This chapter describes a pilot implementation of electronic health record (EHR) interoperability specifications to improve newborn hearing screening reporting to Oregon Health Authority’s (OHA's) Early Hearing Detection and Intervention (EHDI) registry. The Integrating the Healthcare Enterprise (IHE) EHDI Profile describes how hearing screening data is sent from screening device or EHR and converted into an electronic hearing plan of care (HPoC) that is shared with the primary care providers and audiologists responsible for assuring timely diagnostic audiological evaluations to rule out hearing loss. During the planning and development phases of the project, partners developed tools and solutions to aid in sending, receiving, and processing the hearing screening results and the subsequent HPoC. The EHDI HPoC Clinical Document Architecture (CDA) pilot project demonstrated that a state public health agency could receive and consume HPoCs using real patient hearing screening data generated from a hospital's EHRs and that a pilot project using national standards are migrated to a production workflow.