Interoperability of healthcare solutions, or healthcare information exchange, regardless of whether it is ambulatory or enterprise focused, is one of the biggest challenges in the effort to drive patient-centric delivery of data at the point-of-care. The essential element required for achieving this paradigm shift is to switch from reactive to proactive data. From what we read in today’s interface and exchange culture this seems like a simple concept; Health Information Exchanges, ACO's, Patient Centered Medical Home, Meaningful Use are all at the center as a catalyst for patient-centered care models.