Check here regularly for the latest updates to the ISA. Please note, that revisions to individual interoperability needs (such as adding/removing of standards or changes to their informative characteristics) are not included here. Revision history is available on each ISA page. In addition, registered users may subscribe to change notifications to be alerted by e-mail of all revisions to individual interoperability needs or for ISA-wide changes. Once logged in, look for the blue “change notification” button at the bottom of the interoperability need page, or at the bottom of this page to be notified of any changes across the ISA.
An RSS Feed that captures all changes made to the ISA is also available for visibility into more granular ISA updates.
- Fall 2022 - Numerous changes made to address public comments received and prepare the 2023 Reference Edition, including but not limited to:
- In Section I, Vocabulary/Code Set/Terminology, created a new Human and Social Services subsection with two new Interoperability Needs:
- Changed Vocabulary/Code Set/Terminology Race and Ethnicity subsection to Race, Ethnicity and Tribal Affiliation:
- Added Representing Tribal Affiliation Interoperability Need
- Changed Vocabulary/Code Set/Terminology, Laboratory:
- Added Representing Laboratory Test Specimen Interoperability Need
- Changed Representing Laboratory Values and Results Interoperability Need to Representing Laboratory Result Values
- Changed Section II, Content/Structure, Laboratory:
- Changed InVitro Diagnostics( IVD) Test Orders & Results Interoperability Need to Exchange InVitro (IVD) Orders and Results
- Changed Receive Electronic Laboratory Test Results Interoperability Need to Exchange Laboratory Test Results
- Changed Ordering Laboratory Tests for a Patient Interoperability Need to Order Laboratory Test
- Changed Support the Transmission of a Laboratory’s Directory of Services to Provider’s Health IT or EHR System Interoperability Need to Transmit Laboratory Directory of Services to Provider System
- Changed Section II, Content/Structure, Pharmacy Interoperability:
- Renamed subsection Pharmacy Interoperability from Electronic Prescribing and consolidated with previous Drug Formulary subsection
- In Section III, Services/Exchange:
- Added Infrastructure subsection and Client Application Management Interoperability Need
- Changed Section III, Services/Exchange, Resource Location:
- Added Finding and Retrieving Human Services Information Interoperability Need
- In Section IV, Administrative, Operating Rules for Administrative Transactions:
- Added Attributed Patient Roster and Connectivity for Operating Rules Interoperability Needs
- Changed Operating Rules for Benefit Enrollment Interoperability Need to CAQH® CORE Operating Rules for Enrollment and Disenrollment
- Added in 2022 SVAP Approved Standards throughout Reference Edition
- March 29, 2022 - Added Representing Patient Address and Representing Patient Names Interoperability Needs within Section I: Demographics.
- March 18, 2022 - Added Section I: Biologics and Representing Biological Products Interoperability Need.
- March 15, 2022 - Added Adverse Event Reporting Interoperability Need within Section II: Public Health Reporting.
- Fall 2021 - Numerous changes made to address public comments received and prepare the 2022 Reference Edition, including but not limited to:
- Changed Vocabulary/Code Set/Terminology: Laboratory, adding two Interoperability Needs and removing one:
- Added Representing Laboratory Test Ordered
- Added Representing Laboratory Test Performed
- Removed Representing Laboratory Tests
- Changed Vocabulary/Code Set/Terminology: Tobacco Use Interoperability Need from:
- Representing Patient Second Hand Tobacco Smoke Exposure to Representing Patient Secondhand Tobacco Smoke Exposure
- Added Content/Structure: Added Work Information page with Work Information Templates Interoperability Need
- Changed Content/Structure: Admission, Discharge, and Transfer Interoperability Need from:
- Sending a Notification of a Long Term Care Patient’s Admission, Discharge and/or Transfer Status to the Servicing Pharmacy to Sending a Notification of a Long-Term Care Patient’s Admission, Discharge and/or Transfer Status to the Servicing Pharmacy
- Changed Content/Structure: Clinical Decision Support Interoperability Need from:
- Sharable Clinical Decision Support to Shareable Clinical Decision Support
- Changed Content/Structure: ePrescribing Interoperability Needs (2) from:
- Allows a Long Term or Post-Acute Care to Request to Send an Additional Supply of Medication to Allows a Long-Term or Post-Acute Care to Request to Send an Additional Supply of Medication
- Allows a Pharmacy to Request a New Prescription For a New Course of Therapy or to Continue Therapy to Allows a Pharmacy to Request a New Prescription for a New Course of Therapy or to Continue Therapy
- Changed Administrative: Removed CMS Interoperability Standards for Provider to Provider Communication and 3 corresponding Interoperability Needs:
- Durable Medical Equipment/Home Health Agency Document Request
- Durable Medical Equipment/Home Health Agency Order Submission
- Durable Medical Equipment/Home Health Agency Signature Request
- Changed Vocabulary/Code Set/Terminology: Laboratory, adding two Interoperability Needs and removing one:
- June 14, 2021 - Created new Interoperability Need: Representing Mass Vaccination Status within Vocabulary/Code Set/Terminology: Public Health Emergency Preparedness and Response.
