Reflections from Civitas 2025 by Anthony Leon, RVP of Customer Development at b.well
There’s a moment in every conference where you can feel the room shift. Where the energy changes from polite listening to genuine engagement. That happened at Civitas 2025 during a panel, The Evolution of Patient Access and Where it’s Headed Next with Kristen Valdes (b.well), Glenn Keet (Selfiie), and Michael Gagnon (HealtHIE Nevada).
Unlike the other panels I attended, this one drew an overwhelming number of attendees, underscoring a crucial point: there is genuine interest in patient access, and it’s urgent.
The Question That Got Everyone’s Attention
Toward the end of the panel, Kristen posed a question to the room: “Who thinks we’ll end up with a single nationwide network for patient data?”
Silence. Not a single hand went up.
Then she asked, “Who thinks we’ll end up with a network of networks?”
Every hand in the room shot up. Every. Single. One.
It was one of those rare moments of complete consensus in healthcare, an industry not exactly known for agreement, but what struck me wasn’t just the alignment. It was what it represented: we’ve moved past the debate of QHINs. The question isn’t whether Health Information Exchanges (HIEs) will survive or whether national networks will replace them.
The question is how we make them work together.
During this session Glenn Keet (Selfie) shared that local HIEs are getting 95%+ response rates for patient data within their regions. TEFCA? 7%. Carequality? Don’t ask (it’s less). Those numbers were staggering.
Why This Matters: Bailey and Beyond
Kristen opened the panel by sharing a deeply personal story about her daughter, Bailey. If you’re not familiar with Bailey or why Kristen founded b.well, be sure to check out this recent podcast where she talks about her personal journey as a mother advocating for her daughter and how it inspired a mission to simplify healthcare.
As Kristen spoke about Bailey, one statement struck a chord: “I’m not afraid of science and medicine keeping my daughter alive. I’m afraid of the time she has to change health insurance.”
This isn’t just a hypothetical concern. It’s the harsh reality for millions navigating a system that may be technically advanced but is fundamentally broken, with serious consequences for those who struggle to navigate it effectively.
Portalitis: The Disease
While “Portalitis” was hardly spoken about in healthcare two years ago, it’s now an all-too-familiar term. Portalitis happens when patients are forced to juggle multiple logins, reset passwords they can’t remember, or navigate confusing security measures just to access their own health records.
We live in a world where ordering groceries, booking flights, and scheduling rides in self-driving cars can all happen in under five minutes—right from my phone. But if I want to see my medical records? I’m left remembering seven different usernames and passwords, wrestling with various interfaces, and hoping the information I need is tucked away in one of those systems.
The harsh truth is that many patients who attempt to access their records give up at the login stage. It’s not that they don’t care about their data; it’s just that the friction is too much. This is the very frustration that the administration is tackling with the CMS Aligned Network and the initiative to “Kill the Clipboard.”
The AI Reality Check
Michael Gagnon from HealthIE Nevada gave an honest take on AI with no hype and no promises, just the reality
During the panel, Michael noted that 15 to 30 percent of health-related queries are already being handled by foundational AI models and large language models. This is not some distant prediction; it is happening right now
Here’s the problem. If AI models are trained on incomplete patient data because the data is siloed and inaccessible in non-interoperable portals, then the outputs will be inaccurate. Inaccurate AI in healthcare isn’t just an annoyance; it’s dangerous.
Kristen shared an example that stuck with me. Using the new FHIR standards and USCDI v3 data, they identified 780 patients out of just 6,000 nationwide who fit the criteria for a rare disease clinical trial in only 30 seconds. That is the potential of comprehensive, interoperable data. But it only works if the data is actually accessible
Collaboration is Essential for Survival
If Kristen’s panel was the heart of the conference, then Ryan Howells’ keynote was the wake-up call. Ryan, a partner at Leavitt Partners and leader of the CARIN Alliance, told the audience that we are at a pivotal moment. He highlighted this as the third time in 20 years that the federal government has been genuinely aligned on healthcare interoperability. The first was the creation of the Office of the National Coordinator. The second was the HITECH Act. And now we are in the third with the CMS Aligned Networks initiative.
His message to health information exchanges was clear: collaboration is essential for survival.
The days of isolated, regional-only HIEs are behind us. The federal government is enforcing information blocking rules. Payers need data for quality measures. Providers need data for value-based care. Patients are demanding access. If HIEs do not engage with the broader ecosystem, join networks like TEFCA, adopt standards like FHIR and USCDI, and serve as Record Locator Services for national queries, they risk being left behind.
Closing Thoughts on Civitas 2025
I’ve been to a lot of conferences. I’ve heard a lot of keynotes about the “future of healthcare” and the “promise of interoperability.” But Civitas 2025 felt different.
Why? Maybe it’s because:
- The federal enforcement of information blocking is real
- Information blocking penalties are being levied
- Over 60 companies committed to the CMS-Aligned Networks initiative and another 400 are interested
- The technology floor, including FHIR APIs, USCDI v3, and IAL2 identity standards, will be implemented in Q1 2026. Not someday. Next quarter.
Ryan’s message that collaboration is essential for survival resonated deeply because it is an undeniable truth. Isolated players who resist engagement won’t survive. Those who collaborate will drive real patient access.
We signed the CMS pledge to enable patients to access their full health records in real-time through their chosen apps. The future lies in integrating regional strengths with national networks for effective cross-region queries.
The opportunity to scale patient access and unlock vital data is here. We have the tools, standards, and momentum. Let’s not waste it.