Last year, I had a wake-up call. My mom needed more support. Without warning, my sister and I were coordinating her care in ways we had never had to before.
Like so many in the sandwich generation, we found ourselves juggling texts, calls, calendars and medical portals — along with navigating referrals, prior authorizations, insurance hurdles, pharmacist questions and prescription medication changes. The experience we had was not unlike millions of others. But all of it was unnecessarily hard.
Something I didn’t expect from this common experience? Each obstacle we encountered introduced doubt while also eroding trust in our mom’s care. I wondered: If this part of the process isn’t working, will her care suffer?
This experience revealed something important: the burdens my family was facing weren’t clinical or even technologically impossible — they were failures in simple coordination. Patients and their families or caregivers are heavily burdened by the friction created when information doesn’t flow and systems don’t connect.
As someone who works in health tech, I found myself asking: How can we trust the healthcare system when something as seemingly simple as information exchange between care providers isn’t working the way it should? The responsibility for ensuring accuracy and timely coordination is left to those whose focus should be on treating their condition or caring for a loved one.
It was a firsthand reminder that healthcare interoperability isn’t an abstract concept; it’s about human connection, building trust and easing burden on patients and their care providers.
We can’t boil the ocean — but we can fix what’s broken
Even with all the interoperability progress we’ve made as an industry, gaps persist in ways that can materially impact patient care. At a minimum, missing data creates uncertainty at times when patients deserve better than swirling questions like:
- What if a medication is never started because the prior authorization disappears into “neverland”?
- What if a medication change isn’t known by every caregiver involved?
- What if the clinical context behind a treatment change isn’t shared with anyone downstream?
When even one piece of information is missing, trust breaks down — for clinicians, patients and the healthcare system itself.
Incomplete data, missing context and inconsistent updates have a real impact on patient care. Costs and delays stack up and, in the worst cases, lead to preventable complications and hospital visits. According to 2024-2025 research analyzing over 16,000 hospital discharges, patients whose outpatient care teams don’t receive a timely hospital discharge summary face dramatically higher readmission risks: a 79% increase in 7-day readmissions and a 37% increase in 28-day readmissions.
We recognize that these impacts are a symptom of the bigger issue: lacking health data interoperability. When patient data is out of sight or out of reach, danger emerges. We can’t rebuild the entire healthcare ecosystem overnight, but we can focus on the pervasive, persistent problems that show up in every exam room, pharmacy, handoff and transition of care.
Why the CMS interoperability pledge matters
In 2025, the Centers for Medicare & Medicaid Services (CMS) Interoperability Pledge became a pivotal moment. It was a catalyst that re-energized and refocused the healthcare ecosystem on solving this very real problem impacting patients across the country.
The Trusted Exchange Framework and Common Agreement (TEFCA) gave us the foundation for Qualified Health Information Networks (QHINs) that would provide the technical infrastructure to achieve advanced interoperability.
But that’s when interoperability stopped being a technical challenge. The bigger challenge would be building trust into the system — ensuring care providers and patients have the right information to support their care, exactly when and where they need it.
The pledge recognizes the missing ‘trust’ ingredient as essential to improving care delivery and the patient experience. Clinicians must trust the information they receive. Patients must trust the system guiding their care. And the system must trust its own ability to deliver consistent, complete data.
Think of it this way: every successful exchange of information to a patient or care provider is a deposit in the trust bank. Every missing or inconsistent detail is a withdrawal. The pledge accelerates us toward a future where those deposits finally outnumber the withdrawals.
The work that builds trust
Interoperability becomes meaningful when it dissolves barriers at the point of care—not when it adds one more step.
For example, in the American Medical Association’s 2024 physician survey, 93% of physicians report that the prior authorization process delays access to necessary care. These delays significantly disrupt patient care, as 82% of physicians report they can at least sometimes lead to patients abandoning their recommended therapies.
When prior authorization is automated within the prescribing workflow, delays are eliminated quickly thanks to access to information that was once invisible. As a result, trust can grow among care providers and their patients.
Another example is when care providers can identify when a new prescription was written but never picked up (as is the case for more than 1 in 4 new prescriptions). Closing the information gap by delivering care providers with intelligent notifications empowers them to better support their patients and improve medication adherence.
This is the work that matters: Ensuring a healthcare experience works the way people already believe it should.
Now, the responsibility is ours to continue delivering on the promise. We must work on the parts that go unnoticed on the surface, leading innovation and strengthening the invisible interoperability infrastructure.
The invisible work will be felt as the delays or barriers that once prevented a patient from accessing care or a prescription therapy finally fade away. In their place, trust will return to a healthcare system that finally feels connected to patients, families and care providers.
Photo: zhaojiankang, Getty Images
Karla Mills is the Vice President of Product Innovation at Surescripts where she is focused on turning healthcare interoperability strategy into execution at scale. She aligns with Surescripts’ purpose of improving healthcare for patients and those who care for them, and is committed to advancing Surescripts’ interoperability capabilities, expanding FHIR based services while enabling medication intelligence and payer–provider collaboration through trusted, scalable infrastructure.
Karla has proven experience translating federal requirements related to healthcare interoperability into clear product roadmaps and scalable operational frameworks, successfully leading three Qualified Health Information Networks (QHINs) through regulatory onboarding, operations, and expansion efforts.In addition, Karla has built and scaled national healthcare interoperability programs, launched new data and workflow products, and operationalized capabilities that support high-volume, multi-stakeholder exchange across the healthcare ecosystem.
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