Healthcare has more “Big Data” than virtually any other industry, and more complex Big Data than most. Physicians, hospitals, pharmaceuticals, insurance companies and all of their components, spin-offs and combinations draw on business systems, financial records, clinical data, human resources, practice management software, scheduling products and much more, and do so from a bewildering number of operating systems written in languages new and old, and obscure and commonplace. Moreover, healthcare care data have another distinction: accuracy is a matter of life and data. Integrating, combining, parsing and interpreting these data and where they run is perhaps the most important IT challenge of the 21st century. We have some suggestions on how to manage and maximize.