3/31/25
Federal health IT is in the midst of a profound evolution. Government mandates, open-source innovation, AI-driven tools, and the rising expectations of both clinicians and patients are converging to create a moment of opportunity—and urgency. Four industry leaders from Zscaler, Unite Us, Red Hat, and Twilio recently shared their perspectives on what’s driving this transformation and what lies ahead. Common themes emerged: infrastructure modernization, interoperability, patient-centered automation, and a deeper integration of community care.
Infrastructure Modernization: The Critical First Step
Legacy systems remain one of the biggest roadblocks in federal healthcare, particularly in military and civilian environments that have long relied on bespoke, siloed IT infrastructures. The recent executive order encouraging the use of commercial off-the-shelf (COTS) systems is a pivotal shift.
Tamer Backer, Chief Technology Officer for Healthcare, Government & Education at Zscaler, emphasized that “modern technologies exist now to really deal with all these legacy systems, while also enabling you to do all this modern stuff.” He argued that today’s COTS solutions require less tailoring than in the past and can often be deployed with minimal lift—making them an ideal foundation for modernization.
However, successful deployment depends on infrastructure readiness. “You have to transform and modernize the way you do IT and security in the first place,” Backer said. “Once you’ve done that modernization… everything will start accelerating.”
Interoperability Through Open Source
Improving data sharing and automation hinges on breaking down silos—a task made far more difficult when systems are locked into proprietary platforms. Ben Cushing, Chief Architect for Health and Life Sciences at Red Hat, made the case that open-source adoption is not just a preference but a necessity.
“Organizations that have benefited from an open-source approach… have found a flexibility that other organizations just haven’t,” Cushing said. That flexibility enables data to flow across research teams, healthcare systems, and agencies, and is the underpinning of large-scale AI adoption. “One of the biggest hurdles to automation in healthcare is this data interoperability issue,” he added. “So they’re able to overcome interoperability, then actually automate processes—and by extension, start to use advanced AI for diagnostics.”
Cushing noted that much of the true innovation in AI is occurring not in proprietary systems but in open communities. “In the old days, open source was a lagging activity. That has completely changed. The innovation is all happening in the open-source communities now.”
AI and Automation: Better for Providers, Better for Patients
Artificial intelligence has moved from concept to clinical impact—particularly when deployed in ways that reduce burden on care teams. Bruce Marler, Senior Director of Revenue and Social Impact at Twilio, spoke about how AI “assistants” are already alleviating clinician burnout and improving throughput.
“The AI assistance almost looks like a digital twin for the clinician,” Marler explained. “You can embed intelligence in the workflow—whether it’s scheduling tests, real-time translation, or generating notes.” Twilio’s approach focuses on contextual communications, delivering the right information at the right time, and on the patient’s preferred channel.
On the backend, AI and cloud services are tightly linked. “You’re going to see more and more use cases that are going to have to be cloud-based to take advantage of the technologies out there,” Marler said. Federal healthcare systems, he added, must stop thinking of communications as just a contact center and instead build flexible, trust-driven platforms that can scale securely.
Connecting Social Determinants to Clinical Care
Improving outcomes also means addressing the social needs that impact health—particularly in military communities. Michael Tutem, Senior Director at Unite Us, stressed that “the biggest opportunity we see is around a more robust infrastructure that connects the whole healthcare ecosystem.” That includes everything from local food pantries to legal and transportation services.
Unite Us’s national closed-loop referral network links federal healthcare providers with community-based organizations (CBOs), ensuring that care plans extend beyond the clinical setting. “Every dollar requires accountability,” Tutem said. “And that’s what Unite Us brings in spades.” Especially in the Department of Defense context, Tutem noted, meeting basic social needs directly improves readiness and retention.
“If you have trouble on the home front with things like food or childcare, that can really impact a service member’s ability to go and be a warfighter,” he said.
The Road Ahead: Scalable, Ethical Innovation
Collectively, these insights chart a roadmap for federal health IT: prioritize infrastructure modernization, invest in open-source interoperability, deploy AI ethically and scalably, and extend care into communities. This approach doesn’t just make systems more efficient—it makes them more equitable and resilient.
As Backer put it, “There are real advancements that help both from a clinical side and operational side… but that modernization transformation is going to take off for the next three to five years to help us get to a much easier place to innovate even faster.”
By learning from the private sector, embracing flexible technologies, and prioritizing the patient experience, federal health agencies have an unprecedented opportunity to lead in digital healthcare—not follow.
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