Risk Never Sleeps Podcast – Episode #207

Title: Healthcare Has a Data Problem, Not a Technology Problem
Guest: Inderpal Kohli, Chief Technology Officer at Healthix
Host: Ed Gaudet
Date: April 13, 2026

Episode Overview

This episode explores the challenges and opportunities in health information exchange (HIE), focusing on why healthcare's core issue is data quality and integration—not just technology. Inderpal Kohli, CTO at Healthix, outlines Healthix's transformation into a data intelligence organization, discusses standards like FHIR and TEFCA, and reflects on his journey and broader industry trends. The discussion centers on data messiness, interoperability, building trust, and insights-driven healthcare.

Key Discussion Points & Insights

Healthix: Scope and Role

[00:40 – 01:45]

• Healthix is one of the largest public HIEs in New York:
  • Connects with over 9,000 entities, 82 health systems, and 27,000 physicians in the NYC metro area.
  • Handles hundreds of millions of patient records, integrating with all major EMRs (Epic, eClinicalWorks, Cerner, etc.).
• Primary mission: Transitioning from pure HIE to a "data intelligence organization".
• Inderpal Kohli’s role:
  • Build platforms delivering actionable insights from messy, complex healthcare data.
  • "My goal is to really build a platform and then aid in the development of insights from the data." (Inderpal Kohli, 00:40)

The Challenge: Messy Data, Not Technology

[01:54 – 03:25]

• Healthcare data is inherently "messy" due to:
  • Thousands of disparate entities and "few hundred systems of record."
  • Lack of true standardization even when standards exist.
  • Healthix spends enormous effort on data normalization and identity matching.
• The biggest value-add for participants:
  • Healthix sees the longitudinal patient record—enabling analytics, care gap reporting, and population surveillance.
  • "That's the hardest part with this job today: the messy nature of HIE data...the bulk of our effort goes to normalizing and making sure the data makes sense." (Inderpal Kohli, 02:02)

Industry Standards: FHIR, TEFCA, and Beyond

[03:25 – 05:48]

• FHIR (Fast Healthcare Interoperability Resources):
  • "We've been on FHIR for many years...it's one of the standards we're all aspiring for." (Inderpal Kohli, 03:28)
  • Not yet the universal standard—adoption is patchy, but growing.
• TEFCA (Trusted Exchange Framework and Common Agreement):
  • Aims to enable national health information exchange.
  • TEFCA and QHINs (Qualified Health Information Networks) reduce burdens on individual health systems; allows broader, cross-geography data sharing.
  • Current models rely on "pull" (data requested), whereas Healthix operates as a "push" model—delivering real-time alerts and data to care organizations.
  • "The value with TEFCA will be when we really build a critical mass...it may take a few years." (Inderpal Kohli, 04:12)
  • "We are a push model...we receive it, process it, we push it out to all entities in near real time." (Inderpal Kohli, 05:25)

Evolving Priorities: Insights and Trust

[06:11 – 07:56]

• Top priorities:
  1. Evolving Healthix into a data intelligence platform.
  2. Maintain and exceed high trust certification—vital for industry credibility.
  3. Build AI/ML-driven insights and applications to leverage the unique data asset.
  4. Impact not just point-of-care but also population health—"We can solve public health problems, help populations, do disease prevalence, surveillance, compliance...a level beyond that is my priority." (Inderpal Kohli, 06:53)
• Trust is foundational:
  • "That's how I convey the confidence to my participants, build trust with them, that we are the guardians of the most important information and we are taking it very seriously." (Inderpal Kohli, 06:41)

Threats to HIEs: Business Risks, Not Just Cyber

[07:56 – 09:15]

• Potential business threats:
  • TEFCA could threaten regional HIEs if it achieves a "critical mass" of connected health systems.
  • Loss of participant trust would be disastrous: "If we lose trust...that is where most of the hard work goes." (Inderpal Kohli, 08:19)
  • Healthix's strategy: Layer value-added services (alerts, analytics) on data exchange, focusing on data quality and real-time capabilities.
  • "We don't modify any data, we match and tie it all together from various entities. That's our secret sauce." (Inderpal Kohli, 08:50)

Personal Journey: Provider vs. HIE Perspective

[09:15 – 10:47]

• Moving from provider (hospital) to HIE:
  • Broadened exposure: "Now I not just see one health system." (Inderpal Kohli, 10:35)
  • Provider work was broader (network, cybersecurity, applications, AI, etc.); at HIE, focus narrows to data exchange and insight, but applies across many organizations.
  • Career started in Columbia’s biomedical informatics, bridging research and real-world deployment.
  • "What I bring here is a knowledge and inherent understanding of what that data may mean at the point of care." (Inderpal Kohli, 09:23)

The Next 10 Years: Interoperability and Impact

[10:47 – 12:03]

• Vision for the future:
  • Desire for interoperability to be seamlessly embedded—not a special, separate project.
  • Persistent problem: Hundreds of vendors and differing state/federal regulations complicate interoperability.
  • "That standardization of interoperability...is a big problem, and it may or may not go away. If it goes away, that's good for us as patients, and as a technology solution provider for the healthcare industry." (Inderpal Kohli, 11:29)
  • Even if standardization is achieved, new problems (cleaning and organizing data) will remain.

