HHS, ONC Bring TEFCA Live for Nationwide Health Data Exchange

The Department of Health and Human Services (HHS), through the Office of the National Coordinator for Health Information Technology (ONC), has announced that national health data exchange governed by the Trusted Exchange Framework and Common Agreement (TEFCA) is now operational.

The 21st Century Cures Act envisioned the development of a trusted exchange framework and a common agreement, prompting ONC to lead the multi-year, public-private process to implement TEFCA alongside its recognized coordinating entity, The Sequoia Project.

The framework is set to increase patient access to health data and improve interoperability between healthcare providers and payers through a network of networks.

At a TEFCA signing event at HHS headquarters, the agency designated the following five organizations as qualified health information networks (QHINs) after completing the TEFCA onboarding process:

• eHealth Exchange
• Epic Nexus
• Health Gorilla
• KONZA
• MedAllies

“After over a decade of very hard work, today marks another major milestone in our march towards a 21st century digital healthcare system,” Xavier Becerra, HHS Secretary, said in a press release.

“TEFCA allows patients, providers, public health professionals, health insurers, and other healthcare stakeholders to safely and securely share information critical to the health of our country and all of our people,” Becerra continued.

Designated QHINs can immediately begin supporting data exchange under the Common Agreement’s policies and technical requirements.

QHINs support TEFCA’s network-to-network exchange framework, providing shared services and governance to route queries, responses, and messages across networks for eligible participants.

“In February 2023, we announced that TEFCA would be operational by the end of the calendar year, and we are delighted to achieve this goal,” said Micky Tripathi, PhD, national coordinator for health information technology.

“This would not have happened without tremendous stakeholder support, considerable investment of resources and expertise by the QHINs, and the hard work of the RCE and ONC staffs,” Tripathi added.

Mariann Yeager, CEO of The Sequoia Project and RCE lead, led the five QHINs in a round table discussion during the signing event.  

“Designating these first QHINs is just the beginning,” Yeager said in a public statement. “Now, we hope to see the rapid expansion of TEFCA exchange as these pioneering networks roll out the benefits of TEFCA to their customers and members while additional QHINs continue to onboard.”

Common Agreement Version 2.0, which is set to include enhancements and updates to require support for Health Level Seven (HL7) Fast Healthcare Interoperability Resources (FHIR)-based transactions, is under development. QHINs are expected to adopt version 2.0 by the first quarter of 2024.

The initial set of QHINs could grow. In his closing remarks at the signing event, Tripathi mentioned that health information network Surescripts and EHR vendor eClinicalWorks have recently applied to become QHINs.