Top Health Informatics News From Q1 2026: What You Need to Know

Health informatics had a busy 1st quarter in the US, and honestly, a lot of the movement was not random noise. Since the start of 2026, the biggest developments in health informatics pointed to a few clear themes: AI is moving deeper into clinical care policy, interoperability is becoming more tangible, prior authorization reform is getting more operational, and cybersecurity is still a major pressure point for every organization handling patient data (HHS, 2025; HHS, 2026; CMS, 2026).

That matters because health informatics is where healthcare technology stops being theory and starts affecting real workflows, real patients, and real costs. If you work in digital health, EHR operations, analytics, product, informatics, or even healthcare leadership, Q1 2026 gave you a pretty strong read on where the rest of the year may be headed. Some of these stories were policy heavy, some were infrastructure moves, and some were the kind of updates that will quietly shape roadmaps for months (ASTP, 2026; FDA, 2026; CMS, 2026).

AI Took a Bigger Seat

One of the clearest stories of the quarter was the federal government’s push to get more specific about artificial intelligence in clinical care. HHS announced a request for information asking for broad public input on how the department should accelerate the adoption and use of AI as part of clinical care, with questions touching regulation, reimbursement, research, and patient safety. The goal was not framed as a narrow tech exercise. It was framed as a system level question about how AI should fit into care delivery across HHS programs and policy levers (HHS, 2025).

That is a big deal for healthcare technology because it signals that AI is moving out of the vague hype zone and into concrete questions about payment, oversight, implementation science, and clinical workflow. In plain English, the government is asking how AI tools can be used in care without blowing up safety, creating messy incentives, or adding more confusion for providers. That shift matters for health systems, vendors, startups, and informatics teams trying to figure out what will actually be encouraged or tolerated in the near term (HHS, 2025; Regulations.gov, 2026).

Q1 also showed that the AI conversation is getting more specific by use case. On January 29th, ASTP released a request for information focused on diagnostic imaging interoperability standards and certification, asking whether technical standards and certification criteria could improve how diagnostic images are accessed, exchanged, and used through certified health IT. The comment period runs through March 16, 2026, which shows that imaging data flow is now being treated as a major interoperability and AI related issue, not some niche side topic (ASTP, 2026).

Interoperability Finally Felt More Real

Interoperability has been one of those healthcare buzzwords that sounds great and often feels painfully slow. Q1 2026 gave the space something more concrete. In February, HHS announced that nearly 500 million health records had been exchanged through TEFCA, the Trusted Exchange Framework and Common Agreement. The same announcement said that figure was up from roughly 10 million in January 2025, which is a huge jump in a relatively short time (HHS, 2026).

That does not mean interoperability is solved. Far from it. But it does mean the national exchange conversation is no longer just about potential. TEFCA is starting to look more like real infrastructure. When more records can move through a common framework, the downstream effects can touch care coordination, public health, benefits determination, analytics, and patient access. For people working in health informatics, this is one of the most meaningful signals from the quarter because it points to broader data liquidity across organizations that historically have not played nicely together (HHS, 2026; ASTP, 2026).

ASTP also highlighted another important interoperability move in Q1 with Draft USCDI v7, released on January 29, 2026. According to ASTP, the draft includes 29 proposed data elements and 1 significantly revised data element to strengthen nationwide interoperability. The update was tied to areas like adverse event reporting, nutrition information exchange, and quality improvement. That may sound technical, but these data definitions are the plumbing behind more consistent exchange and more useful health data across systems (ASTP, 2026).

This is where health informatics gets very real. Better exchange is not only about moving a PDF from one place to another. It is about making data more usable, more standardized, and easier to integrate into EHR workflows, analytics pipelines, patient apps, and decision support. Q1 2026 did not finish that job, but it definitely pushed it forward (ASTP, 2026).

Prior Authorization Pressure Kept Building

Another major Q1 story sat at the intersection of interoperability and administrative burden. CMS continued moving the industry toward the operational realities of its Interoperability and Prior Authorization Final Rule. CMS says the rule is meant to improve health information exchange and prior authorization processes, with certain provisions taking effect by January 1, 2026 and most API requirements landing primarily on January 1, 2027 (CMS, 2026).

What made this especially relevant in Q1 2026 is that CMS clarified reporting expectations for prior authorization metrics. In guidance updated March 3, CMS said that impacted payers must publicly post certain aggregated prior authorization metrics beginning in 2026 and annually thereafter. CMS also clarified that by March 31, 2026, impacted payers must post prior authorization metrics for calendar year 2025 on their public facing websites (CMS, 2026).

