US Healthcare Interoperability Accelerates via TEFCA and FHIR: Data Sovereignty and AI Key

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The US is advancing its healthcare IT infrastructure through initiatives led by CMS and ONC. Interoperability relies on a 'dual track' approach: TEFCA establishes the national trust and governance framework for data exchange, while the CMS-led ecosystem accelerates innovation using FHIR and APIs. Technically, the goal is enabling patients to access all medical records via a single ID, alongside building nationwide provider directories and breaking down silos between billing and clinical data. Crucially, 'data sovereignty' is emphasized, giving users clear control over their data access. AI applications are being used in areas like end-of-life care decision support, employing LLMs and multi-agent systems to extract structured data from EHRs and improve workflows. Furthermore, services like Amazon Health AI move beyond simple chatbots by integrating personal data and HIE connections to provide a closed loop from consultation to treatment. These developments highlight the critical need for standardized data governance and infrastructure development, offering valuable insights for Japan's healthcare system.