Health Information Exchange

Portrait of Jordan Everson

Achieving Widespread Use of Direct Secure Messaging by US Hospitals

Jordan Everson | July 15, 2025

In 2010, our office helped launch the Direct Project amidst the rollout of the ONC Health IT Certification Program and Centers for Medicare & Medicaid Services Electronic Health Record Incentive Programs. The Direct Project created Direct Secure Messaging, a simple, secure, scalable, and standards-based method to send health information between partners and to provide a straightforward pathway to acquire unique provider and organizational addresses to engage in exchange that resembles secure email. Direct was first piloted in two projects: in Minnesota,

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Portrait of Jordan Everson

Raising the Bar on Interoperability – A Decade of Data Show that “Sometimes” Isn’t Good Enough

Jordan Everson | June 17, 2024

A decade ago, as EHRs were rapidly implemented across the country, ONC sought to make sure these newly implemented technologies were interoperable. Since 2014, ONC has tracked progress toward widespread interoperability among hospitals and physicians by measuring their engagement in four domains of health information exchange: electronically finding, sending, receiving, and integrating patient health information. As shown in the figure below, US hospitals experienced widespread progress toward interoperability with 70% of hospitals reporting that they ‘sometimes’ or ‘often’ engaged in all four domains in 2023,

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Portrait of Jordan Everson

The Digital Health Divide for Populations that have been Marginalized

Jordan Everson | November 13, 2023

Many hospitals have adopted systems for interoperable patient data exchange and are connected to national networks. However, ONC has consistently found that rates of interoperable exchange for smaller, rural, and independent hospitals have notably lagged behind other hospitals. For example, in both 2017 and 2021, rural hospitals were 23 percentage points less likely to engage in interoperable exchange compared to urban hospitals. In a recent study, ONC explored this digital divide to better understand the relationship between interoperable exchange and measures of hospitals that served populations that have been marginalized.

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Portrait of Catherine Strawley

Patient Preferences with Social Needs Information Sharing

Catherine Strawley | October 26, 2023

Screening for patients’ health-related social needs can help providers more effectively coordinate patient care and connect patients to the resources they need. Social needs are social conditions—such as food insecurity, housing instability, and lack of reliable transportation—which often result from underlying social determinants of health and can adversely affect health outcomes if left unaddressed. While studies show that patients are generally comfortable with social needs screening, little is known about patients’ comfort or preferences around how social needs data are captured and shared with other providers and service organizations to inform treatment and care coordination.

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