A methodological framework for developing AI-enabled health information interoperability solutions to improve secure health information exchange across medicaid ecosystems

Medicaid continues to face fragmented HIE despite federal initiatives. This study develops a methodological framework for AI-enabled interoperability through a synthesis of literature, standards, and policy documents. Guided by STS, TOE, and DSR, the framework integrates readiness, standardization, governance, AI development, security, equity, and evaluation. The findings show that existing frameworks provide limited guidance for AI integration and governance, highlighting the need for a structured sociotechnical approach to achieve secure and equitable interoperability across Medicaid.