Collaboration between stakeholders underpinned by dynamic information exchange is the prerequisite of a systems-based market. If other industry sectors such as consumer goods, finance and telecommunications serve as a model for systems-thinking, we will expect novel linkages between healthcare stakeholders to become more prevalent as population health goals unifies incentives. While many acknowledge the need to move toward a more integrated “systems thinking” approach – one that maps influence patterns, amplifies interdependencies, and drives collective outcomes, they struggle with actual implementation. A recent survey of close to 300 Biopharma executives, EU and US Payers, and US providers reveals insight into their needs, their disparate perceptions, and their levels of confidence in the ability to shift to a systems-thinking collaborative culture. Approximately 25% of respondents stated they were not aligned with other stakeholders, though agree they need better alignment and foresee closer collaboration in the future. More than 70% of stakeholders believe data transparency and information-sharing is critically important to a successful and interoperable healthcare system, yet very few from each group were willing to demonstrate such transparency. Most healthcare industry stakeholders are ill prepared for the necessary trust-building activities required by this anticipated transition. A viable and sustainable information network provides the structure, aligned incentives and competitive collaboration the bricks and mortar, and trust the cornerstone. Until they can build that and foster a culture of transparency, they won’t achieve the cost and innovation benefits inherent in these cross-industry partnerships.  Further detail will be given on insights and challenges gleaned from interviewing large and small stakeholders as well as practical strategies, such as experimentation with data integration projects, to guide the transformation to a systems-thinking industry.