Last month, top health care investors and entrepreneurs came together with hospital, payor and government leaders at a conference sponsored by the University of Pennsylvania’s Wharton Healthcare Management Alumni Association to discuss the restructuring of the health care system. Jonathan Blum, CMS Deputy Administrator and Director of the Center of Medicare participated on a panel about about macro health care system changes and one of the key take aways was not surprisingly, that change in the health care system is all about the data. Data will drive not just the delivery and payment of care with respect to a particular patient, but also the direction of the health care system through large pools of data (also known as Big Data). The virtually anywhere-anytime mobile access to data through software applications on portable devices (mHealth or mobile health) highlights the centrality of data to the health care system. But, Blum had to be prodded by a member of the audience who asked the best question—why can’t CMS provide “real time” data? Why isn’t real time data a priority? After all, with the new delivery models that focus on tying payment to performance, coordinating care among and between acute and long term care providers, sharing risk among providers and encouraging patients to comply with treatment protocols, real time data is an essential ingredient for success. Blum agreed with the questioner, but did not provide any solution as to how CMS or any other government payer will get there. Real Time data does not appear to be a priority at the moment offering many entrepreneurs a opportunity to fill this void. Yet, with the emphasis on quality and timely care, what an asset to get real time data from the patient’s home, the operating theater or a doctor’s office—how long was the encounter? When did the physician wash his or her hands? What apps did the physician check to provide a diagnosis? When did the patient take her medicine? Although the medical record captures key information about the encounter, it is generally finalized post-service, and good data may be lost during the editing process. The collection of real time data will truly revolutionize the health care system. We all know that data drives behavior and real time data will definitely change provider behavior when it counts—in real time not after the fact. Real time data must be a major focus of the health care reform policy wonks as they try to improve quality and reduce cost.