TEFCA, framework for nationwide health health exchange, now live from ONC

The Office of the National Coordinator for Health IT on Tuesday announced the availability of the long-awaited Trusted Exchange Framework and Common Agreement.

“Few things have been as elusive as a governance framework for nationwide health information exchange,” said National Coordinator for Health IT Micky Tripathi in a blog post, coauthored with Mariann Yeager, CEO of the Sequoia Project, TEFCA’s recognized coordinating entity

“When ONC was formed in 2004, the concept of a nationwide health information network – where your information could be located across the country in a click – was a big picture vision that drove the federal government’s early health IT infrastructure, standards, policy actions, and investments,” he explained.

Over the past 12 years, two landmark laws – the HITECH Act and the 21st Century Cures Act – have helped pave the way for wider interoperability in the U.S., first by offering stimulus money to encourage electronic health record adoption boost health IT investments, and eventually by mandating patient access and data exchange. 

The launch of the Trusted Exchange Framework and the Common Agreement “marks the beginning of a new era of electronic health information exchange,” said Tripathi and Yeager. 

With TEFCA, ONC and Sequoia have three goals, they said:

Establish a universal policy and technical floor for nationwide interoperability.

Simplify connectivity for organizations to securely exchange information to improve patient care, enhance the welfare of populations, and generate health care value.

Enable individuals to gather their health care information.

The Common Agreement – a baseline describing for the exchange purposes that need to be supported – is a new legal contract that Sequoia Project will enact with each Qualified Health Information Network. The QHIN Technical Framework, which sets the functional and technical requirements that QHINs need to support to make this new connectivity come online. 

ONC is also working on a TEFCA FHIR Roadmap, as that HL7 spec will be an established part of TEFCA-based exchange over time.

This helpful tweet thread from Lisa Bari, CEO of Civitas Networks for Health, describes next steps for voluntary participants.

ONC had promised TEFCA would be live in 2022, and it has delivered. This has been a busy year so far for ONC, which has made some significant announcements. Earlier this month, in a boost for patient matching, ONC released new technical specs for Project [email protected], which provides unified specifications for patient addresses. And this past week, the agency published the eighth annual update of its Interoperability Standards Advisory Reference Edition.

On Wednesday, meanwhile, ONC also released the draft version 3 of United States Data for Core Interoperability for stakeholder feedback, which will be accepted until April 30, 2022 via the Draft USCDI v3 page.

“Thank you to everyone that’s been a part of this work over the years – through the drafts, listening sessions, and webinars you have helped us shape where we have arrived,” said Tripathi and Yeager about the launch of TEFCA. “Be on the lookout for opportunities to engage with ONC and [Sequoia Project] as QHINs onboard, including opportunities to inform continued implementation and future updates to the Common Agreement and QHIN Technical Framework.

“In the coming weeks, the RCE will be hosting several webinars to educate the public about TEFCA and how to participate. These resources will be recorded and available on the RCE’s website,” they added

Twitter: @MikeMiliardHITN
Email the writer: [email protected]

Healthcare IT News is a HIMSS publication.

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