Moving down the road to practical uses for interoperability
No longer an esoteric, distant objective, data exchange is beginning to make an impact on healthcare to enable better care and efficiency.
Interoperability has been a goal for digital health records for more than a generation. It was one of several components that defined meaningful use for electronic health records, as envisioned by the crafters of the HITECH Act back in 2009.
It’s been a long journey. I now think of EHRs as having a car sitting in the driveway. The theoretical notion of interoperability of health information is akin to having a map and planning a trip.
Now, more indications suggest that we’re jumping in the car, turning the key and actually taking the journey.
The ability to seamlessly exchange health information in a way that supports efficiency and enables better care for patients has been the lofty goal. Getting there remains a long and winding road. But the industry is making verifiable progress, clipping past some important mile markers along the way.
Measures of progress
A couple recent announcements show that data exchange efforts are moving beyond basic capabilities to lay the groundwork for achievements that can impact medical care delivery.
In one indication of refinement in data exchange, the Office of the National Coordinator for Health Information Technology has released a draft version of USCDI+ Quality Version 2 for public comment. After assessing public input on the draft standards, a final version is expected to be released later this year.
USCDI+ builds on ONC’s initial efforts surrounding the United States Core Data for Interoperability (USCDI), a standardized set of health data classes and data elements intended to form a foundation for nationwide interoperable health information exchange. The first version was adopted as a standard under the ONC Cures Act final rule, setting a bedrock for the sharing of electronic health information.
USCDI+ supports the identification and establishment of domain- or program-specific data element lists that operate as extensions to the existing USCDI. ONC plans to offer USCDI+ as a service “to federal and industry partners to establish, harmonize and advance the use of interoperable data element lists that extend beyond the core data in the USCDI,” the announcement notes.
The hope is that continued refinement and expansion of the standard to strengthen “standards alignment, improve clarity and better support digital quality measurement while minimizing implementation burden.”
The standards will help organizations communicate information on adverse events, drug allergies, reactions to medication, allergy intolerance and care notes, to name a few quality-influenced data elements.
Progress in LEAPS and bounds
ONC also announced a notice of a funding opportunity as part of its LEAP in Health IT for 2026. While ONC has run this program before, the categories it’s looking at will help demonstrate how IT can impact future care and service delivery.
Leading Edge Acceleration Projects (LEAP) in Health IT funding opportunities “address well-documented and fast emerging challenges that inhibit the development, use or advancement of well-designed, interoperable health IT,” ONC indicates.
The notice for this year’s program says it’s looking for innovation in three areas.
Accelerating the use of agentic artificial intelligence solutions in clinical care.
Expanding Lantern’s API monitoring capabilities by integrating secure, community-driven feedback that complements existing automated checks.
Assessing laboratory interoperability gaps to improve the adoption and use of standard terminology among small, independent laboratories.
The application period closes at noon ET on July 16.
Catching on FHIR
Another mile marker for interoperability’s progress came this week from the Firely and HL7 “State of FHIR Report 2026,” which found growing adoption of the Fast Healthcare Interoperability Resources (FHIR) standard.
FHIR remains a foundational component of how modern patient records systems exchange information, particularly in a variety of specific use cases intended to bring standardization and efficiency to common interactions among healthcare entities, spanning initiatives ranging from value-based care to social determinants of health to research to artificial intelligence.
The survey gathered responses from 101 interoperability experts in 63 countries and “found continued growth in FHIR adoption, increasing regulatory support, and broad agreement that AI and interoperability are becoming increasingly intertwined.”
Key findings showing the breadth of FHIR adoption include the following.
FHIR adoption continues to mature globally. Some 62 percent of respondents now report active FHIR use cases in their countries, and 20 percent identify FHIR as their primary interoperability standard.
Regulatory momentum continues to build. Some 80 percent of respondents whose countries have regulations in place report that FHIR is mandated or recommended through national policy or guidance.
Lack of FHIR knowledge remains the industry's biggest challenge. Three out of four (75 percent) of respondents cited unfamiliarity with the standard as an issue.
FHIR work centers on practical, high-volume use cases. Interest is highest in prescriptions and pharmacy, followed by terminology, diagnostic orders and reports, immunizations and document exchange.
Respondents also suggested that the rise in the use of artificial intelligence will heighten the need for FHIR to be employed as a tool to ensure successful AI deployment.
“As healthcare organizations move from AI experimentation to implementation, the importance of interoperable, standards-based data has only increased,” said Rachel Dunscombe, CEO of HL7 International. “These findings reinforce that AI and interoperability are not competing priorities. In fact, the success of AI increasingly depends on trusted, well-structured, and exchangeable health data.”
Fred Bazzoli is the Editor in Chief of Health Data Management.