Today we are pleased to ring in the new year with the release of the 8th annual update of the Interoperability Standards Advisory (ISA) Reference Edition, ONC’s catalog of curated standards and implementation specifications for health information interoperability that reflects extensive feedback from industry and federal agencies. Many of the updates can be found on our Recent ISA Updates page.

Noteworthy Updates to the ISA for 2022

COVID-19. We’ve added Centers for Disease Control and Prevention (CDC) Immunization Information System (IIS) code set standards and Health Level Seven (HL7^®) IIS implementation guidance to the COVID-19 Novel Coronavirus Pandemic interoperability need.  To better support CDC’s COVID-19 reporting requirements, we’ve added a newer release of HL7 Laboratory Test Compendium Framework to Support the Transmission of a Laboratory’s Directory of Services to Provider’s Health IT or EHR System.

Laboratory. We’ve broken the vocabulary/code set/terminology entries under Laboratory into 3 distinct categories – Representing Laboratory Test Ordered, Representing Laboratory Test Performed, and Representing Laboratory Values/Results – to better align with and meet the needs of users.

ePrescribing. We’ve added National Council for Prescription Drug Programs’ Real-Time Prescriptions Benefit Standard Version 12 to the Content/Structure section, which Allows Pharmacy Benefit Payers to Communicate Formulary and Benefit Information to Prescriber Systems.

Public Health Reporting. HL7 Laboratory Results Interface implementation specification was added to Newborn Screening Results and Birth Defect Reporting to Public Health Agencies, thereby providing an additional standard for jurisdictions who are doing electronic order and result exchanges. A Fast Healthcare Interoperability Resources (FHIR®) US Laboratory Report emerging standard was added to Electronic Transmission of Reportable Laboratory Results to Public Health Agencies, raising awareness of the potential use of FHIR standard for public health reporting.

ISA Supports Social Determinants of Health (SDOH) and Health Equity

PACIO Workgroup Implementation Guides and CMS Data Element Library were added to the Representing Patient Cognitive Status and Representing Patient Functional Status and/or Disability interoperability needs. Publication of the Cognitive Status and Functional Status Implementation Guides in HL7 propel health IT interoperability to better serve some of the most vulnerable populations, such as the elderly and disabled. We’ve added a new interoperability need, Work Information Templates, and populated it with HL7 Occupational Data for Health and Clinical Document Architecture implementation specifications.  LOINC^® codes were added to the Representing Depression and Representing Social Connection and Isolation, providing a source of applicable value sets for use.

The Gender Harmony Project was added to Representing Patient Gender Identity to highlight the ongoing efforts by industry to represent Sexual Orientation/Gender Identity information for various clinical uses. ONC will be keenly following the project, especially as it pertains to changes desired by the industry in future versions of United States Core Data for Interoperability.

There are many other revisions to ISA, including re-wording of interoperability need names, updating standard/implementation specification adoption levels and replacing broken links. We’ve also populated Appendix II with additional models and profiles and updated Appendix IV with state and local public health agency interoperability program links.

We appreciate you taking the time to provide comments on this year’s 2022 ISA Reference Edition. Please know that the ISA is updated incrementally throughout the year and your continued feedback is essential in making its broader range of health IT interoperability needs as comprehensive as possible. Remember to log in or register to the ISA site to provide your feedback.  Larger structural changes to the ISA can be tracked at the Recent ISA Updates page, while more granular updates to the ISA can be tracked using the RSS Feed.  Thank you again for your commitment to advancing health IT interoperability!