How to Select a Healthcare Interoperability Solution

Knowing how to select a healthcare interoperability solution starts with a simple question. What data does your organization need to exchange, and where does it need to go?

From there, look for interoperability solutions that support the right standards, connect with your existing systems, validate data before transmission, protect sensitive information, and help exchange healthcare data accurately across the systems and organizations involved.

The best choice depends heavily on the use case. A hospital connecting to public health agencies has different care interoperability requirements than a pharmacy querying immunization registries or a laboratory reporting test results across multiple states. The right solutions healthcare organizations consider should reflect those differences, not force every workflow into the same technical model.

That is why feature lists only tell part of the story. Healthcare organizations need to know how a solution performs when real patient data, state requirements, external systems, reporting deadlines, and multiple healthcare partners are involved.

What Are Your Healthcare Data Exchange Requirements?

Start with your actual exchange requirements rather than a long list of platform features.

Effective interoperability requires a clear understanding of every system involved and what needs to happen between them. That may include an EHR sending immunization data to an Immunization Information System, a laboratory sending reportable results to public health agencies, or a provider connecting with a QHIN or HIE.

Document the basics before evaluating vendors.

• Systems that will send and receive information
• Types of clinical or administrative data involved
• Required state or federal reporting destinations
• Message formats and APIs currently in use
• Expected transaction volume
• Response time requirements
• Existing healthcare workflows
• Current interface problems
• Future connections already under consideration

This gives the organization something concrete to evaluate, rather than broad promises about healthcare interoperability. The strongest interoperability solutions enable data to move accurately across the broader healthcare ecosystem while fitting the systems and processes already in place.

It also helps teams avoid building solutions around isolated technical requirements that may not support future connections, reporting needs, or changes in the organization’s exchange environment.

Define the Exact Interoperability Problem First

Healthcare interoperability can mean very different things depending on the organization. Some projects focus on structural interoperability, which allows systems to exchange data in consistent formats, while others require semantic interoperability so receiving systems can interpret and use that information with the intended meaning.

An EHR vendor might need one connection that gives thousands of customers access to public health registries. A national pharmacy chain may need to submit immunizations and retrieve vaccine histories across dozens of jurisdictions. A laboratory may need to determine which results require reporting before sending them to the correct agency.

Those differences matter. Effective interoperability ensures that data not only reaches the correct destination but also arrives in a form that supports the organization’s specific clinical, reporting, or operational requirements. For example, Iron Bridge’s Pub Hub Vaccine Management platform connects organizations with 64 state and territorial immunization registries. Iron Bridge reports that Pub Hub processes more than one million vaccine submissions and more than 1.7 million patient history queries each day.

A pharmacy evaluating an interoperability solution for IIS connectivity should therefore ask different questions than a hospital focused on clinical document exchange. Organizations should also determine whether standard functionality can address their needs or whether certain workflows call for custom solutions built around specific systems, destinations, or data requirements.

Map Each Connection

Create a simple map of the data path. For an immunization workflow, that might look like this.

1. The pharmacy or EHR creates an immunization record.
2. The integration platform receives the data.
3. The platform checks required fields and state-specific rules.
4. The record goes to the appropriate IIS.
5. The IIS returns an acknowledgment or error.
6. The originating system receives the status.

This exercise often exposes requirements that disappear in a high-level architecture diagram.

One state may expect different fields than another. An endpoint may require a different transport method. The organization may also need real-time status information after submitting a record.

Look for a solution that handles those details without forcing your team to manage every jurisdiction as a separate project.

Verify Standards Support Beyond the Checkbox

Standards matter, but simply asking whether a vendor supports HL7 or FHIR does not go far enough. Healthcare still relies on a combination of HL7 Version 2 messages, FHIR APIs, standardized terminology, implementation guides, and organization-specific data structures.

Ask what the vendor actually supports within your workflow.

Look Closely at FHIR Capabilities

FHIR plays an increasingly important role in U.S. healthcare data exchange, especially when organizations need standardized API access to clinical information. The current HL7 US Core Implementation Guide is version 9.0.0 and uses FHIR R4. It defines U.S. profiles and RESTful interactions for common clinical data, which makes it a useful benchmark when evaluating a vendor’s FHIR capabilities. A vendor that claims FHIR support should be able to explain which US Core profiles, search parameters, resource requirements, and implementation guides its platform actually supports.

Organizations evaluating FHIR support should also ask about

• Supported FHIR versions
• US Core profiles
• Required implementation guides
• Search parameters
• Resource validation
• Terminology support
• Authentication
• API monitoring
• Version management

A platform should also accommodate organizations that are not ready to replace older standards.

Iron Bridge’s Pub Hub Data Integration services support environments where legacy applications, HL7 messages, APIs, FHIR-based services, HIEs, and QHIN connections may all exist at the same time.

