On July 30, 2025, over 60 of the most powerful companies in healthcare and technology gathered at the White House. They signed a pledge. They made commitments. They promised to transform how health data flows—and more importantly, how it gets used to save lives.
This is an open letter to every company that signed that pledge.
I'm not here to criticize what you committed to. I'm here to show you a technology that delivers on it—better than traditional interoperability ever could. And I'm here to pose a question you'll need to answer: once you know this technology exists, what do you do next?
The Pledge You Signed
President Trump, HHS Secretary Robert F. Kennedy Jr., and CMS Administrator Dr. Mehmet Oz announced the CMS Health Tech Ecosystem Initiative—a voluntary framework to "easily and seamlessly share information between patients and providers" and expand digital health tools "so that patients have the information and resources they need to make better health decisions."
60+ companies pledged to deliver results by Q1 2026.
The companies who signed include the biggest names in technology and healthcare:
And many more. The full list includes 21 networks pledging to become "CMS Aligned Networks," 11 health systems committing to support patient use, and 7 EHR vendors agreeing to "kill the clipboard."
These are powerful words. And the pledge commits to powerful goals: seamless data exchange, patient empowerment, real results by Q1 2026.
But here's the paradox: traditional interoperability—moving data between systems—isn't the same as maximizing the USE of that data to save lives.
The Law: What "Use" Actually Means
The pledge builds on existing law—specifically, the 21st Century Cures Act, signed in December 2016 with overwhelming bipartisan support. The Cures Act prohibits "information blocking" and directs the healthcare industry to support the access, exchange, and use of electronic health information.
Information blocking is defined as a practice that is likely to "interfere with, prevent, or materially discourage access, exchange, or USE of electronic health information."
Penalties: Up to $1 million per violation for health IT developers, health information networks, and health information exchanges. Healthcare providers face "disincentives" through Medicare programs, effective July 31, 2024.
Most discussions of the Cures Act focus on access and exchange—moving data from point A to point B. But the law explicitly protects something more: the USE of health information.
What does "use" mean?
It means taking health information and doing something valuable with it. Synthesizing insights. Making better decisions. Improving outcomes. The law doesn't just protect data pipes—it protects the intelligence that flows through them.
Here's what makes this law so powerful for QIS: the Cures Act guarantees patients access to their own health data. Every patient portal, every EHR system—by law, they must provide patients with their complete health information. No institution can legally refuse.
Which means no one can tell a dying patient they can't share their own data with a QIS network. No one can stop a cancer patient from exporting their records and plugging into a swarm that extracts the relevant features, creates a semantic fingerprint, and synthesizes outcome packets from similar cases worldwide. The institution doesn't have to participate. The patient can route around them entirely.
The organizations that signed the White House pledge have a choice: participate in QIS—bring their R&D expertise to curate the sharpest patterns, define the best similarity metrics, build the most effective domain templates—or watch their patients plug into networks built by others. The question isn't whether QIS will happen. The law guarantees patients can access their data—and from there, life-saving insight will flow. The question is whether you'll help shape how it's used.
And that raises an uncomfortable question.
The Question You'll Need to Answer
If a technology exists that enables dramatically better use of health information—quadratic intelligence scaling instead of linear data transfer—and you choose not to implement it while patients suffer...
Are you "materially discouraging the USE of electronic health information"?
I'm not a lawyer. I can't tell you whether refusing to implement superior technology violates the letter of the Cures Act. But I can tell you this:
The spirit of the law is to maximize patient benefit from health information. The purpose of your pledge is to improve outcomes. And a technology exists—right now—that does both in ways traditional interoperability cannot.
That technology is the Quadratic Intelligence Swarm (QIS) Protocol.
