In 2012, NORC at the University of Chicago conducted the National Survey on Health Information Exchange (HIE) in Clinical Laboratories for the Office of the National Coordinator (ONC). This first-of-its-kind study was part of the State HIE Cooperative Agreement Program evaluation. The goal of the HIE survey was to assess the capability and actual volume of the electronic exchange of test results with clinicians and hospitals participating in the Centers for Medicare & Medicaid Services (CMS) Electronic Health Records (EHR) Incentive Programs. 

In 2020, NORC conducted an environmental scan as a follow-up to the original HIE survey. Multiple technical and policy developments since 2012 have shifted the interoperability landscape. Notably, new interoperability standards for data exchange and terminology have emerged and gained acceptance, although challenges with using specific standards and interoperability remain. The ONC contracted NORC to understand how the electronic exchange of laboratory data has evolved since 2012, emphasizing the use of standards (i.e., vocabulary and messaging standards) and the challenges experienced. Due to the COVID-19 pandemic, ONC was also interested in understanding how information was flowing through the public health system (i.e., potentially from hospital and commercial laboratories to public health departments), as well as the electronic capability of public health laboratories and agencies to exchange information on reportable diseases and conditions. 

The final report summarized our assessment of the interoperability landscape for ONC leadership, staff, and partners. It also defined new areas of focus for a survey refresh and provided recommendations on the content and methodology that should be retained for the next iteration of the survey.