February 26, 2026
AMIA supports the goals of the HTI-5 proposed rule to reduce burden, strengthen interoperability, and expand patient access through standards-based APIs. However, we caution that removing numerous certification criteria, particularly those related to privacy, security, and AI transparency, could introduce unintended risks. We urge clearer safeguards, phased implementation, equity protections, and measurable interoperability benchmarks to ensure sustained and trusted progress in FHIR-enabled data exchange.