Unlocking integrated healthcare through bidirectional data exchange

Healthcare today stands at a pivotal moment. Consumers expect seamless, digitally enabled experiences, and providers need better tools to improve health outcomes.

At the same time, escalating costs and fragmented delivery systems challenge the healthcare industry’s ability to deliver timely, coordinated, and personalized care.

The system can feel daunting. But if we take a step back, we see one critical thread we can pull to accelerate fixing it: bi-directional data exchange.

Bidirectional interoperability: A new standard

Our healthcare system doesn’t need to wait for solutions to improve. Healthcare leaders can create a new standard where data moves freely, securely, and meaningfully across the care continuum.

To build truly integrated healthcare, the industry must appropriately and in compliance with regulations break down silos that keep clinical, behavioral and social data isolated. When data flows privately and securely in near real-time across the healthcare ecosystem, it empowers everyone. Consumers become more engaged. Providers gain timely insights. And health outcomes improve through more proactive, coordinated care.

One example of this in action is Carelon’s Health OS, a clinical data interoperability platform that connects payers, providers, and members in a secure digital environment. Its strength lies in its ability to integrate frictionlessly with electronic medical records, health information exchanges, and other systems. This enables intelligent, private and secure data flows across an individual’s care team, in full alignment with all applicable laws and regulations governing patient data privacy and data exchange.

Its impact is not theoretical. Take Maria, a 62-year-old with diabetes, hypertension, and early-stage kidney disease. In a fragmented healthcare environment, her nephrologist, endocrinologist, and primary care physician (PCP) each operate with partial information, disconnected from one another. Her nephrologist often lacks timely access to Maria’s glucose levels or recent medication changes, making it difficult to optimize her kidney care. The result? Redundant lab tests, missed care gaps, and preventable complications.

But with real-time, bidirectional exchange of data through Health OS, Maria’s providers are no longer in the dark. Her nephrologist receives immediate updates on her average blood sugar levels and medication adjustments from her PCP, enabling more informed, precise treatment decisions. Meanwhile, her care manager sees her full appointment history and notices when she starts missing visits, triggering timely outreach. Maria now has a fully connected care team, leading to fewer hospital visits, proactive treatment, and a sense of being truly supported.

What started as a straightforward data-sharing tool has rapidly evolved. In just three years, Health OS has become a robust clinical data repository linking 88,000 providers and serving 32 million members nationwide. Each year, the system processes over 9 billion clinical data records. These insights are translated from raw diagnosis codes into plain language that is easier for clinicians to use and patients to understand.

This strategic leap accelerates real-time collaboration and sets the stage for integrated, intelligent healthcare delivery.

From data to insight to action

With secure, bidirectional platforms, the healthcare industry will be in a better position to appropriately leverage health records, claims, lab results, and other health data to help consumers lead healthier lives.

Additionally, by unifying these data sources, we create the foundation for predictive analytics and AI-driven programs that can anticipate risk and enable personalized care, rather than reactive treatment.

This approach also empowers individuals. Today’s healthcare consumers want more than treatment; they seek clarity, simplicity, and control. When data is integrated and accessible, individuals gain a fuller understanding of their health and are more equipped to engage in decisions with their providers.

Providers benefit, too. Access to a complete, current patient history enhances diagnoses, supports care coordination, and strengthens population health management. It also helps reduce administrative burden, freeing up time to focus on what matters most: patient care.

Building a future-ready infrastructure

The need for transformation is urgent. Healthcare costs continue to rise, as do consumers’ expectations of the healthcare experience.

In response, healthcare organizations are ramping up investments in technology, with AI and advanced analytics leading the charge. But these tools can only fulfill their promise if they’re built on a foundation of interoperability and real-time data access, while upholding the highest standards of patient privacy and complying with all applicable laws and regulations.

When data flows freely and securely, incredible things happen: connectivity sparks insight, insight informs action, and action transforms care.

This isn’t just about better systems; it’s about better health. It’s about building a healthcare experience that works for patients seeking compassion and clarity, providers striving for excellence, and health plans aiming for sustainable value.

To meet this moment and shape the future, we must lead boldly. With the right technology and the right partnerships, we all can create a healthcare system that is not only more efficient but truly human-centered, built for connection, intelligence, and care.

Let’s not wait for disruption. Let’s be the disruptors.

Peter D. Haytaian serves as an executive vice president of Elevance Health and president of Carelon.

Jeff Plante is president of Carelon Insights, a division within Carelon.