August 18, 2025
By Eric Schiavone and Grace Totman, Capstone Healthcare Analysts
It seems like every few years, there is a burst of excitement about healthcare technology. From AI replacing doctors, to full lab tests with a single drop of blood, to telemedicine-first healthcare. But when the hype dies down, healthcare has a way of snapping back to its old habits. Because of the industry’s entrenched incentives and regulatory complexity, the major “disruption” is hard, but also fundamentally misunderstood. There is no end state of innovation the industry is rushing to, just constant progress. The Trump administration is hyper-focused on progress in the healthcare technology ecosystem, and industry appears like it is finally ready to accelerate this momentum.
Imagine you are a patient arriving for a follow-up at your cardiologist’s office after a stent placement. Instead of walking to the front desk to retrieve forms for check-in, you approach a kiosk and scan a QR code from your insurer’s app that verifies your identity. Instantly, the clinic’s electronic health record (EHR) pulls in your previous health information like your cholesterol test results, your prescription refill history, recent cardiac procedure images, and notes from your previous physician. This helps your cardiologist better assess your condition. In receiving this data, your provider learns of a gap in your care and your insurer’s incentive for closing this gap, helping increase quality scores and practice revenue.
The Trump administration is hyper-focused on progress in the healthcare technology ecosystem, and industry appears like it is finally ready to accelerate this momentum.
In the exam room, your provider’s EHR-embedded clinical decision support tool flags that you likely haven’t been taking medication to lower your heart rate and have “bad” cholesterol levels above target – prompting your clinician to adjust your medication or introduce another medication to be used in combination. While you talk to your clinician, an EHR-integrated AI tool transcribes the conversation, generates clinical notes, and pulls out justifiable and recommended billing and diagnosis codes.
At the same time, your insurer’s administrative system, connected to the same data exchange framework, receives a notification that you are receiving care. The payor verifies eligibility for a scan to assess blood flow in your heart and confirms prior authorization in real time. Post visit, the insurer captures clinical data attached to that encounter for quality metrics, Healthcare Effectiveness Data and Information Set (HEDIS) reporting, and risk adjustment models.
On your phone, in your preferred consumer health application, you receive an updated cost estimate based on your deductible status, consolidated notes on your condition and progress, and your discharge instructions – reducing the need to log in to multiple portals.
This seamless experience is no longer a distant vision, but the Trump administration’s healthcare ecosystem roadmap, detailed in CMS’s Interoperability Framework. The last few months have revealed an unusually cohesive federal push toward a fully connected health data ecosystem. Capstone has mixed feelings about this because while we acknowledge the technical feasibility of doing so, the vision is still voluntary, and misaligned incentives from different stakeholders have always been a barrier. Which is why CMS invited all stakeholders – from payors to providers, EHRs, and AI companies – to pledge to its Interoperability Framework. Not a regulatory requirement, but a “moral commitment” to push healthcare forward.
If this Framework is the catalyst for healthcare transformation, the implications for Healthcare Information Technology (HCIT) are unprecedented. Not because of new requirements, but because of federally encouraged behavior change for improved healthcare. We are always skeptical of flashy announcements, especially when the announcement is of a pledge to do better. But if this is the catalyst for behavior change, AI use proliferation will accelerate at greater pace as more real-time claims and clinical data feeds unlock new possibilities for analytics vendors, clinical decision support tools, and data models (read more about OpenAI’s potential from Brendan Keeler, the Health API Guy). Real-time eligibility, prior authorization, and claims validation will commoditize standard RCM functions, giving the advantage to platforms that leverage newly liquid data.
If the Trump administration delivers on this vision, the investable universe in health tech changes.
If the Trump administration delivers on this vision, the investable universe in health tech changes. Winners will be those who can capitalize on data availability, like analytics vendors who are core to the revenue-driving activities of payors and providers, and the losers will be anyone who is betting on information staying siloed, like vendors whose greatest value is in the “pipes” they create for data exchange.
The devil will be in the details. Capstone’s newly formalized HCIT practice is closely covering the ever-changing policy environment in this space.
Eric Schiavone, Capstone Healthcare Analyst
Grace Totman, Capstone Healthcare Analyst
Read more from Capstone’s Healthcare Team:
The 340B Dilemma: The Power of Vague Law
Policymaker Interest in Healthcare AI Heats Up
The Growing Healthcare Provider Shortage Problem
