TEFCA is live and ready to exchange data, says HHS
The U.S. Department of Health and Human Services announced Tuesday that eHealth Exchange, Epic Nexus, Health Gorilla, KONZA and MedAllies can immediately begin exchanging data under the Trusted Exchange Framework and the policies and technical requirements of the Common Agreement.
WHY IT MATTERS
The nationwide health data exchange governed by TEFCA is now operational and, as a result, patients will have better access to their records while healthcare organizations that serve them can improve their secure exchange of electronic health information, the HHS announcement said.
The Office of the National Coordinator for Health Information Technology led a multi-year public-private process with The Sequoia Project, the initiative's accredited coordinating entity (RCE), to implement TEFCA under the vision of the 21st Century Cures Act.
“This would not have happened without the tremendous support from stakeholders, significant investment in resources and expertise by the QHINs and the hard work of the RCE and ONC staff,” said Micky Tripathi, National Coordinator for Health Information Technology.
The designated qualified healthcare information networks – what ONC calls the pillars of TEFCA network-to-network exchange – that have completed onboarding can immediately begin supporting data exchange under the policy and technical requirements.
QHINs that provide shared services and governance are intended to securely route questions, responses, and messages through networks to eligible patients, providers, hospitals, healthcare systems, payers, and public health agencies.
eHealth Exchange, Epic Nexus, Health Gorilla, KONZA and MedAllies are operationally ready for exchange.
“eHealth Exchange was the first federally approved health information exchange in the country,” Jay Nakashima, executive director of eHealth Exchange, said in a statement. “We are thrilled to see so many different health information networks achieve Designated QHIN status.”
As the largest public-private health information network, eHealth Exchange manages 20 billion data exchanges annually and provides connectivity for 60 regional and national health information exchanges, 75% of U.S. hospitals and many healthcare organizations through 30 different electronic health record technologies through Carequality. and now TEFCA.
Organizations like CRISP Shared Services and ConnectVirginia are two of many HIEs that have committed to participating in QHIN-based exchanges through the eHealth Exchange.
Nakashima added that the Health Exchange Coordinating Committee “has spent countless hours meeting TEFCA's stringent guidelines and successfully passing all compliance testing.”
MedAllies, a direct secure messaging network, said in a statement that becoming operational under TEFCA will expand its reach and expand to additional healthcare stakeholder groups.
Dr. MedAllies CEO John Blair praised ONC and The Sequoia Project for their “vision and commitment” to expanding the excellence of support services and applying lessons learned in the process.
Epic, whose customers, including 489 hospitals, are expected to join TEFCA, has already exchanged data through the Care Everywhere interoperability platform and the Carequality framework.
“We hope this public-private partnership will encourage providers who have not previously participated in nationwide interoperability to join this initiative,” said Matt Doyle, Epic software developer.
The additional designated QHINs – Kno2, eClinicalWorks and Commonwell Health Alliance – have been accepted into the project planning and testing phase of the onboarding and designation process, according to the Sequoia Project website.
HHS noted in its announcement that TEFCA 2.0 – which is expected to support Health Level Seven Fast Healthcare Interoperability Resources-based transactions – is in development and expected to be adopted by QHINs in the first quarter of 2024.
THE BIG TREND
In addition to the Cures Act, the 2020 Interoperability and Patient Access Final Rule articulated the Consumer API Rule, Roadmap, and Data Standards.
Together, these two rules have laid the foundation for what interoperability is expected to look like, said Jonathan Shannon, senior director of healthcare strategy at LexisNexis Risk Solutions.
HL7 FHIR standards, which include API specifications, enable healthcare organizations to easily store, retrieve, update and share patient data and have already received widespread support in the United States, as The Sequoia Project notes in its report . FHIR Roadmap.
Some industry experts say there are opportunities for alignment.
FAST co-chairs Deepak Sadagopan, chief operating officer of Providence, and Duncan Weatherston, chief executive officer of Smile CDR Inc., said FHIR standards provide a consistent path to reducing the variability and costs of data exchange between payers and providers address and achieve interoperability objectives.
Others, like Don Rucker, chief strategy officer of 1upHealth, the former national coordinator for healthcare IT, point to the Cures Act information blocking grants for TEFCA – which relate more to providers and their IT suppliers – and are concerned about the technical limitations when using data outside documents.
“TEFCA is essentially trading the internet security model for a private security and privacy model,” Rucker told me Healthcare IT news on HIMSCast in September.
ON THE RECORD
“Designating these first QHINs is just the beginning,” Mariann Yeager, CEO of The Sequoia Project and RCE leader, said in the HHS announcement. “Now we hope to see the rapid expansion of the TEFCA exchange as these pioneering networks roll out the benefits of TEFCA to their customers and members, with more and more QHINs coming on board.”
“Providers across the country are already recognizing the untapped potential and should join TEFCA for the benefit of patients everywhere,” Craig Richardville, chief digital and information officer of Intermountain Health, said in Epic's statement.
Andrea Fox is editor-in-chief of Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a HIMSS Media publication.