By Mark Scrimshire, Chief Interoperability Officer, Onyx
CMS hosted a special Health Tech Ecosystem Connectathon last week in Washington, DC — a one-day event that brought together nearly 300 participants from across payers, providers, vendors, federal agencies, and standards groups. The size and composition of the crowd made one thing clear: CMS isn’t just regulating interoperability. They are accelerating the ecosystem needed to make it real.
Patients Own Their Data. Period.
As CMS Administrator Dr. Oz emphasized, patients should be empowered to control their healthcare decisions and data.
If we take this seriously — and CMS clearly does — interoperability becomes much more than connecting systems. It becomes the mechanism by which patients exercise digital agency in healthcare.
Patients aren’t the byproduct of data exchange anymore.
They’re the customer.
And that shift forces the industry to handle identity, consent, provenance, and transparency with far more rigor than we’ve ever applied before.
Key Themes From the Day
National Provider Directory: The NPD initiative aims to provide a validated, unified directory of provider and organizational endpoints. Accurate endpoint discovery is essential for reliable, scalable API exchange.
Kill the Clipboard: A simple but powerful vision: eliminate the need for patients to repeatedly fill out the same forms. Instead, empower them to authorize zero-copy digital flows that bring their information with them.
Digital Identity & Patient Matching: Digital identity and matching are converging into a single problem: reliably knowing who is requesting, receiving, or acting on data. A federated identity model is emerging as the only sustainable path forward.
AI Enablement: AI can accelerate workflows, support clinical decisions, and reduce administrative burden — but only if the underlying identity, provenance, and consent layers are trustworthy. AI cannot operate on ambiguous or unverified data.
Where Interoperability Must Go Next
To support true patient agency, the ecosystem needs core building blocks that work across organizations:
- Portable digital identity for both patients and professionals
- Machine-readable consent that travels with the data
- Audit trails that clearly show what moved, when, and why
- Accurate, discoverable endpoint directories
- FHIR APIs that scale and interoperate across networks
If we put these foundations in place, we can move beyond siloed workflows, reduce onboarding friction, and build the trusted infrastructure needed for modern digital health experiences.
Onyx’s Role in This Ecosystem
At Onyx, we’ve long believed that identity, consent, and auditability must be first-class citizens in the interoperability ecosystem. Our work across CMS APIs, FHIR-based exchange, and directory and identity initiatives aligns directly with this direction. What we heard in Washington reinforces the need to keep building scalable, standards-aligned infrastructure that serves patients, plans, and providers alike.
CMS isn’t slowing down on interoperability, and neither are we.
OnyxOS brings together everything payers need for CMS-0057 compliance and beyond: all on a single, FHIR-native platform that’s designed to deliver more than just the minimum.
Curious how OnyxOS puts CMS-0057 into action?
Let’s set up a quick demo.