It has been ten years since the publication of our first paper reporting on the beginning of a new national e- health interoperability journey in Australia and the interoperability framework developed by National e-health Transition Authority (NEHTA) [1]. Many new technologies, standard efforts and architecture approaches have emerged since then. Many new lessons were also learned by different stakeholders involved in using the framework as a basis for interoperability conversations and e-health solution development. Some of these were reflected in the second version of the NEHTA Interoperability Framework. This paper provides further details regarding this new version of the NEHTA Interoperability Framework, shows in more detail how Reference Model for Open Distributed Systems (RM-ODP) standards were used to provide underpinning foundations for interoperability, and lists some other development in e-health interoperability. Further, the paper describes the use of RM-ODP in other interoperability frameworks and describes links between interoperability frameworks, enterprise and solution architectures and interoperability methodologies.