- March 23, 2021 - Changed "Data Segmentation of Sensitive Information" sub-section and Interoperability to: "Security Tags for Sensitive Information" and added a Specialty Care/Settings page for Social Determinants of Health related Interoperability Needs.
- December 12, 2020 - Added Content/Structure: Added Work Information page with Representing Job, Usual Work, and Other Work Information Interoperability Need.
- Removed Patient Industry and Occupation Page with Representing Patient Industry and Occupation Interoperability Need
- Fall 2020 - numerous changes made to address public comments received and prepare the 2021 Reference Edition, including:
- Added Vocabulary/Code Set/Terminology: Public Health Emergency Preparedness and Response, with four Interoperability Needs:
- Changed Vocabulary/Code Set/Terminology: Research Interoperability Need from Representing Analytic Data for Research Purposes to Representing Data for Biomedical and Health Services Research Purposes
- Changed Vocabulary/Code Set/Terminology from Tobacco Use (Smoking Status) to Tobacco Use
- Added Interoperability Need: Sending a Notification of a Patient’s Encounter to a Record Locator Service to Content/Structure: Admission, Discharge, and Transfer
- Changed Content/Structure: Care Coordination for Referrals Interoperability Needs:
- “Referral to a Specialist – Request, Status Updates, Outcomes” changed to “Referral to a Specialist – Request, Status Updates, Outcome”
- “Referral to Extra-Clinical Services – Request, Status Updates, Outcomes” changed to “Referral to Extra-Clinical Services – Request, Updates, Outcome”
- Added Content Structure: Clinical Notes with Interoperability Need: Documentation of Clinical Notes
- Changed Content/Structure: Clinical Quality Measurement and Reporting Interoperability Need from “Reporting Aggregate Quality Data to Quality Reporting Initiatives” to “Reporting Aggregate Quality Data for Quality Reporting Initiatives”
- Corrected typo in Content/Structure: Healthy Weight Interoperability Need from “Sending Health Weight Information” to "Sending Healthy Weight Information”
- Changed Content/Structure: Laboratory Interoperability Need from “Support the Transmission of a Laboratory’s Directory of Services to Health IT” to "Support the Transmission of a Laboratory’s Directory of Services to Provider’s Health IT or EHR System”
- Changed Services/Exchange: Patient Identification Management Interoperability Need from “Exchanging Patient Identification Management Within a Community” to “Exchanging Patient Identification Within and Between Communities"
- Added Interoperability Needs to Administrative: Operating Rules to Support Administrative Transactions:
- Revised Interoperability Needs in Administrative: Operating Rules to Support Administrative Transactions:
- Changed “Operating Rules for Claims, Enrollment, and Premium Payments (Phase IV)” to “Operating Rules for Benefit Enrollment”
- Changed “Operating Rules for Prior Authorization (Phase V)” to “Operating Rules for Prior Authorization and Referrals”
- Changed “Operating Rules to Support Eligibility and Claim Status Transactions (Phase II)” to “Operating Rules to Support Claim Status Transactions”
- Changed “Operating Rules for Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) for Payments and Reconciliation (Phase III)” to “Operating Rules for Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) for Payments and Reconciliation"
- Removed Interoperability Need: “Operating Rules to Support Eligibility Transactions (Phase I)” from Administrative: Operating Rules to Support Administrative Transactions
- Added a Specialty Care/Settings page for COVID-19 related interoperability needs.
