What this domain asks
Risk that organizations treat a standard as a timeless feature, combine incompatible versions or profiles, misstate certification or conformance, and release interfaces without reproducible evidence for the exact artifacts in use.
The domain should retain its own evidence, decision owner, materiality criteria, exception path, and consequence even when it shares organization identity, workflow, or technology with adjacent domains. Aggregation can support oversight; it should not erase the evidence behind different risks or operating outcomes.
Buyer questions
- Which base standard, version, guide, profile, terminology package, and optional capability are supported?
- What is certified, self-attested, tested, documented, or only on the roadmap?
- How are validation results reproduced and exceptions governed?
- How are sender and receiver version differences handled?
- What changes when an adopted baseline differs from the newest published version?
Mapped workflows
FHIR Server And Repository
A demonstration should show the trigger, source, accountable role, decision, exception, evidence, and downstream handoff for FHIR server and repository within this domain.
FHIR API Gateway And Orchestration
A demonstration should show the trigger, source, accountable role, decision, exception, evidence, and downstream handoff for FHIR API gateway and orchestration within this domain.
FHIR Profile And Implementation-Guide Support
A demonstration should show the trigger, source, accountable role, decision, exception, evidence, and downstream handoff for FHIR profile and implementation-guide support within this domain.
SMART On FHIR Authorization
A demonstration should show the trigger, source, accountable role, decision, exception, evidence, and downstream handoff for SMART on FHIR authorization within this domain.
Bulk Data Access And Export
A demonstration should show the trigger, source, accountable role, decision, exception, evidence, and downstream handoff for bulk data access and export within this domain.
Conformance Testing And Validation
A demonstration should show the trigger, source, accountable role, decision, exception, evidence, and downstream handoff for conformance testing and validation within this domain.
Operational Monitoring And Exception Management
A demonstration should show the trigger, source, accountable role, decision, exception, evidence, and downstream handoff for operational monitoring and exception management within this domain.
Authority context
FHIR R4 4.0.1
FHIR R4 defines resources, RESTful interactions, data types, terminology bindings, conformance artifacts, security considerations, and exchange patterns. It includes the first normative FHIR content and remains the base for major U.S. implementation guides.
FHIR R5 5.0.0
FHIR R5 is HL7's current overall published release and adds substantial content beyond R4. HL7 labels the release trial use while individual artifacts can have their own standards status.
US Core 9.0.0
US Core defines U.S. FHIR profiles, interactions, search expectations, and guidance for exchanging common clinical data. Version 9.0.0 remains based on FHIR R4 and incorporates current USCDI-oriented development.
USCDI v6
USCDI v6 defines an expanded national set of health-data classes and elements intended to support interoperable exchange. Publication, regulatory adoption, and voluntary certification advancement are distinct status records.
HTI-1 Final Rule
HTI-1 updates the ONC Health IT Certification Program, adopts USCDI v3 as the baseline from January 1, 2026, revises information-blocking provisions, adds algorithm-transparency requirements, and creates interoperability-focused reporting metrics.
Relevant operating models
- Enterprise Interoperability And Integration Platform
- FHIR Server, API, And Compliance Platform
- Payer Interoperability And API Platform
- Cloud Health-Data Platform
Evidence boundary
Health Interoperability Review provides market, standards, policy, and operating research. It does not provide patient-specific medical advice, determine an individual's rights or coverage, certify product conformity, authorize a disclosure, or replace legal, privacy, security, clinical, or implementation review. A provider's documented capability can identify a research candidate but cannot establish buyer-specific adequacy for this domain.