Health system leaders have questions about big data: When will I need it? How should I prepare? What’s the best way to use it? It’s important to separate the hype of big data from the reality. Where big data stands in healthcare today is a far cry from where it will be in the future. Right now, the best use cases are in academic- or research-focused healthcare institutions. Most healthcare organizations are still tackling issues with their transactional databases and learning how to use those databases effectively. But soon—once the issues of expertise and security have been addressed—big data will play a huge role in care management, predictive analytics, prescriptive analytics, and genomics for everyday patients. The transition to big data will be easier if health systems adopt a late-binding approach to the data now.