That becomes important when an organization wants to introduce modern exchange methods without replacing every source system first.

Check How the Solution Handles Public Health Reporting

Public health interoperability deserves special attention because requirements can vary by jurisdiction and reporting program.

Organizations may need to support immunization reporting, electronic laboratory reporting, electronic case reporting, and syndromic surveillance.

Each workflow brings different rules. A good interoperability solution should help manage those differences rather than simply transmit whatever data it receives.

Evaluate Immunization Registry Connectivity

IIS connectivity involves more than sending an HL7 VXU message.

Organizations may also need state-specific validation, patient matching, acknowledgments, historical vaccine queries, forecasting information, code maintenance, and onboarding support.

Iron Bridge’s Pub Hub Vaccine Management platform provides multiple methods for querying patient immunization histories, including real-time API queries, a user interface, and batch queries. It also supports dynamic state-specific validation before immunization data reaches an IIS.

Organizations should examine that level of detail during product demonstrations.

Ask the vendor to show what happens when a required field is missing or a state rejects a record.

Examine Electronic Laboratory Reporting Capabilities

ELR presents a different set of challenges. Laboratories and other healthcare organizations must first determine whether a result meets reporting criteria. They may also need to account for LOINC codes, SNOMED CT codes, reference ranges, patient characteristics, jurisdiction rules, and changes in reportable conditions. A basic message router may not address those requirements.

Iron Bridge’s Pub Hub RapidReport electronic laboratory reporting solution lets organizations configure reportable conditions using criteria such as LOINC, SNOMED CT, age, and reference ranges. RapidReport also integrates directly with laboratory information systems and gives users insight into the logic applied to reportable results. When comparing ELR products, ask whether reporting logic can change without extensive development work. Also find out who maintains that logic when public health requirements change.

Consider eCR and Syndromic Surveillance Requirements

Electronic case reporting and syndromic surveillance add another layer to public health exchange. eCR supports automated transmission of reportable case information to public health agencies. Syndromic surveillance gives public health departments timely data that can help them recognize emerging patterns and investigate potential public health concerns.

Organizations that need these workflows should evaluate destination coverage, automated submission capabilities, data security, monitoring, and reporting status. Iron Bridge provides eCR and Syndromic Surveillance through Pub Hub, including connectivity to state syndromic surveillance registries and electronic case reporting workflows.

This can matter for hospital systems, EHR vendors, urgent care organizations, and other providers that need several public health reporting services from the same integration environment.

Evaluate Data Validation Before Transmission

Bad data can travel just as quickly as good data. That makes validation one of the most important capabilities to evaluate.

A healthcare interoperability solution should catch problems before they create downstream work whenever possible.

Look for validation that can identify

• Missing required fields
• Invalid codes
• Incorrect formats
• Unsupported values
• Incomplete patient information
• Destination-specific requirements
• Message structure errors

Then find out what happens next.

Does the platform provide a specific error message? Can a user tell which rule failed? Can the originating application receive structured error information?

Iron Bridge’s vaccine services, for example, provide codified error responses that identify failed validations. This helps developers and healthcare teams find problems without interpreting a vague rejection message.

Make Sure the Platform Can Transform Data

Healthcare organizations rarely operate with one data model.

An EHR may create information in one format while a registry, laboratory, payer, or network expects another. The interoperability layer may need to translate formats, map fields, standardize terminology, or restructure data before transmission.

Ask vendors how they handle

• HL7 transformations
• FHIR resources
• JSON payloads
• Local code mapping
• Standard terminology
• Custom fields
• Destination-specific formats

Also ask who maintains the mappings. A platform that works during implementation but requires custom development every time a source field changes can create an expensive maintenance problem.

Review Error Handling and Transaction Visibility

Interfaces fail. Endpoints go offline. Credentials expire. A receiving system changes a requirement. Patient information fails validation. Messages may also reach their destination but return an unexpected acknowledgment.

Your team needs to know when those things happen. Ask vendors to demonstrate a failed transaction during the evaluation.

Look for clear answers to questions such as

• Can users search individual transactions?
• Does the system retain acknowledgments?
• Can staff identify why a message failed?
• Does the platform retry failed transmissions?
• Can users see whether the receiving endpoint responded?
• Are technical teams alerted to recurring failures?

The goal is not to eliminate every possible error. The goal is to make problems visible and actionable.

Review Security as Part of the Architecture

Healthcare interoperability platforms routinely process protected health information.

Security therefore needs to be part of product evaluation, not a final procurement checklist.

Review encryption in transit and at rest, access controls, audit logging, infrastructure security, backups, vulnerability testing, authentication methods, and incident response procedures.

Organizations should also examine compliance with the HIPAA Security Rule and determine how the vendor limits administrative access to sensitive data.

