TEFCA Switch Flips as Epic and Oracle Rewire Health Data Rails; $1.6B Breach Spurs Overhaul

Cloud Backbones Get Reengineered

Major health systems are accelerating migrations to dedicated healthcare clouds as infrastructure becomes the competitive battleground for Health Tech. Oracle continues moving legacy Cerner workloads to Oracle Cloud Infrastructure, pitching unified data models and a single patient record across venues of care. In parallel, Epic customers are expanding use of Azure services via Epic’s deepening ties with Microsoft, including ambient clinical documentation and data services.

The cloud race is widening beyond hyperscalers. Data-layer vendors like Snowflake and Databricks are anchoring longitudinal patient datasets with healthcare-specific governance. Integration networks such as Redox are increasingly positioned as critical plumbing between EHRs and analytics platforms, easing FHIR and HL7 traffic at scale.

Partnerships are turning into infrastructure commitments. Microsoft’s tie-up with Epic brought Azure OpenAI into clinical workflows, according to the companies. Meanwhile, Google Cloud is advancing its Healthcare Data Engine for harmonizing multimodal datasets, with recent expansions detailed in a Google Cloud update. Amazon Web Services is pushing HealthLake for FHIR-native architectures, as providers standardize on data models that can span research, operations and care delivery.

Interoperability Goes National Under TEFCA

With the Trusted Exchange Framework and Common Agreement (TEFCA) moving from policy to production, the first Qualified Health Information Networks (QHINs) are standing up national-scale exchange. The Office of the National Coordinator highlights the program’s rollout and governance on its TEFCA site, with early participation from networks operated by Epic, Health Gorilla, Kno2, MedAllies and eHealth Exchange.

For enterprise CIOs, TEFCA narrows the complexity of multi-state data exchange and enables standardized routing for clinical summaries, imaging and lab results. That simplification is expected to reduce interface build-outs and maintenance overhead while improving data liquidity for referral management and population health.

The next phase is operational scale: mapping organizational data governance to cross-network consent and query patterns, and tying exchange to analytics. This is where platforms from Snowflake, Databricks, and Google Cloud become the landing zones for normalized TEFCA traffic. For more on related Health Tech developments.

Cyber Resilience Becomes a Board Mandate

The February 2024 ransomware attack on Change Healthcare forced unprecedented downtime across U.S. claims rails and is expected to cost UnitedHealth about $1.6 billion, according to Reuters. In response, payer and provider infrastructure strategies are shifting from perimeter defense to zero-trust segmentation, immutable backups, and continuous compromise assessments. UnitedHealth Group is overhauling authentication and network segmentation as part of a broader resilience push.

Regulators are also sharpening guidance on software and data safeguards. The FDA’s framework for AI/ML-enabled medical software and lifecycle controls underscores secure update pathways and validation protocols outlined by the agency. This builds on broader Health Tech trends where security-by-design is treated as core infrastructure, not an optional add-on.

Governance is expanding beyond hospital walls. In the U.K., the National Health Service awarded the Federated Data Platform contract to Palantir, underscoring how large-scale data operating systems require robust provenance tracking, role-based access, and transparent audit trails. U.S. clinicians and administrators will watch that rollout closely as they refine their own data platforms and safeguards.

Edge and AI Infrastructure Move Into the Clinical Frontline

Hospitals are shifting compute closer to care settings to cut latency and control PHI. Imaging suites and ED triage areas are seeing localized deployment of AI inference servers, with centralized data layers for retraining and validation. The aim: speed clinical decision support while keeping sensitive data within trusted network zones.

Cloud providers are knitting these edge zones to centralized governance. Google Cloud and Microsoft are integrating edge orchestration with clinical documentation and retrieval augmented generation, while AWS HealthLake is aligning FHIR-native stores with streaming data pipelines. Health systems like Mayo Clinic are piloting architectures that connect on-prem imaging and telemetry to cloud analytics, pairing strict access controls with scalable compute.

The result is an infrastructure stack that turns compliance requirements into technical architecture: everywhere-access to the right data, with least privilege and cryptographic enforcement. Vendors such as Redox, Health Gorilla, Snowflake and Databricks are increasingly the connective tissue between TEFCA exchange, EHR workflows and AI toolchains.

What’s Next: Durable Rails, Measurable Outcomes

Over the next 12–18 months, health systems will judge infrastructure wins by throughput, data quality and mean time to recovery rather than hype cycles. Expect more standardized FHIR adoption, managed QHIN connectivity, and data clean rooms spanning payers and providers to enable longitudinal analytics without shuttling raw PHI.

Spending will tilt toward platforms that unify auditability with performance and shorten time-to-value for frontline teams. The most credible strategies pair TEFCA-scale exchange with cloud-native data layers, hardened security and practical edge deployments—an approach already visible across Oracle, Epic, Google Cloud and AWS.