At the beginning of 2026, HL7 appointed Rachel Dunscombe as its new CEO, succeeding Charles Jaffe, M.D., Ph.D., who led the interoperability organization for nearly two decades. On May 12, Dunscombe delivered the keynote address to the WEDI spring conference, describing how HL7’s work was aligning with fast-moving policy changes in Washington, D.C.

Before joining HL7, Dunscombe served as CEO of openEHR International, where she led global adoption of open health data standards and strengthened partnerships with governments, standards bodies, and healthcare organizations worldwide. OpenEHR is a nonprofit organization that publishes technical standards for an EHR platform, along with domain‑developed clinical models to define content. She's also held positions across the UK health and technology landscape, including leading the NHS Digital Academy, serving as an advisor to the UK Secretary of Health and contributing to national policy through the UK Government AI Council. In addition, she holds a visiting professorship at Imperial College of London and serves as on the board of directors for the Digital Health Society.

Dunscombe said the work of HL7 goes beyond creating specifications. “It’s about what happens when we've created the specification and we need to scale into interoperability. We can write standards, we can make them usable and consistent, but how do we use them to reduce burden and improve outcomes? That’s what I'm really interested in.”

The FHIR accelerators such as Gravity Project, Codex, Vulcan, Helios and others, are how HL7 makes that leap from standards to real-world implementation.

Dunscombe mentioned several initiatives from CMS and ONC. “We've got CMS-0057-F, which has created concrete implementation deadlines. We've got prior auth, which is becoming the test case,” she said. “We’ve got AI and automation, which are raising those expectations, and now standards must prove the operational capability. That's where all of the work that we're doing matters.”

She said that in prior authorization, transparency is a game changer. “It really does speed up the prior authorization and that, in turn, improves healthcare pathways. It improves clinicians experience. It ensures the time to treatment is shorter, and we're doing that via the FHIR-based APIs.”

Dunscombe said that in prior authorization, we need to be very specific about the reasons for denials. “Allowing that to be done via these technologies will really make things an awful lot clearer. We need public prior authorization metrics so we can see what the performance is.”

CMS-0057-F, as a rule, Dunscombe said, is about improving health information exchange and access to health records for patients, payers and providers. “We need to ensure that all of those are involved, and that is very much what our ethos is for the future. The future work is supporting that scaled adoption, and there are a number of things that we're doing at HL7 to ensure that we can support that.” 

One, she added, is about reducing implementation variability. “We’re very much aligning with CMS and ASTP on their priorities. We're making standards easier to adopt. We’re really working hard at enabling people to adopt them in the lowest-friction manner,” she said. 

Dunscombe said HL7 is supporting AI and automation safety. “We're aligning our standards, making them machine-readable so that they can be used by both humans and by the technology,” she explained. “We’re reducing burden for providers and vendors. All of the focus that we've got at the moment on things like prior auth is about taking that friction out of the healthcare system. We're measuring impact, not just compliance, so we are looking at the benefits of what we're actually delivering. We've got to be able to test things and make sure that they're ready for deployment and real-world use.”

Coinciding with Dunscombe’s talk at WEDI, HL7 announced it has been designated a “Friend of the Ecosystem” within the CMS Health Tech Ecosystem. This designation recognizes HL7’s essential role in supporting CMS’s Kill the Clipboard initiative and the broader Health Technology Ecosystem project, both of which aim to reduce administrative burden and improve data access across the U.S. healthcare system.
 
The CMS Health Tech Ecosystem is designed to accelerate the adoption of modern, standards‑based technologies that allow patients, clinicians, and health systems to exchange information seamlessly. The initiative focuses on replacing manual, paper‑based, and duplicative processes with interoperable digital solutions that make health data easier to access, share, and use.

“Our market-driven, consensus-based approach to developing open standards has built the foundation the AI era will run on,” said Daniel Vreeman, D.P.T., HL7’s chief standards development officer, in a statement. “Initiatives like the CMS Health Technology Ecosystem create the alignment to catalyze breakthrough capabilities for patients, clinicians, and innovators across the ecosystem.”