Over the last five years, electronic health records (EHRs) have been widely implemented in the United States, and health care systems now have access to vast amounts of data. While they are beginning to apply “big data” techniques to predict individual outcomes like post-operative complications and diabetes risk, big data remains largely a buzzword, not a reality, in the routine delivery of health care. Health systems are still learning how to broadly apply such analytics, outside of case examples, to improve patient outcomes while reducing spending.