Healthcare is at an inflection point. While FHIR has become the widely accepted syntax for data exchange, the semantics—how data actually maps into FHIR resources—remain fragmented across systems. This inconsistency creates costly integration barriers, slows innovation, and prevents the healthcare ecosystem from fully realizing the benefits of interoperability.
To understand where we are, it helps to look at where we’ve been.
Lessons from the Past: EDI in the 1960s–2000s
When industries like logistics, retail, and insurance faced disparate, proprietary systems exchanging invoices, claims, and orders, chaos reigned. Electronic Data Interchange (EDI) transformed that landscape by introducing:
What EDI Solved:
- Introduced standardized transaction sets (X12, EDIFACT)
- Created syntax rules and dictionary-driven fields for repeatable automation
- Enabled cross-industry plug-and-play integration
- AND it took 60 years to refine!
Parallel Today: The healthcare industry is experiencing
A similar fragmentation—FHIR is the syntax, but how data maps to FHIR (canonical semantics) is still widely variable across systems.
- A reference data model (FHIR-centric) aligned with CMS regulatory requirements
- Field-level mappings that serve as the “dictionary” for health data transformation
- A foundation to support new “transaction sets” for future use cases like prior auth, ePA, or clinical trials
- For all healthcare ecosystem participants, with a particular focus on enabling…
- Health plans
- HIT Vendors
- Implementers
It wasn’t instant—it took 60 years of refinement—but EDI ultimately became the trusted foundation for business-to-business exchange.
Parallel Today: Healthcare and FHIR
Healthcare now faces a similar challenge. FHIR provides the syntax, but canonical semantics are still lacking. The result is variable implementations across payers, providers, and vendors. Without a unified reference model, organizations reinvent the wheel with each project, draining resources and delaying compliance.
That’s where HealthLX comes in.
The Solution: CoCo — A Canonical Schema for Healthcare
HealthLX is open-sourcing CoCo, our Canonical XML schema for FHIR + CMS Interoperability Rules. This is not theory—it’s the production-hardened schema already powering live CMS compliance implementations for:
- Patient Access API
- Payer-to-Payer Exchange
- Upcoming CMS regulations (where applicable)
By joining this collaborative ecosystem, healthcare organizations can:
- Eliminate redundant schema development and months of rework.
- Accelerate time-to-market with a ready-to-use canonical schema (.xsd)
- Ensure consistency and scalability in FHIR data transformation.
- Establish a technical benchmark for CMS compliance.
Why Open Schema?
CoCo provides a complete tech stack to support interoperability at scale:
Industry Collaboration
- Join leading healthcare innovators contributing to the ecosystem.
- Influence the standard through active community participation.
- Access collective expertise from payer, provider, and vendor domains
Accelerated Development
- Eliminate months of schema development with a ready-to-use .xsd canonical.
- Reduce integration complexity through standardized field mappings.
- Fast-track FHIR compliance with field-level technical specifications
Production-Proven Excellence
- Real-world validated in live CMS compliance implementations (9115 and 0057)
- Enterprise-grade reliability serving critical healthcare workflows
- Zero theoretical risk — built on past CMS production implementations
Industry Collaboration
HealthLX is committed to adopting community-driven standards. By engaging with CoCo, you can:
- Join leading payers, providers, and vendors contributing to the ecosystem.
- Influence the standard through active participation.
- Access collective expertise to accelerate your own compliance journey
Production-Proven Excellence
Unlike theoretical pilots, CoCo is validated in real-world CMS compliance workflows (9115 and 0057). It delivers enterprise-grade reliability for mission-critical healthcare operations, removing risk and uncertainty from interoperability projects.
The Opportunity Ahead
Just as EDI evolved from chaos to consensus, healthcare is poised for its own breakthrough. With CoCo, the industry can establish a shared, open-source semantic framework that reduces cost, speeds innovation, and ensures compliance.
Healthcare interoperability doesn’t need to take 60 years. With HealthLX, the future is here now.