That may sound a little wonky, but it is important. Public reporting creates pressure. Once approval rates, denial rates, appeals, and lists of items and services requiring prior authorization are expected to be posted, the conversation gets more transparent. For healthcare organizations, vendors, and informatics teams, this is not just a compliance issue. It is a workflow, data governance, and reporting issue. Someone has to capture the right data, structure it correctly, and publish it in a way that holds up under scrutiny (CMS, 2026).

This is also why health informatics teams need to pay attention to prior authorization even if they are not on the payer side. The data standards, APIs, and reporting expectations tied to prior authorization are part of a broader shift toward cleaner digital transactions in healthcare. It is not flashy, but this stuff can save time, reduce friction, and expose weak spots in operational systems. That is real value, and yeah, it is overdue (CMS, 2026).

Health IT Rules Kept Moving

Q1 2026 also brought continued movement in health IT regulation through ASTP’s HTI 5 Proposed Rule. The public comment period for the rule closed on February 27, 2026. ASTP says the proposal is designed to reduce burden on health IT developers, update information blocking regulations, and create a new foundation for future FHIR based APIs and AI enabled interoperability solutions (ASTP, 2026).

This rule matters because it goes right at the health IT certification landscape. ASTP’s materials say the proposal would remove 34 and revise 7 of the existing 60 certification criteria, and the agency estimates $1.53 billion in compliance cost savings along with more than 1.4 million compliance hours saved in the first year for certified health IT developers. Those are not tiny adjustments. That is a serious attempt to simplify part of the certification environment and reset the groundwork for future interoperability efforts (ASTP, 2026).

There are a couple ways to read this. The optimistic read is that outdated or redundant requirements are being cleared out so developers can spend more time building useful products and less time chasing dead weight. The more cautious read is that every major reset creates transition questions, especially for EHR vendors, provider organizations, and compliance teams that have to interpret what changes actually mean in practice. Both reads are fair. But either way, HTI 5 was one of the biggest rulemaking stories of the quarter in U.S. health informatics (ASTP, 2026).

ASTP also used its February 2026 update to say it had initiated its first oversight actions under 45 CFR 170.580 related to certified health IT review, including potential nonconformance tied to the Information Blocking Condition of Certification and API Maintenance of Certification requirements. That is another sign that information blocking enforcement and oversight are becoming more active, which keeps pressure on certified health IT developers to deliver what the rules actually require (ASTP, 2026).

Cybersecurity Stayed Central

No Q1 2026 roundup in healthcare technology would be complete without cybersecurity, because this problem is still hanging over the industry like a storm cloud. HHS OCR’s January 2026 Cybersecurity Newsletter focused on system hardening and protecting electronic protected health information, emphasizing patching, reducing attack surface, and paying close attention to medical device cybersecurity labeling and risk management. OCR also pointed regulated entities toward resources like the Security Risk Assessment Tool and federal vulnerability sources such as NIST and CISA (HHS OCR, 2026).

That guidance landed alongside enforcement activity. In February, OCR announced a settlement with Top of the World Ranch Treatment Center, calling it the 11th enforcement action in OCR’s Risk Analysis Initiative. In March, OCR announced another settlement with MMG Fusion and said it was the 12th enforcement action in the same initiative. The MMG Fusion case involved a breach affecting 15 million individuals, which is the kind of number that makes people in this space sit up real quick (HHS OCR, 2026; HHS OCR, 2026).

The theme here is pretty clear. Federal agencies are still signaling that cybersecurity in healthcare is not optional housekeeping. It is core infrastructure. Risk analysis, patching, device security awareness, and governance around ePHI are all still front and center. That means cybersecurity remains one of the most practical and urgent parts of health informatics, especially as AI tools, connected devices, and broader data exchange create more complexity across the stack (HHS OCR, 2026).

Where EHR and Digital Health Seem To Be Headed

Q1 2026 did not produce one giant EHR headline that swallowed everything else, but it did show where EHR adjacent policy and digital health are heading. The FDA’s TEMPO pilot is a good example. According to FDA guidance updated in February, the agency began receiving statements of interest on January 2, 2026 for this pilot, which is tied to digital health devices intended to improve patient outcomes in 4 CMMI ACCESS clinical use areas: early cardio kidney metabolic, cardio kidney metabolic, musculoskeletal, and behavioral health. FDA said it expects to begin sending follow up requests to certain potential participants around March 2, 2026 (FDA, 2026).

