The analysis conducted under the Certificate Interoperability Initiative has been completed. A summary of the report was delivered to the HIT Standards Committee on August 17th, 2011. The Coordinator of the Certificate Interoperability Initiative is John Hall.
  • To view the full final report including key findings, please click here
  • To view the summary presented to the HIT Standards Committee on August 17th, 2011, please click here


Nationwide exchange of health information requires a fabric of trust that enables secure data transfer and identity assurance among providers, HIEs and other healthcare industry participants. A nationwide trust fabric is greatly facilitated by methods that are secure, standardized, and broadly adopted. These methods help to set and query the identity policies and attributes of standards-based digital certificates, enabling a variety of contexts for secure exchange (signing, encryption, TLS, etc.).

Purpose and Goals

This initiative aligns with Meaningful Use and aims to enable providers to electronically exchange and protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities. The preliminary focus will be on developing an analysis of the issues related to complying with digital certificate requirements for exchanging data with Federal agencies.

Target goals for this Initiative include:
  • Cross-certification of Certificate Authorities (CAs) with Federal Bridge Certificate Authority (FBCAs)
  • Adoption of well-defined standards for certification authorities to issue interoperable digital certificates for organizations and individuals.
  • Minimize costs to obtain, maintain, and use digital certificates
  • Existence of a robust market for reliable digital certificate issuers for healthcare


The preliminary focus of the Initiative is to address the charge of the HIT Standards Committee:

“To enable Direct users to exchange health information with federal health agencies, the HIT Standards Committee recommends that the ONC investigate architectural and operational alternatives for cross-certifying Health ISPs (HISPs) with the Federal Bridge Certificate Authority, including an examination of potential benefits and implications on cost, market dynamics, and complexity”