In this episode, Dr. Schoch and Theresa discuss the state of interoperability at the end of 2023 and look ahead to 2024. They reflect on the evolution of interoperability over the past few decades, from HL7 V2 messaging in the 80s to the adoption of IHE profiles and CDA in the 2000s. They also explore the concept of federated interoperability and the movement towards organization-to-organization and organization-to-patient communication. Dr. Schoch shares his personal experience with implementing electronic health records and discusses the ongoing challenge of defining interoperability and meaningful communication. The conversation concludes with a discussion on the confusion surrounding the term 'interoperability' and the desire for further progress in the field in 2024.