Abbasi Ali B, Layden Jennifer, Gordon William, Gregurick Susan, DeLew Nancy, Grossman Jordan, Bierman Arlene S, Monarez Susan, Curtis Lesley H, Viall Abigail H, Rocca Mitra, Rivera Donna R, Marston Hilary, Mugge Alexandra, Smith Scott R, Bent Katherine, Macrae James, Sheehy Ann, Wegrzyn Renee D, Valdez R Burciaga, Johnson Carole, Bush Laina, Blum Jonathan, Cohen Mandy K, Bertagnolli Monica M, Califf Robert M, Tripathi Micky
US Food and Drug Administration, Silver Spring, Maryland.
Centers for Disease Control and Prevention, Atlanta, Georgia.
JAMA. 2025 Mar 25;333(12):1074-1079. doi: 10.1001/jama.2025.0068.
Health information technology, such as electronic health records (EHRs), has been widely adopted, yet accessing and exchanging data in the fragmented US health care system remains challenging. To unlock the potential of EHR data to improve patient health, public health, and health care, it is essential to streamline the exchange of health data. As leaders across the US Department of Health and Human Services (DHHS), we describe how DHHS has implemented fundamental building blocks to achieve this vision.
Across DHHS, we have implemented 3 foundational building blocks called for by the 2016 21st Century Cures Act to create a unified approach for secure, high-quality, and timely exchange of health data across the health care system. The United States Core Data for Interoperability provides a minimum baseline for data elements that must be available in federally regulated health information technology systems such as certified EHRs. These data elements now must be accessible using Fast Healthcare Interoperability Resources-a secure, flexible, and open-industry standard for health data exchange. The Trusted Exchange Framework and Common Agreement provides a network to securely exchange health data across the country. The 3 building blocks of United States Core Data for Interoperability, Fast Healthcare Interoperability Resources, and Trusted Exchange Framework and Common Agreement are now in place thanks to diligent public and private sector work over 2 administrations. Across DHHS, we are working to refine these building blocks and increase their adoption through regulatory authorities, grants, and public-private partnerships.
The technological building blocks described in this article are creating a unified approach to health data exchange for patient access, clinical care, quality improvement, scientific research, public health, and other uses of health data. Collaborations between the public, nonprofit, and private sectors are needed to maximize their potential. By unlocking the potential of health data, these building blocks are the foundation of a 21st-century digital health care system that will improve the experience of patients and clinicians and result in better health outcomes.
诸如电子健康记录（EHR）之类的健康信息技术已被广泛采用，但在美国分散的医疗保健系统中访问和交换数据仍然具有挑战性。为释放EHR数据改善患者健康、公共卫生和医疗保健的潜力，简化健康数据交换至关重要。作为美国卫生与公众服务部（DHHS）的领导，我们描述了DHHS如何实施基本要素以实现这一愿景。
在整个DHHS，我们实施了2016年《21世纪治愈法案》要求的3个基础要素，以创建一种统一方法，实现医疗保健系统中健康数据的安全、高质量和及时交换。美国互操作性核心数据为联邦监管的健康信息技术系统（如认证的EHR）中必须可用的数据元素提供了最低基线。现在必须使用快速医疗保健互操作性资源来访问这些数据元素，这是一种用于健康数据交换的安全、灵活且开放的行业标准。可信交换框架和共同协议提供了一个在全国范围内安全交换健康数据的网络。由于两届政府期间公共和私营部门的辛勤工作，美国互操作性核心数据、快速医疗保健互操作性资源以及可信交换框架和共同协议的这3个要素现已到位。在整个DHHS，我们正在努力完善这些要素，并通过监管机构、拨款和公私合作伙伴关系提高其采用率。
本文所述的技术要素正在创建一种统一的健康数据交换方法，用于患者访问、临床护理、质量改进、科学研究、公共卫生以及健康数据的其他用途。需要公共、非营利和私营部门之间的合作以最大限度地发挥其潜力。通过释放健康数据的潜力，这些要素是21世纪数字医疗保健系统的基础，该系统将改善患者和临床医生的体验并带来更好的健康结果。
