HEALTH INTEROPERABILITYREVIEW

Move data. Preserve meaning. Prove the exchange.

Authority library

Standards and policy record

Each record preserves the issuing authority, jurisdiction, instrument or authority type, legal or operating status, version and application dates, affected audience, workflow mapping, source link, and interpretation boundary.

International; adopted or referenced by specific programs and implementation guides · international health-data standard

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.

International; adoption depends on program and implementation context · international health-data standard

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.

United States realm · U.S.-realm implementation guide

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.

United States · U.S. national health-data standard

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.

United States · U.S. federal final rule

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.

United States · U.S. federal final rule

HTI-2 Final Rule

HTI-2 finalizes TEFCA-related definitions, establishes 45 CFR Part 172 provisions supporting TEFCA reliability, privacy, security, trust, and transparency, and leaves the TEFCA Manner Exception unchanged.

United States · U.S. federal final rule

HTI-3 Final Rule

HTI-3 adds a definition of reproductive health care for information-blocking regulations, revises the Privacy and Infeasibility Exceptions, and creates a Protecting Care Access Exception.

United States · U.S. federal proposed rule

HTI-5 Proposed Rule

HTI-5 proposes changes to the ONC Certification Program, information-blocking regulations, and standards-based API foundations. Its provisions remain proposals as of the seed date.

United States; specified Medicare Advantage, Medicaid, CHIP, federally facilitated exchange, and provider provisions · U.S. federal final rule

CMS-9115-F

CMS-9115-F requires specified payers to maintain FHIR-based Patient Access APIs for claims, encounter, cost, and maintained clinical data, and establishes other interoperability and provider-notification provisions.

United States; specified Medicare Advantage, Medicaid, CHIP, and federally facilitated exchange payer programs · U.S. federal final rule

CMS-0057-F

CMS-0057-F expands Patient Access API content and requires Provider Access, Payer-to-Payer, and Prior Authorization APIs for impacted payers, with associated privacy, opt-in or opt-out, metrics, and operational provisions.

United States nationwide exchange framework · nationwide exchange agreement and governance framework

TEFCA Common Agreement v2.1

The Common Agreement establishes the legal and governance foundation for nationwide exchange among QHINs, Participants, and Subparticipants, with operating detail supplied by the QTF and standard operating procedures.

United States nationwide exchange framework · nationwide exchange technical framework

QTF v2.1

The QTF defines technical and functional requirements for QHIN-to-QHIN exchange and works with the Common Agreement and operating procedures to support nationwide exchange.

International with broad U.S. adoption · international FHIR authorization implementation guide

SMART App Launch 2.2.0

SMART App Launch defines discovery, authorization, scopes, token exchange, and app-launch patterns for applications accessing FHIR APIs from within or outside an EHR workflow.

International · international FHIR implementation guide

Bulk Data Access 3.0.0

The Bulk Data Access guide defines asynchronous export patterns for large FHIR datasets, including system-, patient-, and group-level workflows and associated authorization considerations.

United States realm · U.S.-realm payer FHIR implementation guide

PDex 2.1.0

PDex profiles FHIR-based exchange of clinical, claims, encounter, and prior-authorization information among payers, patients, and providers and introduces bulk APIs for provider and payer-to-payer access.

United States realm · U.S.-realm payer FHIR implementation guide

CARIN Blue Button 2.2.0

CARIN Blue Button defines FHIR profiles for consumer-directed exchange of claims and encounter information using the Common Payer Consumer Data Set.

United States realm · U.S.-realm clinical-document implementation guide

C-CDA 5.0.0

C-CDA 5.0.0 consolidates U.S. clinical document templates and current guidance while remaining based on the underlying CDA R2 document standard. It uses FHIR tooling to represent templates but does not turn CDA documents into FHIR resources.

United States healthcare exchange ecosystem · ANSI-recognized secure messaging standard

The Direct Standard Version 1.3

The Direct Standard specifies a secure, authenticated, scalable method for sending health information to known recipients using profiled internet messaging, public-key infrastructure, certificate discovery, trust, and delivery notifications.

How to read the library

Binding requirements, official guidance, technical standards, implementation guides, program rules, and authority data are not interchangeable. Each page names the source class and states what it can and cannot establish about an organization or product.