Turn EHRs into orchestrated knowledge assets and care pathways

A 2026 vision for advancing American healthcare infrastructure in informatoin exchanges to move from simple data exchange to a sophisticated orchestration layer. It argues that while existing networks like QHINs and Health Data Utilities have successfully built the "pipes" for moving information, they must now evolve into intelligence hubs that synthesize fragmented data into longitudinal patient records. This transition is framed as a five-rung capability ladder, moving from basic document exchange to predictive trajectories and accountable, routed actions. By focusing on the episode of care rather than isolated clinical encounters, these networks can ensure the three proofs of value: service, safety, and benefit. Ultimately, the paper advocates for a policy and investment shift toward digital knowledge assets that proactively guide care journeys through a unified "Circle of Arcs."