Standards, Interoperability, and Trust in Health IT

Presente by Google and Carahsoft

Interoperability and trust sit at the core of federal health IT modernization, and few organizations are more central to that effort than the Office of the National Coordinator for Health IT. Molly Prieto, Principal Deputy Director of the Office of Standards, Certification, and Analysis within ASTP/ONC at HHS, explains that standards-based certification has long been the foundation for enabling systems to securely exchange information across providers, hospitals, and patients.

rieto notes that despite years of progress, patients still experience fragmented care through multiple portals and disconnected systems. Standards are the key to solving that problem. By ensuring health IT systems “speak the same language,” clinicians can access complete patient histories regardless of where care is delivered, and patients gain better access to their own information.

ONC’s voluntary certification program plays a critical role in this effort. While participation is not mandatory, it is reinforced by CMS payment incentives that encourage providers to adopt certified, standards-based technology. Prieto emphasizes that certification criteria are continually updated to reflect modern standards and emerging technologies, ensuring the program supports innovation rather than hindering it.

As artificial intelligence becomes more prevalent in healthcare, transparency has taken on heightened importance. Prieto stresses that clinicians must understand how AI tools generate outputs in order to trust and use them effectively. Certification requirements increasingly emphasize transparency around data inputs, algorithms, and system behavior, helping providers make informed decisions and avoid “black box” technologies.

Justin Kerr, Principal Architect at Google Public Sector, expands the discussion by focusing on ecosystems that sit alongside formal standards. While interoperability provides the technical foundation, Kerr argues that cultural and operational change ultimately determines whether innovation succeeds. Voluntary initiatives and cross-industry collaboration help bridge gaps where standards may still be evolving.

Kerr highlights efforts to eliminate redundant paperwork and improve patient experiences, noting the frustration many people feel when asked to repeatedly provide the same information. He also points to real-world examples in maternal and rural health where mobile devices, wearables, and virtual assistants extend care beyond traditional clinical settings. These approaches improve accessibility while reducing strain on providers.

Together, Prieto and Kerr underscore that trust is built through a combination of standards, transparency, and collaboration. When systems are interoperable, secure, and understandable, providers are more willing to adopt new tools, and patients are more confident in how their data is used. The result is a health IT ecosystem that supports innovation while maintaining accountability and public confidence.