how clinicians use data. Dr. Sunil Nihalani highlighted how AI-driven data summarization tools can surface care gaps in real time, supporting proactive and meaningful conversations with patients. Brendan Keeler added that while structured, high-quality data is ideal, broader access comes first. Ubiquitous interoperability allows clinicians and patients to tap into advanced tools that enhance clinical encounters and empower patients to be active participants in their care.
Looking Ahead
One of the podcast’s final takeaways is that interoperability is not a single problem. Instead, it encompasses a range of workflows and use cases. Brendan Keeler advised clinicians frustrated by current limitations to advocate for improvements and hold technology vendors accountable. Progress comes from collective action and a clear demand for solutions that support better patient care.
Healthcare interoperability is an ongoing journey, but as evidenced by this candid discussion, the industry is moving in the right direction. With new policies, technologies, and a focus on both provider and patient needs, the future looks promising for making healthcare data exchange truly seamless.
For more deep dives, tune into Care Decoded and keep the conversation about better care through better data alive.
Podcast's Website - https://caredecoded.com/
Dr. Sunil Nihalani - CEO and Founder at Inferscience - https://www.linkedin.com/in/sunil-nihalani-a6983a5/
Inferscience - https://www.inferscience.com/
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“Disclaimer: Informational only. Not medical advice. Consult your doctor for guidance.”