ISA Timeline and Comment Process

Comments on the ISA are accepted year-round, and changes are made to the web version of the ISA frequently throughout the year, based on comments and other changes to the health IT standards environment as ASTP becomes aware of them. An annual Review and Comment period also occurs each summer-fall, when a majority of comments are received. See the process timeline below for more details. 

Annual ISA Process Timeline

  • January: Current Year Reference Edition is published, web version of ISA is available for ongoing review and comments.
  • Winter/Spring/Summer: Changes may be made to the web-version of the ISA throughout the year, while the ISA Reference Edition remains static.
  • Late Summer/Early Fall: Annual Review and Comment Period opens for sixty days - site changes are on hold so all reviewers are seeing the same content. 
  • Fall: ASTP and HHS staff review comments received, make site updates and prepare the following year's Reference Edition for publication by early January. 

How to Comment on the ISA

  • An ISA site account is required in order to comment on the ISA.
    • If you have an account already, click the "Login" button at the top right of the ISA. 
    • To create an account, click the "Login" button, then "Create new account" tab above the login window. Account approval is required, and is generally completed within 1 - 24 hours. 
  • Once you're authenticated to the ISA site, you can submit comments on most ISA pages - just scroll to the bottom of the relevant page, enter the text of your comment (or provide attachments, if needed) and submit. Your comment will be reviewed by ASTP or other HHS subject matter experts, and changes will be considered for publication to the ISA. 
  • While comments by topic (posted to individual Interoperability Need pages) are preferred, and allow greater visibility to your comments by other industry stakeholders, consolidated comment letters are also accepted. You may provide these comments on general information pages, and ASTP staff will triage them, and assign them to subject matter experts. 

 

FormGuide

Help

1. Optional: Background Text / Cover Letter

The "Optional Background Text / Cover Letter" field provides space for additional context or introductory information related to your comment.

This field is entirely optional and serves the following purposes:

  • Provides context for reviewers
  • Serves as an introduction if submitting multiple comments
  • Functions as a cover letter for formal submissions

If you are submitting a single comment for a specific data class or element, you may leave this field blank. For multiple comments, this space is useful for explaining the overall purpose or connection between your comments.
 

Optional Background Text / Cover Letter

Fig 1 The "Optional Background Text / Cover Letter" field allows users to provide contextual information or introductory remarks for their comment submission.

 2. Complete the Comment Form

The comment form contains several fields that require your input:

ISA Content: This field is automatically populated based on the page you are currently viewing. No action is required.

Standards and Implementation Specifications: This drop-down menu is pre-selected based on the topic you're commenting on. The selection reflects the relevant standard or implementation specification for your current page.

Subject: Enter a concise title that summarizes the focus of your comment. This helps reviewers quickly understand the nature of your feedback.

Comment: This is the main field where you provide your detailed feedback, concerns, or suggestions. The comment box includes a text editor with formatting options that allow you to:

  • Format text as bold or italic
  • Insert hyperlinks
  • Create bullet points
  • Create numbered lists
  • Apply strike-through formatting
  • Attach images
  • Insert tables

Use these formatting options as needed to clearly present your information.

text editor toolbar

Fig 2 The comment text editor toolbar provides formatting options including bold, italic, links, lists, tables, and image insertion capabilities.

3. Optional: Upload Supporting Files

The platform allows you to upload supporting documentation to enhance your comment:

  1. Locate the "File Upload" section at the bottom of the comment form.
  2. Click to upload any files (such as PDFs or documents) that provide additional context, evidence, or clarification for your comment.

Important: If you have already entered your comments using the form fields, there is no need to upload duplicate content in PDF format. The file upload feature is intended for supplementary materials only. Please avoid uploading files that contain the same information already provided in your comment text.

File Upload

Fig 3 The "File Upload" section permits users to attach supporting documentation that supplements their written comments.

4. Optional: Save and Exit

If you need to pause your work and return to complete your comment later:

  1. Click the "Save and Exit" button at the bottom of the form.
  2. Your comment will be saved as a draft that you can access and complete later.
  3. When you return to the platform, you will see a red triangle with an exclamation mark next to the "Return to saved Comment" button, indicating that you have saved comments in draft status.
  4. Click the "Return to saved Comment " button to continue working on your draft.
  5. You will be taken to a review page where you can:
    1. Select "Submit Comment" to officially submit your feedback.
    2. Click "Edit" to return to the comment form and make changes
    3. Select "Discard Draft" to delete the saved draft and start fresh
Return to saved Comment

Fig 4 A red triangle with exclamation mark indicator appears next to the "Return to saved Comment" button when draft comments are saved in the system.

5. Review and Submit

Once you have completed your comment:

  1. Click the "Review and Submit" button at the bottom of the form.
  2. This will take you to a review screen displaying your comment(s) in full.
  3. Review all information for accuracy and completeness.
  4. On this review screen, you have three options:
    1. Click "Submit Comment" to officially submit your feedback
    2. Click "Edit" to return to the comment form and make changes
    3. Click "Discard Draft" to delete the comment and start fresh
  5. The review screen also includes a "Print" button that allows you to create a printed copy of your comments for your records.
  6. If you choose to submit, your comment will be recorded in the system and made available for review by the appropriate stakeholders.
Review and Submit

Fig 5 The review screen includes a "Print" button that allows users to create a record of their comment submission.

ISA Comments

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Comment

Submitted by rashmitiw on

Nice

Nice

Submitted by ravi.kafle@doh… on

Thank you for the…

Thank you for the opportunity to comment on the new version of Interoperability Standards Advisory (ISA) 2024. The attached comments are provided on behalf of Washington State Department of Health.

ISA 2024 Comments WA DOH.docx

Submitted by mphillips@caqh.org on

CAQH CORE 2025 ISA Updates

CAQH CORE reviewed the ISA and indicated recommended edits in the attached comment letter. 

CORE Submission_2025 ISA Updates.pdf

Submitted by FEHRMSVAP51 on

NEW ISA platform

The FEHRM has reviewed the ISA website and submitted the attached file with our comments.

ASI_Comments_08062024-.docx

Submitted by David Klonoff on

Integration of Continuous Glucose Monitor Data into the EHR

A consensus group of 130 stakeholders (organized by Diabetes Technology Society) from academia, government, and industry developed iCoDE with data standards and workflow processes for integrating the wearable device Continuous Glucose Monitors into the EHR. The iCoDE standard contained 54 recommendations when it was completed in November 2022.  Many of its terms for expressing results of CGM testing are worthy of adoption by the (next) USCDI 5.  The link to the iCoDE standard is here: <https://www.diabetestechnology.org/icode/>

Submitted by ScottStuewe on

DirectTrust ISA Updates - 2023

Updates to links for permanence. Updates to adoption levels. Inclusion of Context IG now that it is in use in the Notifications Standard.  ANSI Naming added to ANSI approved standards.

ISA Updates 2023 0 DirectTrust.xlsx

Submitted by mphillips@caqh.org on

CORE Response to the 2024 ISA Open Comment Period

Thank you for the opportunity to provide substantive recommendations that promote consistency and update the content of the ISA. Comprehensive responses from CORE can be found at this link: CORE Submission for the 2024 ISA Open Comment Period. This link has also been posted to relevant pages throughout the ISA, referencing page numbers where edits can be found.

Please note, on page 2 of the linked letter, CORE has made several recommendations that ensure consistency of Operating Rule nomenclature across all pages of the ISA.

Please do not hesitate to contact us with questions.