National Survey of Health Information Exchange Organizations (HIO) - 60-Day Comment Request

Notice

Agency Information Collection Request; 60-Day Public Comment Request

A Notice by the Health and Human Services Department on 04/20/2026

• This document has a comment period that ends in 65 days.
  (06/22/2026) View Comment Instructions

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• Public Inspection Published Document: 2026-07642 (91 FR 21006) Document Headings ###### Department of Health and Human Services

1. [Document Identifier: OS-0955-0019]

AGENCY:

Office of the National Coordinator for Health IT, Office of the Secretary, HHS.

ACTION:

Notice.

SUMMARY:

In compliance with the requirement of the Paperwork Reduction Act of 1995, the Office of the Secretary (OS), Department of Health and Human Services, is publishing the following summary of a proposed collection for public comment.

DATES:

Comments on the ICR must be received on or before June 22, 2026.

ADDRESSES:

When commenting, please reference the document identifier/OMB control number OS-0955-0019 and title of collection, “National Survey of Health Information Exchange Organizations (HIO)”. You may send your comments electronically to Wei Chang, wei.chang@hhs.gov.

FOR FURTHER INFORMATION CONTACT:

To obtain copies of supporting material for the proposed collection(s) summarized in this notice, please include the document identifier OS-0955-0019 and title of collection “National Survey of Health Information Exchange Organizations (HIO)” for reference, and address inquiries to Wei Chang, wei.chang@hhs.gov, or call 202-706-8913.

SUPPLEMENTARY INFORMATION:

Interested persons are invited to send comments regarding this burden estimate or any other aspect of this collection of information, including any of the following subjects: (1) The necessity and utility of the proposed information collection for the proper performance of the agency's functions; (2) the accuracy of the estimated burden; (3) ways to enhance the quality, utility, and clarity of the information to be collected; and (4) the use of automated collection techniques or other forms of information technology to minimize the information collection burden.

Title of the Collection: National Survey of Health Information Exchange Organizations (HIO).

Type of Collection: Revision of a previously approved collection.

OMB No.: 0955-0019.

Abstract: Electronic health information exchange (HIE) was one of three goals specified by Congress in the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act to ensure that the $30 billion federal investment in certified electronic health records (EHRs) resulted in higher-quality, lower-cost care. Subsequent legislation and regulations have continued to prioritize the sharing of data electronically across EHRs and other health information systems. Within the Department of Health and Human Services, the Office of the National Coordinator for Health IT (hereafter ONC) is responsible for coordinating across the federal government, industry, and the health care community to achieve nationwide interoperability of electronic health information exchange. Health information exchange organizations (HIOs) play a pivotal role facilitating health information exchange across disparate providers, labs, pharmacies, public health departments, and others. This information collection request will gather data from HIOs across the nation through the administration of a survey of HIOs to generate the most current national statistics and associated actionable insights to inform policy efforts. The timely collection of national data from our survey will assess current capabilities of HIOs to support effective electronic information sharing within the U.S. health care system and further aims to achieve nationwide interoperability.

Since prior to HITECH there has been ongoing assessment of trends in the capabilities of HIOs to support clinical exchange through nationwide surveys of HIOs. These prior surveys and studies have collected data on organizational structure, financial viability, geographic coverage, scope of services, implementation and use of standards, perceptions of information blocking, support for public health exchange, and participation in networks and the Technical Exchange Framework and Common Agreement (TEFCA). Continuing the ongoing data collection will be critical to construct a current and comprehensive picture of HIOs' role in facilitating exchange and ensuring rapid access to important health care data and information when it matters most, including vital data to address public health emergencies.

The survey will collect data on HIO capabilities to support electronic health information exchange, their maturity, and challenges they face. There are five key areas that require assessment: (1) adoption of technical standards; (2) perceptions related to information blocking; (3) network-to-network connectivity and TEFCA; (4) public health data exchange; and (5) organizational demographics, including technical capabilities offered by HIOs and the challenges they face in supporting electronic health information exchange.

The survey is being revised (previously approved in 2022 and 2024; ( printed page 21007) OMB Control No: 0955-0019) to reflect progress made and ongoing efforts in areas including public health, TEFCA, and information blocking to ensure alignment with current priorities such as improving public health interoperability and Make Health Tech Great Again. These updates were developed in consultation with subject matter experts (SMEs) to improve the relevance, clarity, and usefulness of the data collected in all five key areas of the survey. For example, certain questions with low response rates and have lower relevance to current priorities have been removed or reorganized. Some question and response wording have also been updated to ensure consistency with current policy efforts. For example, in the TEFCA section, the list of Qualified Health Information Networks (QHINs) have been updated to reflect the current list. These changes are intended to reduce respondent burden and improve overall data quality while maintaining continuity with prior surveys where appropriate.

This is a 3-year request for OMB approval.

| Forms
(if necessary) | Respondents
(if necessary) | Number of
respondents | Number of
responses per
respondents | Average
burden per
response
(hours) | Total burden hours |
| --- | --- | --- | --- | --- | --- |
| | U.S. based public and private HIOs | 100 | 1 | 0.75 | 75 |
| Total | 75 |
Based on a review of the information collection since our last request for OMB approval, we have made no adjustments to our burden estimate.

Catherine Howard,

Paperwork Reduction Act Reports Clearance Officer, Office of the Secretary.

[FR Doc. 2026-07642 Filed 4-17-26; 8:45 am]

BILLING CODE 4150-45-P

Published Document: 2026-07642 (91 FR 21006)