FHIR technology is revolutionizing healthcare by providing a standardized way for providers and patients to manage and exchange healthcare data. The operational data layer (ODL) approach to interoperability is making meaningful progress in healthcare IT possible, especially for large organizations with huge data requirements. FHIR implementation approaches include bringing in an ODL that exposes legacy system information and keeps it in sync with the legacy system, but then lands it in an ODL in the FHIR standard. The cloud stands out as a key driver of promise and peril in healthcare, presenting a unique challenge for architects and developers at organizations with older legacy systems. A digitally transformed healthcare industry will weave real-time data analytics with more personalized care, maximizing the human experience while advancing away from legacy technology systems that slow down both healthcare practitioners and patients.