Rockin' HIT Sales Podcast

Podcast / Steve Posnack

Interoperability, AI and Policy: What Health IT Builders Need to Know Now

Steve Posnack, MS, MHS, is the Principal Deputy Assistant Secretary for Technology Policy and Principal Deputy National Coordinator for Health Information Technology in the Office of the National Coordinator for Health IT.

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Hosted by David Hacker, CPHIMS | Director, Elevate HIT Sales | MEDDPICC® Certified Trainer

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Episode Summary

In this episode of Rockin’ HIT Sales, David Hacker sits down with Steven Posnack, MS, MHS, from ASTP/ONC for a practical conversation on how health IT policy, interoperability, standards, and AI are shaping the market for builders, sellers, and investors.

Steve explains ONC’s role in helping define how health data moves, how certification and interoperability standards influence product design, and why founders should understand policy not just as compliance, but as a source of market opportunity.

The discussion also covers information blocking, TEFCA, USCDI, health IT certification, AI governance, clinical adoption, and the practical resources early-stage companies should know about as they build products for regulated healthcare environments.

Why This Matters for Health IT Companies

Health IT policy and standards are not issues companies should wait to address after the product is built. Rules governing health-data access, exchange, certification, interoperability, privacy, and emerging AI use can influence what a company builds, how it connects to provider infrastructure, and where new market opportunities emerge.

For Health IT companies, understanding the policy environment early can therefore become part of product and go-to-market strategy rather than simply a compliance exercise. Steve specifically encourages entrepreneurs to understand the policy “surround,” because regulatory changes can create opportunities for new services, product capabilities, and more scalable data exchange.

What You’ll Hear in This Episode

  • How ASTP/ONC thinks about health data access, exchange, and use
  • Why policy and standards matter early in a Health IT company’s roadmap
  • How interoperability, certification, and information blocking shape market entry
  • What builders of AI copilots and decision-support tools should understand about trust
  • Why clinical context and governance matter before AI tools are deployed
  • Key resources for founders, including healthit.gov, USCDI, and the Interoperability Standards Advisory
  • The question every founder should ask before building for the clinical environment

Questions This Episode Answers

Why should an early-stage Health IT company care about federal policy and standards before the product is mature?

Because policy can shape both requirements and opportunity. Understanding the intent behind healthcare rules, what they include or exclude, and how those requirements are changing can help founders identify new services, compliance needs, and areas where technology can solve emerging problems.

What role does ASTP/ONC play in the Health IT market?

ASTP/ONC focuses heavily on how health information is accessed, exchanged, and used. Its work includes interoperability standards, health IT certification, information blocking, and nationwide connectivity initiatives such as TEFCA.

Why is interoperability still a major issue for Health IT builders?

Healthcare data has to move across different systems, organizations, applications, and networks. Federal policy is increasingly emphasizing standards-based, API-driven exchange and connectivity at scale, which means vendors need to understand how their products fit into that environment rather than treating integration as a later-stage issue.

What should AI companies understand about health-system adoption beyond model accuracy?

They need to understand the clinical context where the tool will operate, who will use it, and who will ultimately decide whether it is deployed. Steve also notes that health systems are establishing governance councils and other review processes to understand how AI tools work and how models are trained.

What are the “three Rs” influencing AI adoption in healthcare?

Steve describes three areas HHS is examining: regulation, reimbursement, and research and development. Each can affect whether AI technologies move successfully into clinical care and how quickly adoption occurs.

What standards and resources should Health IT startups understand early?

Steve highlights the United States Core Data for Interoperability (USCDI), the Interoperability Standards Advisory, semantic data standards, and HL7 FHIR. These resources help companies understand how healthcare data is represented, exchanged, and increasingly expected to work across systems.

What should be on a basic policy-and-standards readiness checklist?

Companies should understand whether HIPAA applies, whether state privacy laws or Federal Trade Commission requirements may apply, what data standards are relevant to their product, and what connectivity or exchange standards will be required. Steve specifically calls out HL7 FHIR as a major standard for health-data exchange.

Can smaller Health IT companies realistically participate in federal policy and standards discussions?

Yes. Steve encourages smaller companies to follow policy developments, comment when appropriate, and stay connected through public resources. He emphasizes that federal health IT work increasingly seeks broader participation from innovators and entrepreneurs.

What public resource should Health IT founders bookmark?

Steve calls healthit.gov the primary “front door” and also recommends subscribing to updates so founders can stay current on policy, standards, and federal Health IT initiatives.

What should every founder ask before building a new tool for the clinical environment?

Steve boils it down to three questions: What problem am I trying to solve? Am I making a real issue better for people? And what is my pathway to scale that impact to as many lives as possible?

David’s GTM Takeaways for Health IT Vendors

1. Policy belongs in product strategy, not just compliance. A change in interoperability requirements, certification, information blocking, privacy expectations, or AI oversight can alter both the risk and the opportunity for a Health IT company. Founders should understand that landscape before product and GTM decisions become difficult to reverse.

2. Interoperability readiness is part of commercial readiness. If a product depends on healthcare data, the company should understand how that data will be represented, accessed, exchanged, and integrated before entering provider conversations. Standards such as USCDI and FHIR are not just technical details—they can influence implementation friction and whether a solution fits the health system’s environment.

3. Start with the provider problem, then work backward to policy and technology. Steve’s closing framework is especially useful for founders: define the real problem, determine whether the solution improves it for people, and understand how the impact can scale. That keeps regulatory and technical decisions tied to actual healthcare value rather than building around technology for its own sake.

About the Guest

Steven Posnack, MS, MHS, is a longtime health IT policy leader with the Office of the National Coordinator for Health IT, where his work focuses on health data movement, interoperability standards, certification, information blocking, and nationwide data exchange.

In this conversation, Steve brings a practical policy and standards perspective for Health IT companies trying to build products that can work in real-world healthcare environments — not just technically, but within the regulatory, interoperability, and clinical adoption realities that shape whether solutions can scale.

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