Every provider agrees on the need for healthcare interoperability to achieve clinical data insights at the point of care. The question is how to get there from the myriad technologies and the volumes of data that comprise electronic medical records. It’s been difficult to organize among participants that have had little incentive to cooperate. And standards for sending and receiving data have been slow to develop. This is changing, but the key components that are still vital to realizing insights are closed-loop analytics and its accompanying tools, an enterprise data warehouse and analytics applications. This article defines the problems and explores the solutions to optimizing clinical decision making where it’s needed most.