That matters because TEMPO reflects a more flexible regulatory approach to some digital health devices while still expecting eventual FDA marketing authorization. In other words, the government is looking for ways to test access expanding digital health pathways without pretending safety and oversight no longer matter. That is a pretty telling signal for companies building remote monitoring, software driven tools, and other technology that sits close to the clinical workflow (FDA, 2026).

Put that together with the AI RFI, the imaging interoperability RFI, TEFCA growth, and HTI 5, and the direction feels pretty obvious. The federal health IT conversation is becoming more connected. AI, interoperability, certification, imaging, digital health devices, and burden reduction are no longer separate little lanes. They are starting to blend into one larger operating picture for healthcare technology in the United States (HHS, 2026; ASTP, 2026; FDA, 2026).

Why This Q1 of 2026 Matters

So what is the big takeaway from Q1 2026? Health informatics is getting pulled in 2 directions at the same time, and that is not a bad thing. On one side, the industry is being pushed toward more openness, more interoperability, more standardization, and more public accountability. On the other side, it is being pushed to handle bigger risks around cybersecurity, safety, implementation, and governance. That tension is very real, and honestly, it is probably healthy if it leads to smarter systems instead of sloppy speed (HHS, 2026; CMS, 2026; HHS OCR, 2026).

For anyone working in healthcare, technology, or artificial intelligence, this quarter was worth paying attention to because it set the tone for the rest of 2026. AI policy moved closer to clinical care. TEFCA made interoperability feel less theoretical. Prior authorization reform kept inching toward operational reality. Health IT certification rules stayed in motion. Cybersecurity kept reminding everyone that weak infrastructure can wreck everything else. That is a lot for one quarter, and yeah, health informatics definitely did not come in slow this year (HHS, 2025; HHS, 2026; ASTP, 2026; CMS, 2026; FDA, 2026).

References

HHS. “HHS Announces Request for Information to Harness Artificial Intelligence to Deflate Health Care Costs and Make America Healthy Again.” https://www.hhs.gov/press-room/hhs-ai-rfi.html

Regulations.gov. “HHS Health Sector AI RFI: Accelerating the Adoption and Use of Artificial Intelligence as Part of Clinical Care.” https://www.regulations.gov/document/HHS-ONC-2026-0001-0001

HHS. “TEFCA, America’s National Interoperability Network, Reaches Nearly 500 Million Health Records Exchanged.” https://www.hhs.gov/press-room/tefca-americas-national-interoperability-network-reaches-nearly-500-million-health-records-exchanged.html

ASTP. “HTI-5 Proposed Rule.” https://www.healthit.gov/regulations/hti-rules/hti-5-proposed-rule/

ASTP. “HTI-5 Proposed Rule Chart.” https://www.healthit.gov/resources/hti-5-proposed-rule-chart/

ASTP. “HTI-5 Proposed Rule Overview Presentation.” https://www.healthit.gov/wp-content/uploads/2026/02/2026-02-19_HTI-5_Proposed_Rule_Overview_Presentation_508.pdf

ASTP. “Request for Information: Diagnostic Imaging Interoperability Standards and Certification.” https://www.healthit.gov/standards-and-technology/request-for-information-diagnostic-imaging-interoperability-standards-and-certification/

ASTP. “ONC Standards Bulletin 2026-1.” https://www.healthit.gov/standards-and-technology/onc-standards-bulletin/onc-standards-bulletin-2026-1/

CMS. “CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F).” https://www.cms.gov/cms-interoperability-and-prior-authorization-final-rule-cms-0057-f

CMS. “Prior Authorization API FAQ.” https://www.cms.gov/priorities/burden-reduction/overview/interoperability/frequently-asked-questions/prior-authorization-api

FDA. “TEMPO for Digital Health Devices Pilot Frequently Asked Questions.” https://www.fda.gov/medical-devices/digital-health-center-excellence/tempo-digital-health-devices-pilot-frequently-asked-questions

HHS OCR. “January 2026 OCR Cybersecurity Newsletter.” https://www.hhs.gov/hipaa/for-professionals/security/guidance/cybersecurity-newsletter-january-2026/index.html

HHS OCR. “OCR Settles HIPAA Security Rule Investigation with Top of the World Ranch Treatment Center.” https://www.hhs.gov/press-room/ocr-settles-hipaa-security-rule-investigation-twrtc.html

HHS OCR. “OCR Settles HIPAA Investigation of MMG Fusion, LLC Breach Affecting 15 Million Individuals.” https://www.hhs.gov/press-room/ocr-mmg-fusion-hipaa-agreement.html