Health data interoperability — HTI-1 USCDI v4 and decision support controls
Certified EHR developers and healthcare providers must finish upgrades by late 2025 to meet the ONC HTI-1 rule’s 1 January 2026 deadlines for USCDI v4 data support and trustworthy decision support disclosures.
Executive briefing: The Office of the National Coordinator’s Health Data, Technology, and Interoperability: Certification Program Updates, Algorithm Transparency, and Information Sharing (HTI-1) final rule (88 FR 85928) sets 1 January 2026 compliance dates for several Conditions and Maintenance of Certification requirements. Certified health IT must support United States Core Data for Interoperability (USCDI) Version 4 in the standardised FHIR API and deliver decision support intervention (DSI) transparency artifacts. By October 2025, EHR developers and provider organisations need deployment-ready builds, governance, and training to avoid certification lapses and information blocking exposure.
Compliance checkpoints
- USCDI v4 payloads. §170.213 requires adoption of USCDI v4 data classes, expanding medication, social determinants, and provenance data exchanged through APIs.
- FHIR API updates. §170.315(g)(10) mandates conformance to the HL7 FHIR US Core Implementation Guide v6.0.0 and SMART 2.0 security profiles.
- DSI transparency. §170.315(b)(11) obliges certified developers to generate standardized documentation describing algorithm purpose, training data, and risk management for clinical decision support interventions.
Operational build
- Complete development, validation, and deployment of API upgrades across production environments, including integration partner testing.
- Curate DSI documentation libraries with provenance, governance, and risk controls that clinicians can review at the point of care.
- Update change management, training, and customer communication plans so providers adopt new data classes and documentation workflows before the compliance date.
Enablement moves
- Align HTI-1 workstreams with information blocking compliance to ensure new capabilities support permissible data sharing.
- Engage payers, health information networks, and public health agencies to validate downstream consumption of USCDI v4 elements.
- Establish governance boards overseeing DSI lifecycle management, bias monitoring, and clinician feedback loops.
Sources
Zeph Tech partners with health IT developers and providers to deliver HTI-1 upgrades—accelerating API enhancements, DSI transparency, and training programmes.