- April 13, 2020 - Rolled out improved site navigation for enhanced user experience. Dropped Section "numbers" (i.e., Section I, Section II, Section III, Section IV, etc) and instead use type of standards as Section title.
- March 24, 2020 - Added Interoperability for COVID-19 Novel Coronavirus Pandemic
- Fall 2019 – numerous changes made to address public comments received and prepare the 2020 Reference Edition, including:
- Added Section I: Clinical Notes and Interoperability Need: Representing Clinical Notes
- Added Section I: Cognitive Status and Interoperability Need: Representing Patient Cognitive Status
- Added Section I: Demographics and Interoperability Need: Representing Patient Contact Information for Telecommunications
- Added Section I: Dietary and Nutritional Needs and Interoperability Need: Representing Nutrition Assessment, Diagnosis, Interventions and Monitoring/Evaluation
- Changed Section I: Encounter Diagnosis to Encounter Diagnosis, Assessment and Plan and added Interoperability Need: Representing Assessment and Plan of Treatment
- Added Section I: Goals and Interoperability Need: Representing Patient Goals
- Added Interoperability Need: Representing Laboratory Values/Results to Section I: Laboratory
- Added Section I: Provenance and Interoperability Need: Representing Data Provenance
- Added four new Interoperability Needs to Section I: Social, Psychological and Behavioral Data:
- Added Section II: Care Coordination for Referrals and three new Interoperability Needs:
- Added Interoperability Need: Documenting Care Plans for Person Centered Services to Section II: Care Plan
- Added Interoperability Need: Allows a Prescriber to Send a Prescription to a Pharmacy for a Controlled Substance to Section II: Electronic Prescribing.
- Added Interoperability Need: Collection and Exchange of Patient Reported Outcomes to Section III: Consumer Access/Exchange of Health Information.
- Added Interoperability Need: Administrative Transaction Acknowledgements to Section IV: Administrative Transactions – Non-Claims
- Added Interoperability Need: Operating Rules for Prior Authorization (Phase V) to Section IV: Operating Rules to Support Administrative Transactions
- April 4, 2019 - Added two new Interoperability Needs in Section I: Tobacco Use:
- February 18, 2019 - Added several Interoperability Needs in Section II: Electronic Prescribing:
- Allows for Communication of Information Between Prescribers and Dispensers
- Allows a Prescriber to Communicate with a REMS Administrator
- Allows a Prescriber to Recertify the Continued Administration of a Medication Order
- Allows for the Exchange of State Prescription Drug Monitoring Program (PDMP) Data
- Allows a Prescriber to Communicate Drug Administration Events
- Allows a Long Term or Post-Acute Care to Request to Send an Additional Supply of Medication
- February 11, 2019 - A section dedicated to ONC Standards has been added, including the API Resource Collection in Health (ARCH) and the U.S. Core Data for Interoperability (USCDI). In addition, new functionality is now available that supports "Specialty Care and Settings" to display a list of interoperability needs supporting particular care needs or settings, including Pediatrics and Opioids (prevention and treatment).
- January 11, 2019 - A new Interoperability Need: Allows a Prescriber to Send a Prescription to a Pharmacy for a Controlled Substance has been added to Section II: Electronic Prescribing.
- January 9, 2019 - A new Appendix IV has been added, providing links to State and Local Public Health Agencies and their interoperability efforts.
