Tearing Down Healthcare’s Digital Walls

In July 2025, the White House and CMS launched the Health Tech Ecosystem Initiative. This represented a voluntary but sweeping plan to make health data move more freely and securely across the U.S. healthcare system. Over 60 participants have signed on, including large EHR vendors (Epic, Oracle, athenahealth), health systems (Providence, NYP), and tech companies like Apple, Amazon, Google, and OpenAI.

It’s the clearest signal yet that we may be entering a new phase of American healthcare: one where the default is connection, not fragmentation. And that shift could be incredibly meaningful for patients, for the system, and for the startups trying to modernize it.

Why Interoperability Matters

For decades, health data has been trapped in institutional silos. Providers struggled to get records from other clinics. Patients couldn’t access their own information without substantial effort. Developers faced needed to implement numerous custom integrations just to pull vitals into an app.

This isn’t just annoying, it’s dangerous and expensive. Redundant imaging, repeated labs, preventable errors, and missed follow-ups all stem from the fact that data doesn’t flow. The promise of the Health Tech Ecosystem Initiative is simple — change the underlying infrastructure so that it does.

Participants have committed to a few core goals:

• Build APIs using the FHIR standard, with patient-controlled data access
• Create digital identity tools to authenticate individuals across systems
• Replace repetitive check-in paperwork with portable digital profiles
• Enable real-time event notifications between networks (e.g., admissions, discharges)
• Expand data-sharing capabilities to apps, not just EHRs

This is the beginning of healthcare’s ​“Rails moment.” Standardize the plumbing and a thousand applications can ride on top.

From Data Infrastructure to Real-World Outcomes

What does this unlock?

Frictionless onboarding

Patients could bring their full medical history to a new provider in seconds. No more forms, faxes or extensive questionnaires. Imagine walking into an urgent care clinic and the doctor already knows your allergies, recent labs, and prescriptions. Companies like b.well and OneRecord are building toward that vision.

Continuous care outside the clinic

When data becomes portable, chronic disease management gets easier and better. A diabetic patient could share glucose data from a connected device like Levels or Abbott’s Libre directly with their endocrinologist. Programs like Virta or Welldoc can feed insights back, closing the loop between patient and provider.

Smarter digital front doors

AI tools from Zocdoc, Hippocratic, and OpenAI are already being integrated into care navigation. But without context, they’re limited. Connected data changes that. An AI assistant could pull in your insurance status, recent visits, and lab results to give tailored guidance.

Easier entry for startups

Historically, integrating with EHRs required custom work per hospital. This was cost-prohibitive for early-stage companies. With standard APIs and CMS-aligned networks, startups can build once and deploy broadly. The move toward open infrastructure will favor nimble developers with focused value props over bloated vendor suites.

The Near-Term Risks

This change isn’t inevitable. Significant challenges still lay ahead.

The initiative is voluntary.

There’s no regulatory teeth yet. If key stakeholders delay, drag their feet, or check the box without meaningful implementation, progress could stall. Public dashboards and CMS flagging of ​“aligned networks” may help, but follow-through will require sustained pressure.

Security and privacy concerns.

More data liquidity means more risk surface. While consent is required, it’s not always clearly understood. Who’s responsible when an app misuses access — there is significant potential for a ​“Cambridge Analytica” moment, meaning guardrails may be overly restrictive at first.

A Quiet Platform Shift

What makes this initiative different from past interoperability efforts like TEFCA is its posture: it doesn’t try to centralize everything. Instead, it’s building a federated, standards-based environment where the patient is the hub. Apps talk to EHRs. Networks talk to each other. Patients are in control.

This unlocks modularity, composability, and personalization. Healthcare starts looking more like the rest of the digital economy: open platforms with many point solutions, rather than monoliths. For entrepreneurs, this creates a new canvas. It’s now viable to build a thin, elegant layer on top of the system like a coaching app, an AI scribe, a proactive care manager. This is because the hard part (data access) is being abstracted away.

For patients, it could make healthcare feel more like banking: manageable, mobile, on-demand.

Our Take

At Averin, we think infrastructure changes matter most when they shift what’s possible for applications. This initiative does that. It creates clearer entry points for startups. It reduces the moat of entrenched vendors and lays the groundwork for more intelligent, patient-centric care models. 

There’s still a lot to prove. But the involvement of both incumbents and upstarts, and the presence of real deadlines, suggests this may not just be another white paper. If healthcare data becomes liquid, intelligent tools will follow.