Multiple technical and policy developments have shifted the interoperability landscape of health information exchange.

In 2012, the Office of the National Coordinator for Health Information Technology (ONC) conducted a first-of-its-kind National Survey on Health Information Exchange (HIE) Among Clinical Laboratories. The survey was conducted in collaboration with NORC as part of the evaluation of the State HIE Cooperative Agreement Program. The goal of the survey was to assess exchange capability and volume of electronic exchange of test results among clinicians and hospitals participating in the Centers for Medicare & Medicaid Services Electronic Health Records Incentive Programs.

Since that survey, new terminology and data exchange standards for interoperability have emerged and gained acceptance, and challenges with the use of specific standards and interoperability remain. New information was needed to better understand the current state of affairs.

NORC evaluated how the electronic exchange of laboratory data has evolved since 2012.

In 2020, ONC tasked NORC with conducting a landscape assessment to explore how lab information exchange had changed over the years and to explore the need for conducting a follow-on national survey of clinical laboratories.

The landscape assessment consisted of a targeted literature review and interviews with a multi-disciplinary group of key informants. The assessment focused on:

• Adoption of standard terminologies, vocabulary, and messaging standards; and implementation guides
• Exchange capabilities of clinical laboratories
• Sharing data with patients
• Public health departments and electronic laboratory reporting