Steven Posnack kicked off the first panel of the Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology (ASTP/ONC) Annual Meeting this week with a rally cry.
“What do we want? Transparency and affordability! When do we want it? Now!”
The Principal Deputy National Coordinator for Health IT joked about taking it outside to the sidewalk during the lunch break. But inside the room, the sentiment was serious—and no one on the panel was accepting “maybe later” as an answer.
DrFirstChief Medical Officer Colin Banas, M.D., M.H.A., joined Cynthia Fisher, founder of PatientRightsAdvocate.org, Jocelyn Keegan, VP, Aetna Interoperability, and Sumit Nagpal, HIMSS board member and CEO/founder of Cherish, for a wide-ranging discussion.
To the shock of absolutely no one, the consensus was that opaque rules, fragmented data, and outdated processes are still the culprits standing in the way of better healthcare.
“We all have better visibility into the Domino’s pizza order than we do into a lifesaving medication—in terms of status, where it is, what it’s going to cost, when it’s going to arrive,” Dr. Banas said, adding that this is particularly true when it comes to prior authorizations. “There is no reason that this cannot be conquered in the year 2026.”
An appetite for change and the technology to achieve it are both there. What’s missing is execution—getting the right information into the right workflow at the right time.
“The shift is moving from what happens today, which is largely retrospective, to more real-time data,” Keegan said. “The tools are there for us to do it. We think the better we can do with information up front, the more we’ll reduce back-end churn that causes so much distress, waste, and anxiety in people’s lives.”
Patients are applying pressure with a very simple, but fair, question, Dr. Banas added: “Why can’t healthcare deliver the same experience they get in aviation, banking, and retail?”
With the growing acceptance of AI by clinicians, there is hope.
“I’ve never seen providers actually ask for something technology-related,” he said, recalling the “kicking and screaming” days of EHR adoption and Meaningful Use. “Now, ambient scribing is table stakes. It’s not even novel anymore.”
“The fact that we can actually see real-time prescription benefit (RTPB) transactions within workflow the majority of the time is a huge difference,” Dr. Banas said. “I remember when that was a pipe dream.”
But for the information to be useful, it has to be trusted by providers. Once a doctor gets burned by a bad estimate, the RTPB tool goes ignored, he said.
These problems are compounded by access restrictions. RTPB data is often locked behind e-prescribing privileges by the sources of the information, which shuts out others who need cost information to coordinate care effectively.
“Healthcare is a team sport,” Dr. Banas said. “A social worker needs to see what things cost. A case manager needs to see those things. Nurses. Pharmacists. Patients. There’s no reason that only I, the provider, should be able to see this.”
And the trust problem extends beyond prescribing. Fisher shared cases of huge discrepancies, including a $97,000 appendectomy bill at a hospital whose own transparency file listed the lowest price for the procedure at $1,300.
“The only way we restore trust is to shine sunlight on all of this,” she said. “We are at a crisis tipping point. People are so fearful they don’t get the care they need for fear of financial ruin.”
“There’s an insanity about how things have gotten to where they are,” Keegan said. “What can we do with technology, understanding that we’re in the business of simplifying and getting care to people? How can we leverage technology the way every other industry has?”
The status quo isn’t acceptable, she said. “It’s about our members and patients being able to get the care they need, when they need it, in a fully informed way—without going bankrupt or receiving a surprise bill.”
“The definition of insanity is doing the same thing over and over and expecting a different outcome,” said Nagpal, who has spent 35 years in digital health. “The solution is going to come from competition, from new players, and from consumers actually being able to make choices because those new players have emerged.”
Posnack used the metaphor of a TV or movie character being pulled back from the brink to ask if technology is the “hand” that will rescue healthcare. “Should we be as optimistic as we are?” he asked.
“I’m encouraged with the progress and momentum to deliver transparency to the consumer,” Fisher said.
“I do think we’re at this inflection point for technology,” Dr. Banas added. “I think we’re ready to embrace it. I’m excited.”
Want to continue the conversation? Meet with us at HIMSS 2026.