Navigating the Interoperability Maze: Can 2025 Finally Deliver Seamless Data Exchange?

The following is a guest article by Ryan Sullivan, Product Manager at Oystehr

The promise of seamless data exchange has been the holy grail of enterprise healthcare technology for decades. As we enter 2025, organizations continue to grapple with the challenge of making disparate systems talk to each other effectively. While significant progress has been made, the path to true interoperability remains complex – but there are promising developments on the horizon.

HL7 has served as a somewhat adequate (albeit costly) standard for healthcare data exchange for decades. However, its limitations are becoming increasingly apparent in today’s healthcare landscape. Legacy EHR systems, reliant on traditional HL7 interfaces, are struggling to meet modern interoperability demands. These systems often require high resources and costs to maintain, creating bottlenecks in care delivery and stifling innovation.

The Current State of Play

The interoperability landscape in 2025 is markedly different from just a few years ago. The widespread adoption of cloud-native architectures, API-first design principles, and standardized data formats has created a more conducive environment for data exchange. However, legacy systems, proprietary formats, and organizational silos continue to pose significant challenges.

Legacy EHR systems, heavily reliant on the 36+ year-old HL7 2.x standard, face notable limitations: batch processing delays, complex interface maintenance, lack of semantic standardization, and inability to support real-time data exchange. These shortcomings lead to delayed care decisions, higher costs, and obstacles to implementing modern healthcare solutions.

FHIR, with its RESTful APIs, real-time capabilities, and granular data access, is better equipped to meet today’s healthcare needs. Organizations transitioning from legacy HL7 interfaces to FHIR-based APIs can achieve substantial improvements in data exchange speed, information granularity, and the ability to support mobile and cloud-based applications.

The rise of low-code/no-code platforms has also democratized integration capabilities, enabling business users to create data workflows without deep technical expertise.

Overcoming Obstacles to Healthcare Interoperability

Several key factors are driving progress toward better interoperability:

Maturing Standards and Protocols

The industry has rallied around modern data exchange standards. GraphQL has gained significant traction as a flexible query language for APIs, while the FHIR standard has become nearly universal in healthcare data exchange. The widespread adoption of event-driven architectures and message brokers has also made real-time data sharing more feasible.

AI-Powered Integration

Artificial intelligence is playing an increasingly crucial role in solving interoperability challenges. AI-powered tools can now automatically map data schemas, suggest integration patterns, and even generate code for data transformations. This is particularly valuable when dealing with unstructured data or complex legacy systems.

Regulatory Pressure

Regulations like the EU’s Data Act and various industry-specific mandates have forced organizations to prioritize interoperability. This regulatory pressure has led to increased investment in standardization efforts and better documentation of data exchange protocols.

Challenges That Persist

Despite progress, several obstacles continue to impede seamless data exchange:

Security and Compliance

Security presents a significant challenge, as older protocols weren’t designed with modern cybersecurity threats in mind. Healthcare organizations must implement additional layers of security and monitoring, further driving up maintenance costs. Perhaps most concerning is the growing gap between these legacy systems and modern healthcare technologies – mobile health apps, remote monitoring devices, and cloud-based services often require complex workarounds to integrate with traditional interfaces, adding both cost and complexity to what should be straightforward integrations.

Technical Debt

Traditional interfaces built on legacy standards like HL7 v2 are becoming increasingly burdensome to maintain. Organizations face several critical pain points: specialized HL7 developers command premium rates due to scarcity, while the limited pool of qualified resources creates bottlenecks in development and maintenance cycles. Additionally, the real-time capabilities of these legacy systems fall short of modern healthcare demands, where instant access to patient data can be crucial for care decisions.

Organizational Resistance

Technical challenges aside, organizational barriers often prove to be the biggest hurdle. Data silos persist not just because of technical limitations, but because of organizational structures, competing priorities, and concerns about data ownership.

The Path Forward

As we look ahead, several trends suggest that 2025 could indeed be a turning point for interoperability:

Composable Architecture

The shift toward composable business architecture is gaining momentum, with organizations breaking down monolithic applications into modular services. This approach naturally promotes better interoperability by design.

Enhanced Data Fabric Solutions

Modern data fabric solutions are becoming more sophisticated, offering intelligent data discovery, automated governance, and seamless integration capabilities. These platforms are making it easier to manage data across diverse environments.

Industry Collaboration

There’s growing recognition that interoperability is a shared challenge that requires industry-wide collaboration. Cross-industry working groups and open-source initiatives are accelerating the development of common standards and best practices.

Unlocking Interoperability: Headless EHRs

By decoupling backend data management from frontend user interfaces, headless EHR solutions offer flexibility, allowing healthcare organizations to design custom workflows tailored to their unique needs. With API-driven architecture and support for FHIR standards, headless EHRs facilitate seamless data exchange and reduce reliance on traditional, vendor-locked systems. By adopting this model, organizations can establish a scalable and adaptable framework.

• API-first architecture enabling real-time data exchange
• Reduced dependency on point-to-point interfaces
• Better support for modern healthcare workflows
• Enhanced ability to integrate with emerging technologies
• Lower total cost of ownership compared to traditional EHR interfaces

Looking Ahead

The maze of interoperability isn’t going away entirely, but the paths through it are becoming clearer. Success will come to those organizations that approach the challenge strategically, leveraging new technologies while addressing both technical and organizational barriers.

As we progress through 2025, the focus should be not just on connecting systems, but on creating sustainable, scalable approaches to data exchange that can evolve with changing business needs. The goal isn’t just to solve today’s interoperability challenges, but to build a foundation that can support tomorrow’s innovations.

About Ryan Sullivan

Ryan Sullivan is a product manager at Oystehr, a platform providing developers with the APIs and infrastructure to build next-generation health tech and EHR solutions. He also supports marketing efforts at MassLight, helping startup founders launch and scale their ventures.