Interoperability in API-Driven Healthcare IT: ONC Proposal and AI Roadmap

Details

The article analyzes the 'Health Data, Technology, and Interoperability: ASTP/ONC Relaxation of Regulations Proposal' released by the U.S. Office of National Coordinator for Health IT (ONC). The core arguments revolve around three key elements: generative AI, FHIR standardized APIs, and healthcare system interoperability. Drawing upon these, the author proposes a unique framework—the 'IAM Interoperable Smart Grid Layered Technical Architecture' and a 'Four-Dimensional Domain Governance System.' This proposal offers phased implementation guidelines tailored for four types of stakeholders: policy makers, software vendors, medical institutions, and researchers. Furthermore, it maps out a complete development roadmap for the next 10 years covering medical smart agent technology, regulation, and market evolution. The background highlights that despite the widespread adoption of electronic health records in the U.S., chronic issues such as data fragmentation across heterogeneous systems, excessive administrative burden on medical staff, and the limited passive response capability of traditional AI have long constrained healthcare efficiency. The article positions this proposal as a comprehensive solution addressing these systemic problems, offering guidance for American digital transformation from both technical feasibility and risk constraint perspectives. This framework provides valuable insights for policymakers and system developers in Japan, where data linkage challenges and establishing standardization/governance for AI are also critical issues following the adoption of EHRs.