Interoperability Initiatives Environmental Scan

This Environmental Scan was created to provide an image of the current landscape in which interoperable, nationwide health information exchange occurs. The following entities were included given their work to address interoperability needs via a variety of methods and collaborations. This Scan offers a wide range of details on each entity, including overview information, their method of exchange, and details on the stakeholders and processes involved. Please use the filters to review all information gathered for each entity. A full version of the scan is available for download, and further details on each entity is available by clicking on their organization link.

The information gathered from this scan was leveraged in the creation of the HIMSS Interoperability Call to Action, which provides principles to drive interoperability forward.

The Environmental Scan will be updated regularly as new interoperability approaches gain traction or new efforts evolve from these existing entities. If you have suggestions on updates, new organizations, or additional considerations, please email

View a list of Interoperability Environmental Scan Acronyms & Definitions.

Use the scrollbar to view additional criteria. Select an organization to view the full description.
Organization Governance Website Type How does this approach facilitate exchange? Access Method (use cases) Number of live connections and/or participants Members Primary Participants Costs (Amount and/or Party Incurring Cost) Directory/MPI Details Standards Leveraged Onboarding Process (Requirements to connect) Data Persistance Certification Requirements for Participation Testing Future Plans Current Collaboration across Efforts
Care Everywhere

Governed by a peer-elected Governing Council and associated Rules of the Road agreements. Provider-centric network

Care Everywhere is an HIE platform that is primarily a federated model that is controlled by the patient and can be used... More

Push and pull exchanges are embedded within Epic applications used by providers and consumers:

  ▪  Advanced record... More

100% of Epic’s U.S. customers using clinical applications, or over 1,700 hospitals and 34,000 clinics are live on Care... More

Not applicable

Patients, Hospitals, Clinics, CINs, ACOs, Payers, Pharmacies, and Retail Clinics

Care Everywhere is free to use for treatment and care coordination, regardless of the exchange partners technology platform... More

Care Everywhere facilitates automatic distribution of exchange-ready providers and healthcare organizations regardlesss of... More

Care Everywhere exchanges information using industry standard transport protocols.Query Approach: Transactions from the XCA... More

Care Everywhere is natively integrated into the Epic EHR and does not require a separate implementation process.  

... More

Federated Model: There is no centralized hub or data storage. No data flows through Epic servers involved in the exchange... More

There are no certification requirements.

Standard connectivity testing is conducted during the initial implementation.  New sites are connected with no additional... More

Extend the content of documents exchanged to match the needs of specialists. Each provider should find information relevant... More

Care Everywhere is an implementer of the Carequality Framework. (... More

Community HIE

Governed by Participant Agreements, usually in turn governed by a Board of stakeholders. In some cases governed by State or... More


Community-based HIE organizations serve states or specific regions to provide services to enable the sharing of information... More

Various use cases include: ADT alerts, results delivery, electronic order delivery, order entry, query, public health... More

Varies, depending upon the capabilities of the HIE.  While some HIEs place focus on a particular type of member (hospital,... More

Members may range from providers, provider organizations, post-acute care organizations, private labs and other ancillary... More

Systems may include nearly any EHR, lab, pharmacy, or other HIT system, payer systems

Varies greatly depending on funding mechanisms, grant funding, capabilities of the HIE and size of HIE staff.

Various levels of centralized resources necessary to meet participant needs though most maintain a master-patient index... More

Varied use of IHE standards, HL7 standards, C-CDA standards, and/or a combination of these and other standards.

Varies, depending upon the capabilities of the HIE and the needs of the members/customers.

Varies, depending upon the capabilities of the HIE. Some are based upon query/retrieve models, while others persist data in... More

Depending upon the services provided by the HIE, many have received certification for portion of their solutions in order... More

Generally, standard test scripts based upon transaction type and required minimum content.

Varies by HIE
Growing focus on providing data cubes for analytics, expanding available clinical and claims data along... More

Numerous community HIEs are DirectTrust members, with some even serving as accredited HISPs for the implementation of... More