FAQs

The Interoperability Standards Advisory (ISA) process represents the model by which the Office of the National Coordinator for Health Information Technology (ONC) will coordinate the identification, assessment, and public awareness of interoperability standards and implementation specifications that can be used by the United States healthcare industry to address specific interoperability needs including, but not limited to, interoperability for clinical, public health, and research purposes. ONC encourages all stakeholders to implement and use the standards and implementation specifications identified in the ISA as applicable to the specific interoperability needs they seek to address. For more information, see the About the ISA page.

The ISA is meant to serve as a resource for the health IT community. ONC has heard from stakeholders across the health IT industry – public health agencies, standards development organizations, health IT developers, healthcare delivery systems, hospitals, and more – that they are finding a single list of available standards to be a helpful resource for their work to improve healthcare through interoperability.

The web version of the ISA is updated on a regular basis by ONC and other HHS staff as changes in the health IT standards environment become apparent or when public comments are received at any point throughout the year. Annually, ONC solicits comments during an official “review and comment period”, typically in the Summer/Fall timeframe, which helps ensure the ISA content is up to date for the annual Reference Edition publication.

To comment, you’ll need to create an account first. See the Timeline and Comment Process page for more information about account creation, tips for comments, and more.

ONC began publishing ISA Reference Editions in 2017 when the ISA transitioned from a static PDF document (with draft/final versions and multiple comment periods annually) to a more interactive web platform. The Reference Edition is meant to provide a stable, non-changing version of the ISA that can be pointed to by industry stakeholders that have that requirement (i.e., for use in contracts, etc). The web version of the ISA is intended to be dynamic and may change a number of times throughout the year as additional comments are received or as ONC becomes aware of changes in the standards listed within the ISA.

The adoption level attempts to consider all implemented technology that would be used to address the identified interoperability need, and is not limited to EHRs.  Adoption means that the standard or implementation specification is being used in health IT in the field by end users to address the specific interoperability need. Adoption levels listed are based on ONC’s analysis of several factors, including, but not limited to: 1) whether and/or how long a standard or implementation specification has been included in regulation for health IT certification (if applicable) or another HHS regulatory or program requirement which is used only as a proxy for industry adoption; 2) feedback from subject matter experts and 3) public comments.

The adoption level also considers the variety of stakeholders and stakeholder groups that would use the standard and implementation specification to address the specified interoperability need and attempts to display it as such, with the understanding that the designation is a generality or "best guess" and not a pre-defined measured value. Where available, annotated references or links to publicly available documentation known about adoption levels for listed standards are also provided.

Yes - ONC is always looking for additional interoperability needs that might be valuable for industry stakeholder awareness. You can propose a new interoperability need through the ongoing comment process (account required).

A standard's listing in the ISA itself does not require its implementation or adoption. The ISA serves as an informational resource for available standards, specifications, profiles, etc that exist to meet the interoperability needs contained within. Stakeholders should ensure and verify that they are adhering to applicable federal, state, and/or local laws, program requirements, or regulations regarding requirements to use a specific standard or specification that may conflict with the information listed in the ISA, as these requirements supersede the ISA.