What strikes me is that interoperability isn’t just about moving records.
It’s about enabling longitudinal intelligence.
If data truly flowed — across institutions, time, and modalities — we could begin to measure not just encounters, but trajectories.
Right now, our infrastructure supports transactions. It does not support compression of disease arcs.
AI layered on fragmented, encounter-based data risks industrializing inefficiency faster.
AI layered on interoperable, longitudinal data could do something different — identify inflection points earlier, support upstream intervention, and shift the objective from managing decline to altering course.
Thank you for such a thoughtful piece Sean.
What strikes me is that interoperability isn’t just about moving records.
It’s about enabling longitudinal intelligence.
If data truly flowed — across institutions, time, and modalities — we could begin to measure not just encounters, but trajectories.
Right now, our infrastructure supports transactions. It does not support compression of disease arcs.
AI layered on fragmented, encounter-based data risks industrializing inefficiency faster.
AI layered on interoperable, longitudinal data could do something different — identify inflection points earlier, support upstream intervention, and shift the objective from managing decline to altering course.
Interoperability is the substrate.
The real question is what we build on top of it.