Early Career & Motivation

[12:03 – 13:31]

• Entry into healthcare IT:
  • Started as a programmer in financial software, ended up at Columbia University Biomedical Informatics after relocating to the US.
  • Early exposure to research and hospital solutions gave him a "bench to bedside" perspective.
  • "A year into it I made a deliberate decision to keep doing it...this is the only thing I know." (Inderpal Kohli, 12:25)
  • Passion for mission-driven work: constantly reminds team of healthcare’s impact.
  • "Mission is so important...that's one of the roles I play every time I bring someone on my team, is to connect them with why we are doing it." (Inderpal Kohli, 13:21)

Career Reflections and Advice

[13:31 – 18:00]

• Advice to his younger self:
  • Focus not just on building technology, but adoption and real-world utility.
  • "Technology is 60%, 40%, 50% of the whole equation. It's really adoption for which you need a clinician or an operational leader working with you." (Inderpal Kohli, 14:10)
• Career dreams outside health IT:
  • Sees himself as a "solutions and delivery person." Completion and impact are vital—prefers to deliver (not just develop).
• Hobbies:
  • Enjoys golf (not an expert), gardening for relaxation—"It slows everything down, which is nice. You see something grow to keep nurturing something." (Inderpal Kohli, 15:44)
• Risks taken:
  • Returning to school after a ten-year break, while starting a family—"Very rewarding...at that time, it looked risky." (Inderpal Kohli, 16:05)
• Advice to newcomers:
  • Learn healthcare deeply; don’t just write code but understand users’ (clinicians') day-to-day reality.
  • "Take time to learn about the workflows and utilization...technology is not the job for clinicians, it's a tool." (Inderpal Kohli, 16:45)
  • Advocates for vendor immersion visits (like Epic’s) for developers.

Notable Quotes & Memorable Moments

• "HIE data is messy data. So the hardest part is...normalizing that data and making sure it makes sense and identity proving that data." – Inderpal Kohli [02:02]
• "Fire is definitely...one of the standards we are all aspiring for...is it a standard all across? Probably not, but I think we're getting there." – Inderpal Kohli [03:28]
• "Tefka, just like other solutions right now, is a pull model...whereas we are a push model. The data is pushed across almost real time." – Inderpal Kohli [05:25]
• "If we lose trust...I think that's where most of the hard work goes." – Inderpal Kohli [08:19]
• "Technology exists to solve a problem or reduce friction or to add a function...it's really adoption for which you need a clinician or an operational leader working with you." – Inderpal Kohli [14:10]
• "I have a feeling if I'm not doing this, I will be doing something like that—where there is a goal, there's a target to achieve and then deliver it." – Inderpal Kohli [14:41]
• "Take time to learn about the workflows and the utilization...technology is not the job (for clinicians), it's a tool." – Inderpal Kohli [16:45]

Timestamps for Key Segments

• 00:40: Healthix’s Scope and Role
• 02:02: Main Data Challenges in HIE
• 03:28: FHIR Standardization Status
• 04:12: TEFCA’s National HIE Vision
• 05:25: Push vs Pull Data Exchange Models
• 06:11: Evolving Priorities – Intelligence and Trust
• 07:56: Business Threats to HIEs
• 09:23: Transitioning from Provider to HIE
• 10:47: Future of Interoperability
• 12:06: Inderpal’s Entry to Healthcare IT
• 13:36: Advice to Younger Self
• 14:41: Personal Passions and Work Philosophy
• 16:05: Riskiest Career Move
• 16:45: Advice for Healthcare IT Newcomers

Conclusion

This episode spotlights the fundamental role of data quality, standardization, and trust in advancing healthcare IT. Inderpal Kohli compellingly argues that while technology frameworks matter, real progress requires relentless focus on clean, connected, and useful data, organizational trust, and understanding real-world clinician workflows. Transforming HIEs into insight-driven platforms promises to benefit not only care providers and systems but, most importantly, the patients themselves.