Interoperability is operational

A hospital can no longer treat record sharing like a side project run by one integration team in the basement. On April 8, 2026, Epic said its customers became the first to send medical records to the Social Security Administration through the Trusted Exchange Framework and Common Agreement, which is the federal network for moving records across organizations. (epic.com) That matters because the Social Security Administration is not another hospital looking for a discharge note. It uses records to decide disability benefits, and Epic said the new connection can help the agency make determinations up to 50% faster. (epic.com) The federal network behind this is the Trusted Exchange Framework and Common Agreement, a set of common rules from the Office of the National Coordinator for Health Information Technology. The agency says it is meant to remove barriers so providers, patients, public health agencies, and payers can share records electronically beyond their own closed systems. (healthit.gov) The government has been building this for years because a patient’s chart often sits in separate hospital, clinic, lab, and insurer databases like money split across banks that do not talk to one another. The Office of the National Coordinator wrote in October 2025 that Social Security disability claims take roughly 200 days at the initial stage, and faster record exchange is one way to cut that delay. (healthit.gov) Hospitals are also dealing with a second pressure point called information blocking, which is the federal ban on practices that improperly interfere with access, exchange, or use of electronic health information. The Department of Health and Human Services Office of Inspector General says violators can face civil money penalties of up to $1 million per violation. (oig.hhs.gov) So the job has changed for hospital technology chiefs. It is no longer enough to say the electronic record system can export data in theory; hospitals now need production workflows, legal agreements, identity checks, audit trails, and staff who know which records can move to which outside party under which rule. (healthit.gov) (oig.hhs.gov) A third pressure point is the United States Core Data for Interoperability, which is the federal list of data elements that systems are expected to share in a standard way. The Office of the National Coordinator says that list is the common payload for nationwide exchange, and its January 2026 draft version 7 update shows the list is still expanding. (healthit.gov 1) (healthit.gov 2) That sounds abstract until a hospital has to map one blood pressure field, one medication field, and one problem-list field from its own system into the federal format every single time. The January 2026 draft explains that United States Core Data for Interoperability version 3 is already adopted in federal regulation for certain certification criteria, which turns data cleanup into a compliance task instead of a nice-to-have. (healthit.gov) Epic gave a preview of this shift in June 2025 when it said more than 1,000 hospitals were connected to the federal network through Epic Nexus. At the time, Epic said Social Security and the Department of Veterans Affairs were expected to join later that year, and the April 2026 Social Security launch shows those connections are now moving into live use cases. (epic.com 1) (epic.com 2) The hard part in 2026 is not buying one more interface engine. The hard part is hiring people who can turn federal policy into working data flows, because every new outside connection now sits at the intersection of patient privacy, software standards, and agency-specific rules. (healthit.gov 1) (healthit.gov 2)