Reflections from the ADAPT Chief AI Officers on Innovation Panel Discussion, November 2025

After decades of working toward seamless health data interoperability, we find ourselves at another pivotal moment. The rapid adoption of Artificial Intelligence (AI) in healthcare presents us with a familiar challenge wearing a new face: how do we ensure these powerful new tools work together transparently, accountably, and in the service of better health for people everywhere?

At a recent ADAPT conference panel, I had the opportunity to reflect on what our interoperability journey can teach us as we venture into standardizing intelligence, not just data. Here are some key insights from that conversation.

The Journey Continues

First, a grounding perspective: this is a journey, not a destination. Despite all the progress we've made in healthcare interoperability, too often, people still move faster and further than their health information. The ability for any digital tool—including AI—to help people make better health decisions is always limited by the scope of data in its purview and its capability to make sense of it.

Even the most powerful AI we can imagine must overcome the same boundaries we've always faced: technical, organizational, business, and jurisdictional barriers that prevent us from seeing the complete picture of health information relevant for individuals or populations.

However, HL7's decade-plus journey with Fast Health Interoperability Resources (FHIR® ) has taught us something crucial: open standards are a potent fuel for innovation. The vibrant, open, collaborative community around FHIR wasn't just a nice byproduct—it was the key force that created a well-tuned specification and enabled it to flourish in the marketplace.

Open standards level the playing field, reduce barriers to participation, and free organizations from proprietary formats. They unlock new connectivity, preserve data sovereignty, and most fundamentally, enable new digital freedoms. As we approach AI standardization, maintaining this commitment to openness isn't guaranteed, but it's the future we're fighting for.

The U.S. Department of Health and Human Services (HHS), in collaboration with over 45 of the nation’s largest health insurers, has announced an important step forward in transforming the problematic processes of prior authorization. By pledging to reduce delays, increase transparency, and standardize processes by 2027, these organizations have signaled a long-overdue shift toward easing administrative burdens and improving access to evidence-based care.

The pledge spans insurance markets (commercial coverage, Medicare Advantage and Medicaid managed care) and will benefit an impressive 257 million Americans. But turning that vision into reality will require more than declarations. It will demand the kind of trusted technical infrastructure that HL7’s community has built together for over 35 years.

 As implementation begins, prior authorization reform demands scalable, open and consensus-driven standards.