Interoperability continues its slow but steady trudge forward with a few hiccups back. The latest steps forward include a rise in EHR adoption rate among primary care providers from 20 percent to nearly 40 percent since 2009, according to Farzad Mostashari, MD, national coordinator for health IT; and the announcement that the Office of the National Coordinator for Health IT will advance the growth and spread of health information exchange by specifying the next layer of core standards and policies this year. One small step in place, if not backward, is the three-month delay in enforcement action against any entity that is required to comply with the HIPAA Version 5010 transaction sets.