HHS Budget Proposal Funds New CTO Office to Advance Interoperability

The Department of Health and Human Services’ (HHS) proposed restructuring of its chief technology office will give developers the time and space to build more capabilities for electronic health record (EHR) modernization, federal leaders said at the 2025 Health IT Summit.

Avinash Shanbhag, associate deputy and executive director at the Office of Standards, Certification and Analysis for the Assistant Secretary for Technology Policy (ASTP), said during the event that interoperability will drive AI adoption and integration into EHR modernization.

“Hopefully the EHR developers will now have the space and time to focus on interoperability and we expect them to actually advance and build out on capabilities with perhaps more AI functionality such as the model context protocols or A2A, agent to agent, capabilities,” Shanbhag said.

HHS Discretionary Budget Calls for New CTO Office

HHS’ $94.7 billion discretionary budget proposal for fiscal year 2026 targets areas like digital infrastructure, EHR modernization and interoperability. It also allocates $130 million to establish the CTO office under the chief information officer.

The new CTO will focus on promoting a nationwide, interoperable health IT infrastructure to ensure providers and patients can efficiently and securely exchange electronic information across all levels of the health care continuum. The CTO will also be responsible for continuing Trusted Exchange Framework and Common Agreement (TEFCA) implementation.

Open APIs ‘Unleash’ Federal Health Data

Kyle Cobb, acting deputy director for Technology and Products in the Office of Public Health, Data, Surveillance and Technology at the Center for Disease Control (CDC), said that APIs have unleashed the potential of health care data to contribute to public health outcomes.

“APIs have unleashed this amount of data which we are now trying to organize and figure out and distribute in ways that are meaningful,” Cobb said. “We’re trying to figure out new models and ways to really leverage health care data that could easily be accessed through open APIs for public health in any number of ways.”

Cobb said interoperability has advanced EHR modernization but also raised new challenges in managing the growing complexity of distributed models and point-to-point connections. She noted that standardized data collection from states helps ease this burden for the agency.

“At the CDC we have core [data use agreements (DUA)] with the states and for data collection in emergency response and every state gets the same core DUA for signature. We’re working through the states and this is a new initiative for CDC, but it allows us to have somewhat of a federated model where we’re collecting the same data from each state and it’s completely transparent. The backbone of these things has to be standards,” Cobb said.

Ben Cushing, Chief Architect, Health and Life Sciences at Red Hat, said that the economics of data distribution necessitates APIs, which are capable of gaining access to data without having to move it between servers.

“Moving data around is incredibly expensive and so we have to look at data that exists across multiple clouds whether it’s on prem, in a cloud, in Azure, in AWS, in Oracle, in IBM …we have to be able to move the inference and the compute to where the data resides. To do that, APIs are incredibly important for gaining access to that data,” Cushing said.

HHS Turns to Industry to Support Interoperability

Shanbhag encouraged industry to take up the mantle of driving interoperability using APIs, with government serving as the foundation underpinning their systems.

“We are at a stage now with the API access, with data semantics, that some of you could build some app that can essentially ‘kill the clipboard’ and that was not possible a decade ago when we started our journey to digitize the first decade of health record technologies,” Shanbhag told the audience. “We are now at this juncture where we can envision a variety of use cases now as a government … where my office, and I think broadly government, is leaning in is building the foundation.”