When Hallmark and CareFortis embarked on ambitious digital-health initiatives, the goal was to deliver richer patient outcomes, smarter workflows and real-time coordination across care teams. What they—and the industry broadly—too often overlook is this: they’re trying to build tomorrow’s healthcare on yesterday’s Internet infrastructure. And that misalignment carries risk, cost and compromise for care, security and experience.
Legacy infrastructure: the quiet drag
Let’s start with the baseline. According to data from the Office of the National Coordinator for Health Information Technology (ONC), by 2023 roughly 70 % of non-federal acute care hospitals reported either “sometimes” or “routinely” engaging in all four domains of interoperability (send, receive, query, integrate). Fierce Healthcare+1 On the surface, that sounds like success. Yet dig deeper: “sending” clocks in at about 92 %, but “integrating outside data without manual re-entry” is only about 78 %. Fierce Healthcare+1
The problem? These systems were built for a time when Internet infrastructure—networks, APIs, cloud-services, identity models—were far less demanding. The dynamic, always-connected, heterogeneous world of smart devices, remote care, telehealth and IoT wasn’t in mind. So organizations like Hallmark and CareFortis using digital front-ends, patient-facing portals and AI analytics are now plugging legacy plumbing into new waterworks—and leaking every drop.
Why this matters for care delivery and security
Let’s take Hallmark’s scenario: They want to roll out a seamless patient app that includes virtual visits, integration of wearable data, and a shared care plan visible to patients and care managers. But if their underlying network still relies on on-premises servers, legacy VPNs, monolithic EHRs, and limited API endpoints—then the user experience is patchy, the introduction of new capabilities is slow, and data flows may be brittle.
Consider security and compliance: Healthcare data breaches are skyrocketing. In 2023, there were 725 reported breaches affecting more than 133 million protected health records. The HIPAA Journal When your infrastructure wasn’t designed for fast, distributed, mobile-first access, the “bolt-on” fixes (e.g., remote access, shadow IT, multiple portals) introduce gaps. CareFortis, in its expansion of home-based rehab and remote monitoring, faced exactly those hidden latencies and inevitable shadow-IT workflows.
Building on the past but stepping into the future
So what does it take for organizations like Hallmark and CareFortis to truly “build tomorrow’s healthcare” rather than just retrofit yesterday’s? Here are three strategic areas I advise:
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Re-architect connectivity and API layers
Don’t just wrap modern user-interfaces around old EHRs. Build a modern API/mesh architecture that allows real-time exchange, modular services and agile deployment. Ensure your network and cloud backbone are robust, low-latency and built for scale. For CareFortis’s remote-monitoring arm this meant rethinking the edge-device integration of patient vitals data, meaningfully reducing latency and improving the care manager’s ability to act. -
Prioritise interoperability AND integration
It’s not enough to transmit data. Hallmark learned this the hard way when their “portal” had data flowing in but care teams still had to manually reconcile it in the EHR. The difference between sending and integrating is what turns data into insight. ONC’s data shows a gap remains in integration—even in advanced systems. Fierce Healthcare+1 -
Mind the underlying trust and security model
As the plumbing becomes more distributed, the attack surface grows. Retrofitting legacy infrastructure never gives you the clean slate you’d have building fresh. For CareFortis, scaling into networked home-care devices meant rethinking identity management, encryption, remote-storage and endpoint protection. In parallel, leadership must anticipate both regulatory (HIPAA, OCR breach reports) and board-level oversight.
Why this approach is no longer optional
Patients expect it. Clinicians demand it. Payers reimburse for value, not just visits. Hallmark’s patient satisfaction scores improved only after they aligned their underlying plumbing with their digital ambitions. CareFortis found that remote-monitoring adherence rose by 18 % when systems “just worked” and data was seamlessly integrated. In short: without modern infrastructure, you’re handicapping your front-end ambitions.
Leadership must recognise that the “Internet” of today is not the one we built 10 years ago. A modern healthcare organisation must treat its infrastructure as a strategic asset—not a cost centre. Retrofitting will cost more and deliver less. Building for tomorrow means embracing modular systems, API-first approaches, cloud/edge flexibility, and robust security built-in from day one.
In my work with executive teams, I often say: “If you’re still designing your consumer-facing app before you’ve rebuilt the network and API foundation, you’re polishing fast a slow machine.” Hallmark and CareFortis demonstrate what’s possible when you reverse that order. The result? Faster time-to-market, better outcomes, and the ability to scale when the next wave hits (remote care, wearables, AI-assisted diagnosis).
If your organisation is still operating on yesterday’s internet infrastructure but trying to deliver tomorrow’s healthcare, the truth is: you’re building on shifting sand. Better to rebuild the foundation now—and reap the benefits of a secure, scalable future-proof system.
