ONC releases framework to spur health information exchange

Jan. 18, 2022

The U.S. Department of Health and Human Services’ (HHS) Office of the National Coordinator for Health Information Technology (ONC) has published the Trusted Exchange Framework and the Common Agreement (TEFCA).

HHS said that organizations will soon be able to apply and be designated as Qualified Health Information Networks (QHINs), which will connect to one another and enable their participants to engage in health information exchange across the country.

 HHS said the Common Agreement will “allow stakeholders — such as health information networks, ambulatory practices, hospitals, health centers, federal government agencies, public health agencies, and payers — to benefit from TEFCA through improved access to health information. Individuals will also be able to benefit from TEFCA and seek access to their health information through entities that offer individual access services.”

The 21st Century Cures Act, passed in 2016, called for the development of a trusted exchange framework and a common agreement. “The Trusted Exchange Framework is a set of non-binding but foundational principles for health information exchange, and the Common Agreement is a contract that advances those principles. The Common Agreement establishes the technical infrastructure model and governing approach for different health information networks and their users to securely share clinical information with each other — all under commonly agreed-to rules-of-the-road,” HHS said.

ONC also has made available the TEFCA Health Level Seven (HL7) Fast Healthcare Interoperability Resource (FHIR) Roadmap (TEFCA FHIR Roadmap), which outlines how TEFCA will accelerate the adoption of FHIR-based exchange across the industry.

The Sequoia Project, which serves as the TEFCA Recognized Coordinating Entity under a cooperative agreement with ONC, is charged with rolling out and maintaining the Common Agreement and QHIN Technical Framework, which is the technical specification for how QHINs connect to one another. In addition, the RCE plays a central role in designating, onboarding, and providing oversight of QHINs, HHS said.

The RCE will host a series of public engagement webinars to provide further information about TEFCA.

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