FHIR Is No Longer the Challenge, Operationalizing It Is
FHIR adoption is no longer emerging; it is becoming embedded in healthcare infrastructure. In 2024, seven in 10 U.S. hospitals reported using standards-based APIs, such as FHIR, to enable patient access to health information. At the same time, federal interoperability requirements continue to accelerate adoption, with CMS requiring impacted payers to implement additional FHIR APIs for provider access, payer-to-payer exchange, and prior authorization beginning in 2027. Standards-based exchange is increasingly becoming an expected part of the healthcare technology landscape.
But implementing FHIR does not automatically create effective interoperability. An API can be technically operational while the processes surrounding it remain manual. Data can successfully move from one organization to another without reaching the people who need it when they need it. And an organization can meet an interoperability requirement without realizing the broader value of the data it is exchanging.
The next challenge for healthcare is not simply implementing FHIR. It is operationalizing it.
Moving from Technical Connectivity to Operational Interoperability
Technical interoperability answers an important question: Can the data move?
Operational interoperability asks a different set of questions: Is the right data moving? Is it usable? Does it arrive at the right time? Does it fit into existing workflows? And does it ultimately help someone make a better decision or take action? Consider a payer and provider exchanging clinical data. Establishing a FHIR connection between the two organizations is an important milestone, but it is only the beginning.
The organizations still need to determine which patients are included in the exchange, identify and match those patients accurately, standardize the information being exchanged, incorporate the data into existing quality and risk workflows, and make it available to the people and systems that can act on it. If those surrounding processes still rely on spreadsheets, manual file transfers, one-off mappings, or disconnected workflows, implementing a FHIR API has solved only part of the interoperability problem. Technology works, but the workflow doesn’t.
Why Interoperability Gets Hard After the API Goes Live
Operationalizing FHIR requires healthcare organizations to think beyond individual interfaces and consider the entire data exchange process. Several factors become particularly important.
- Data must be usable, not simply available. Standards enable consistent exchange, but data still needs to be validated, standardized, matched, and organized to support downstream use cases.
- Exchange must fit into existing workflows. Interoperability creates more value when information reaches healthcare teams within the processes and systems they already use.
- Solutions need to work at scale. Infrastructure should support growing data volumes, new partners, and additional use cases without requiring a new point-to-point solution each time.
- Automation matters. An API only solves part of the problem if the surrounding workflow remains manual. Automation helps move information more efficiently from exchange to action.
Build Once, Then Extend the Value
One of the biggest opportunities created by operational interoperability is the ability to use the same data foundation for more than one purpose. Clinical and administrative data exchanged for a regulatory requirement can also support quality measurement, risk adjustment, population health, care coordination, and value-based care. As organizations develop AI and advanced analytics capabilities, standardized and well-governed healthcare data can become the foundation for those applications as well.
This changes the interoperability conversation. Instead of asking, “What connection do we need to build for this requirement?” organizations can begin asking, “What capabilities can we enable with the data and infrastructure we already have?”
That shift can help healthcare organizations move away from isolated interoperability projects and toward a reusable data strategy.
How Opala Helps Operationalize Interoperability
At Opala, we view FHIR as the foundation for interoperability, not the end goal. Opala HealthSynq™ collects, standardizes, and consolidates healthcare data so payers and providers can exchange information through standards-based workflows and put that information to work across the organization.
Rather than building a separate solution for every interoperability requirement, HealthSynq™ provides a scalable foundation that can support multiple use cases, including attribution, clinical data exchange, quality measurement, prior authorization, population health, and value-based care.
Opala also supports both transactional and population-scale exchange. That allows organizations to apply the right approach to the use case, whether they need information about an individual patient at a specific point in a workflow or need to exchange data across an entire population.
Most importantly, the focus extends beyond establishing the connection. We work with payer and provider organizations to integrate standards-based exchange into the operational processes surrounding the data so interoperability can reduce manual work, improve access to information, and create value beyond compliance.
The Next Phase of Interoperability
FHIR has given healthcare a common framework for exchanging information. The opportunity now is to make that exchange work in the real world. That means moving beyond measuring interoperability by the number of APIs deployed or connections established. Success increasingly depends on whether those connections improve workflows, reduce administrative burden, make data more useful, and enable organizations to respond more quickly to the needs of patients and providers. FHIR remains an essential part of that foundation. But the organizations that get the greatest value from interoperability will be the ones that focus not only on implementing the standard, but on operationalizing what it makes possible.