- Fall 2018 - numerous changes made to address public comments received and prepare the 2019 Reference Edition ISA, including:
- Added Interoperability Needs for:
- Representing Relationship Between Patient and Another Person
- Allows a Pharmacy to Request a New Prescription For a New Course of Therapy or to Continue Therapy
- Allows a Pharmacy to Request, Respond to, or Confirm a Prescription Transfer
- Allows a Pharmacy to Request Additional Refills
- Allows a Prescriber to Prescribe Medication Using Weight-Based Dosing
- Operating Rules for Claims, Enrollment, and Premium Payments (Phase IV)
- Operating Rules to Support Electronic Prescribing Transactions
- Changed Health Care Providers to Health Care Providers, Family Members and Caregivers, reflecting additional interoperability needs and a more inclusive sub-section title
- Changed Section I – Lab Tests to Laboratory to align with other ISA sections
- Relocated Unique Device Identification Interoperability Needs to Section II for better representation of underlying standards (content/structure)
- Changed Drug/Formulary Benefits Interoperability Need to “Allows Pharmacy Benefit Payers to Communicate Formulary and Benefit Information to Prescriber Systems
- Revision of multiple Electronic Prescribing Interoperability Need titles from “A prescriber’s ability to..” to “Allows a prescriber to..”
- Revision of Patient Education Materials Interoperability Need title.
- Revision of various Research Interoperability Need titles
- Changed “Document level segmentation” to "Data segmentation" in Segmentation of Sensitive Information section
- Added Interoperability Needs for:
- March 6, 2018 - Changed menus and table of contents to reflect move from "lettered" sub-section format to alphabetized sub-section titles. Further work ISA-wide continues to ensure individual pages are updated to the same format.
- December 2017 - numerous changes made to address public comments received and prepare the 2018 Reference Edition ISA, including:
- Revision of ISA Introduction language.
- Change of Section I-S title from Social Determinants to "Social, Psychological, and Behavioral Data".
- Addition of two new interoperability needs in Section II-B: Care Plan, including "Documenting and Sharing Medication-Related Care Plans by Pharmacists" and "Sharing Patient Care Teams for Care Planning in Multiple Clinical Contexts".
- Consolidation of previous Sections II-D and II-E into a single Section II-D: Clinical Quality Measurement and Reporting.
- Addition of three interoperability needs to Section II-H: Electronic Prescribing, including Allows Prescriber to Respond to a Prior Authorization for a Medication Electronically to the Payer/Processor", "Prior Authorization Cancel Request", and "A Prescriber’s Ability to Obtain a Patient’s Medication History from a Prescription Drug Monitoring Program".
- Addition of an interoperability need in Section II-K: Images, "Format of Radiation Exposure Dose Reports for Exchange and Distribution".
- In Section II-O: Patient Identification Management, a change to the title of the interoperability need to "Patient Demographic Record Matching".
- In Section II-Q: Public Health Reporting, addition of four new interoperability needs, including "Data Submission for Title X Family Planning Annual Reporting", "Reporting Death Records to Public Health Agencies", "Reporting Newborn Screening Results to Public Health Agencies", "Reporting Birth and Fetal Death to Public Health Agencies" and a revision to one interoperability need's title "Exchanging Immunization Data with Immunization Registries" to better reflect the interoperability need.
- Addition of a new Section V-F: CMS Interoperability Standards for Provider to Provider Communication with three interoperability needs related to CMS' Electronic Medical Documentation Interoperability work.
- Numerous updates within individual interoperability needs from public comments.
- October 25, 2017 - A new subsection (I-W: Pregnancy Status) and associated interoperability need, Representing Patient Pregnancy Status, has been added to the ISA to reflect Federal Advisory Committee recommendations.
- October 18, 2017 - Functionality has been added allowing users to submit proposals for new ISA interoperability needs for ONC consideration.
- September 18, 2017 - New Questions and Requests for Stakeholder Feedback have been added as part of the Fall 2017 comment and review period.
- September 18, 2017 - A new sub-section related to Consumer Access/Exchange of Health Information has been added, with four initial interoperability needs. This was recommended by the 2017 ISA Task Force and the Health IT Standards Committee.
- September 15, 2017 - Advanced Search functionality has been added, allowing users to find content based on standards/implementation specifications, informative characteristics, etc. Please note: we are aware of some minor issues with this functionality and are working to resolve these as quickly as possible.
- August 16, 2017 - A new Section V has been created that includes standards for administrative transactions.
- April 19, 2017 - A new interoperability need, Reporting Birth Defects to Public Health Agencies, has been added to Section II-R: Public Health Reporting.
- April 3, 2017 - A new appendix has been added, with informational and educational resources as recommended by the Health IT Standards Committee.