Do not stop at a general claim that the product is HIPAA-compliant.

Ask what controls protect data as it enters the platform, moves between systems, and remains available for troubleshooting or reporting.

Check Current Federal Interoperability Requirements

A healthcare interoperability platform also needs to support an environment where federal data requirements keep changing.

For organizations that use or integrate with certified health IT, the ASTP and ONC HTI-1 Final Rule provides an important reference point. The rule made USCDI Version 3 the baseline standard in the ONC Health IT Certification Program on January 1, 2026, and expanded standardized data requirements that support areas such as public health interoperability. That means vendors serving EHR developers, providers, and public health workflows need a clear process for keeping mappings and supported data elements current.

Ask vendors how they respond when standards change. Who updates the platform? How are new data requirements tested? What work falls to your internal team?

Those answers matter as much as present-day compliance.

Consider CMS API Requirements

The same forward-looking approach applies when interoperability involves payers.

The CMS Interoperability and Prior Authorization Final Rule requires impacted payers to implement or enhance several FHIR-based APIs, with most API compliance dates beginning January 1, 2027. Those requirements include Patient Access, Provider Access, Payer-to-Payer, and Prior Authorization exchange. Organizations building payer connections should therefore evaluate whether their interoperability architecture can support standardized FHIR-based data exchange without requiring another isolated integration layer later.

This does not mean every provider needs a payer interoperability platform today.

It does mean healthcare organizations should avoid making integration decisions that leave no practical path toward the exchange models their partners may soon require.

Think About QHIN and HIE Connectivity

Not every interoperability project stops at one trading partner.

Hospitals, physician groups, and other providers may also need access to broader health information networks. Ask whether the solution can support HIE participation and connections to Qualified Health Information Networks without requiring the organization to create another disconnected integration architecture.

Iron Bridge includes a QHIN and HIE On-Ramp within its Pub Hub Data Integration offering. The service helps healthcare providers connect with nationwide and regional exchange networks while maintaining an integration layer between existing systems and external networks. For organizations planning broader data exchange, this deserves attention early in the selection process.

Understand the Implementation Work

A good product can still become a difficult project when responsibilities remain unclear.

Before signing a contract, determine who handles each part of implementation. That includes

1. Technical discovery
2. Source system configuration
3. Mapping and transformation
4. Registry or trading partner enrollment
5. Interface testing
6. Validation
7. Production approval
8. Error resolution
9. Ongoing updates

Public health projects can involve more than technology. Someone may need to coordinate with state agencies, complete enrollment paperwork, test messages, resolve validation issues, and track approvals before production traffic begins.

Ask vendors exactly how much of that process they manage.

Test the Product With Realistic Scenarios

A polished demonstration can make almost any platform look easy.

Make the evaluation harder. Give vendors examples that resemble your actual environment.

Ask a vaccine interoperability vendor to show how the platform handles a state-specific validation error. Ask an ELR vendor how a newly reportable condition gets configured. Ask a data integration vendor how it translates a legacy message into the format required by a modern API.

You should leave the demonstration knowing how the platform behaves when something goes wrong. That information often proves more useful than seeing another successful transaction.

Use a Scorecard to Compare Healthcare Interoperability Solutions

Once you have narrowed the field, score vendors against the same requirements.

Useful categories include:

• Support for required HL7 and FHIR standards
• EHR and LIS integration
• IIS connectivity
• ELR capabilities
• eCR and syndromic surveillance
• Data validation
• Mapping and transformation
• FHIR APIs
• QHIN and HIE connectivity
• Security controls
• Error monitoring
• Transaction visibility
• Public health onboarding support
• Regulatory updates
• Implementation responsibilities
• Support after launch
• Total cost of ownership

Not every category deserves the same weight. A retail pharmacy may put registry access and patient vaccine queries near the top. A laboratory may care much more about reportable condition logic, LIS integration, and state ELR connectivity.

The scorecard should reflect the work your organization actually needs to accomplish.

Choose a Solution Built Around the Exchange You Need

Knowing how to select a healthcare interoperability solution comes down to understanding the complete data journey.

Look beyond whether a vendor says it supports HL7, FHIR, or APIs. Find out where the data goes, how the platform validates it, how it deals with different state and trading partner requirements, what happens when a transaction fails, and how easily you can add another connection later.

Those details separate a working interoperability program from another collection of interfaces your team must maintain.

Iron Bridge helps hospitals, EHR vendors, laboratories, pharmacies, urgent care organizations, long-term care providers, and other healthcare organizations connect with public health registries and broader healthcare networks.

Explore Iron Bridge solutions for vaccine management, ELR, eCR, syndromic surveillance, FHIR enablement, and healthcare data integration, or schedule a demo to discuss the connections your organization needs.