What QIS Actually Does
Traditional interoperability moves data between systems. QIS creates intelligence from distributed data—without moving the data at all.
| Aspect | Traditional Interoperability | QIS Protocol |
|---|---|---|
| What flows | Raw data, records, documents | Outcome packets—semantic patterns that are the insight itself |
| Privacy model | Data must be shared or aggregated | Raw data never leaves the source |
| Scaling | Linear (N data sources = N insights) | Quadratic (N agents = N(N-1)/2 synthesis opportunities) |
| Timing | Batch transfers, periodic updates | Real-time pattern matching |
| Architecture | Centralized or federated | Decentralized (hybrid and centralized variants also supported) |
| What patients get | Access to their own records | Outcome packets synthesized from cohorts matched by expert-defined similarity |
Here's the core insight: when N agents can route by semantic similarity and synthesize patterns with matched peers, intelligence scales as N(N-1)/2—quadratic, not linear.
For 10,000 patients, that's not 10,000 isolated records. That's nearly 50 million unique synthesis opportunities. Each patient gets real-time access to outcomes from similar patients worldwide—what treatments worked, what didn't, what to watch for—without anyone's raw data ever leaving their control.
Every component of QIS is proven technology deployed at massive scale: similarity-based routing (vector databases, DHTs, recommendation engines), semantic embeddings (Google Search, ChatGPT), consensus and synthesis rules (how insights are tabulated, votes weighted, outcomes aggregated). QIS doesn't require new inventions or rely on untested theory. Every single component already exists and is battle-tested at planetary scale. QIS simply connects these proven pieces for a purpose no one thought to connect them for before.
How QIS Fulfills Your Pledge
Let me be specific about how QIS delivers on the commitments you made:
"Eliminate walled gardens"
Traditional approach: Build pipes to move data between gardens.
QIS approach: Gardens share outcome packets without sharing data. Walls stay up for privacy. Intelligence flows anyway.
"Patient access to health information"
Traditional approach: Patients can view their own records.
QIS approach: Patients access outcome packets synthesized from everyone's anonymized patterns—not just their own records.
"No centralized database"
Traditional approach: Federated data stores with central coordination.
QIS approach: Fully decentralized. No coordinator. Patterns find each other through semantic routing.
"Patients in control"
Traditional approach: Consent management for data sharing.
QIS approach: Patients control what outcome packets are published. Raw data never moves. Control is absolute.
"Kill the clipboard"
Traditional approach: Digital intake forms.
QIS approach: Intelligent pattern matching from first contact. The system already knows what's relevant before you fill anything out.
QIS doesn't replace your pledge commitments. It fulfills them at a level you may not have imagined possible.
The Five Questions
I'm not asking you to take my word for any of this. I'm asking you to answer five questions:
The Stakes
If You Do Nothing
- Patients continue receiving siloed care based on isolated records
- Treatment decisions lack real-time insight from similar cases
- Quadratic intelligence potential remains unrealized
- A documented record exists that you were informed
- Someone else builds this—and you explain why you didn't
If You Act
- Patients gain access to outcome packets from every similar case—similarity defined by the best experts each network can hire
- Treatment optimization happens in real-time, not multi-year trials
- Your pledge commitments are fulfilled at a level beyond expectation
- You lead the transformation you promised
- Lives are saved that would otherwise be lost
The Context: This Isn't Theoretical
I'm not approaching this from a position of naivety about how the healthcare industry works. I've watched the gatekeeping firsthand:
The regulatory environment is shifting. The legal landscape is evolving. And the expectations set by your own pledge create a new baseline for what "good faith" looks like.
I'm offering you a path forward that exceeds those expectations.
The Invitation
The Door Is Open
I'm not threatening legal action. I'm not demanding anything. I'm extending an invitation.
QIS is available for licensing. The protocol specification is public. The math is documented. The implementation pathway is clear.
You committed to transforming healthcare data. I built a technology that delivers on that commitment. The question isn't whether this works—the components are proven at scale. The question is whether you'll evaluate it seriously.
The ball is in your court. I'm here when you're ready to talk.
My father died because a pattern existed somewhere that could have saved him, but data silos kept it hidden. My brother is permanently damaged because the right insight didn't reach the right doctor in time.
These weren't failures of technology. They were failures of architecture. Failures of imagination. Failures to see that the same data—organized differently—could have changed everything.
You signed a pledge to fix this. I built a technology that actually does. The rest is up to you.