Electronic Health Records (EHRs) interoperability must prioritize security and privacy to maintain trust in digital healthcare systems. Secure data exchange frameworks incorporate encryption, authentication, and access controls to protect sensitive patient information. Standards-based APIs, particularly those built on FHIR, support role-based access and audit trails, ensuring compliance with regulations like HIPAA. Interoperability does not mean unrestricted access; rather, it enables controlled, consent-driven sharing. Patients increasingly expect transparency and control over who can view their data. By embedding security into interoperability standards, healthcare organizations can balance accessibility with protection. This approach reduces breach risks while supporting innovation. As cyber threats evolve, secure interoperable EHR ecosystems remain essential for sustainable digital health growth.