By Susan Flynn, Director of Accreditation Operations
I had the opportunity to attend ViVE 2026 last week in Los Angeles, and like many industry gatherings this year, the energy felt different. The conversations were less about possibility and more about proof.
Prior years have centered on bold visions for digital transformation, but ViVE 2026 focused on something more foundational: building the infrastructure — policy, governance, trust frameworks, and security architecture — that makes innovation sustainable.
Here are the themes that stood out most to our team:
The “Medicare App Library” and a New Digital Health Gold Standard
At ViVE, the Centers for Medicare & Medicaid Services (CMS) announced the development of its Medicare App Library as part of the agency’s broader Health Technology Ecosystem framework. The library will serve as a curated directory where Medicare beneficiaries can access vetted patient-facing digital health tools.
To participate, app developers must complete several key requirements. During the event, we were pleased to announce that CMS designated DirectTrust’s CARIN Code of Conduct for Consumer-Facing Applications (CARIN-CFA) Accreditation Program as a pathway for app developers to be included in the library.
The Medicare App Library signals a shift toward a more structured, standards-based marketplace for digital health tools, and one that emphasizes interoperability, identity assurance, and validation against the CARIN Code of Conduct. This ensures a new era of accountable innovation, where the data of Medicare’s 68+ million beneficiaries is handled with the highest level of transparency and consumer protection.
From “AI Hype” to Agentic Reality
AI was everywhere at ViVE, but the tone has matured. The focus has shifted from generative AI experiments and chatbot demos to the more operational Agentic AI. These autonomous systems don’t simply summarize information, they coordinate workflows, surface insights, and take action within defined guardrails.
Health systems shared how scaling ambient documentation across thousands of clinicians is meaningfully reducing the “documentation tax.” By embedding AI into clinical workflows, organizations are reclaiming provider time and addressing burnout in measurable ways.
The takeaway wasn’t that AI is flashy, it’s that AI is becoming infrastructure. Governance, risk management, and clear accountability frameworks are no longer optional, they are prerequisites for deployment.
Health Equity as Core Infrastructure
“Health for All” wasn’t just an event slogan this year; it has evolved into a long term business strategy. With the rollout of the federal Rural Health Transformation Program, many sessions centered on bridging “healthcare deserts” through technology. The discussion went beyond telehealth expansion to include broadband access, secure data exchange, identity assurance, and AI tools tailored for safety-net clinics.
What struck me most was the framing. Equity was not positioned as a side initiative or corporate social responsibility effort. It was described as operational infrastructure, essential to value-based care, AI effectiveness, and long-term system sustainability.
Innovation that only reaches well-resourced systems widens gaps, but innovation deployed intentionally can close them.
“Secure by Design” and the Zero Trust Imperative
Security conversations were pragmatic and urgent. In the wake of continued high-profile healthcare breaches, the Zero Trust model has moved from aspirational to baseline expectation. The emphasis is shifting from reactive patching to designing systems that assume breach and continuously verify access.
Particular attention was placed on protecting the rapidly expanding Internet of Medical Things (IoMT). Connected infusion pumps, remote monitoring devices, and imaging systems increase clinical capabilities and require proactive layered protection to manage the expanded attack surface. This shift also demands greater transparency from vendors, moving toward a model where third-party compliance assessments provide the objective proof that connected devices meet the high-stakes security requirements of a modern clinical environment.
The CMS Interoperability Push: Toward a Patient-Centric Ecosystem
Interoperability once again took center stage, but this year’s conversation felt more unified. Industry leaders discussed a voluntary, standards-based alliance designed to unlock seamless data sharing between payers and providers.
The goal? A truly patient-centric ecosystem that moves beyond fragmented silos and the constraints of volume-driven incentives. By providing a 360-degree view of the patient journey, this seamless data exchange allows providers to transition from reactive, episodic care to proactive, health-improving interventions.
Looking Ahead: The New Era of Accountable Innovation
What stood out most at ViVE 2026 was the collective recognition that healthcare’s digital transformation is no longer in its exploratory phase. The industry is hardwiring standards, embedding governance, and operationalizing collaboration. In this mature landscape, ‘trust but verify’ has become the mandate; organizations are now expected to back their digital initiatives with rigorous proof of compliance, turning regulatory readiness into a strategic competitive advantage.
The innovation is impressive, the ambition is bold, but the success of what comes next will ultimately depend on our ability to build and sustain trust, backed by discipline and our willingness to build together.
The DirectTrust team would like to extend a sincere thank you to all the partners, members, and new friends who visited us at our booth in the InteropNow! Showcase. Whether you came by to discuss accreditation, technical standards, or just to share your vision for a more connected health ecosystem, your insights were the highlight of our week. It’s the energy of this community that turns bold ambition into shared reality.
We’re walking away from this year’s event more energized than ever to continue building the foundations of a secure, patient-centric healthcare future alongside all of you.