With TEFCA, Interoperability in the United States Launches Ahead
Health data exchange may not appear in the news headlines often, but this important area of healthcare stands on the brink of a moonshot moment.
With TEFCA (short for the Trusted Exchange Framework and Common Agreement), the United States has its first-ever federally endorsed governance framework for cross-network exchange of healthcare records.
If that doesn’t sound like a big deal, it should. When you make a surprise trip to urgent care while you’re out of town, when you visit a care site that’s new to you, or when your doctor refers you to a specialist outside your health system – in these cases and others, healthcare organizations need the ability to securely share and access your health information. That’s what interoperability makes possible. Interoperability allows the right information to guide the care we receive, whenever and however we receive it.
TEFCA represents a major milestone on the path toward nationwide health data interoperability in the United States. And it’s an important moment for my organization, eHealth Exchange, whose goal is to improve patient care nationwide through the secure sharing of health information.
A Long-Standing Aspiration
Published in January 2022 by the Office of the National Coordinator for Health Information Technology (ONC), TEFCA replaces local information-sharing policies with a universal national policy and a technical floor for nationwide interoperability. Participating in TEFCA exchange offers significant potential benefits, including expanded use cases (such as public health), fewer barriers to data access, and streamlined connectivity among providers, payers, health IT vendors, and patients. While participation is optional, it represents values that are core to our organization.
In 2006, the Nationwide Health Information Network (now eHealth Exchange) began as a federal program within the ONC. Over the years, we have grown into a leading network that connects healthcare providers, state and regional health information exchanges (HIEs), and federal agencies to inform and improve patient care. As a nonprofit, we care deeply about public good. That’s why values such as transparency, accountability, inclusion, and security are so important to our business.
In that spirit, we are now working diligently to meet TEFCA requirements. We intend to offer TEFCA exchange to participants by applying to become a Qualified Health Information Network (QHIN), the RCE’s designation for networks approved to offer TEFCA exchange.
Trial and Reward
Coincidentally, TEFCA arrives near the 60th anniversary of U.S. President John F. Kennedy’s speech where he famously called reaching the moon among the accomplishments worth undertaking “not because they are easy, but because they are hard, because that goal will serve to organize and measure the best of our energies and skills, because that challenge is one that we are willing to accept, one we are unwilling to postpone.”
The ONC has set the bar high for prospective QHINs. The application process is arduous. Applicants face challenging requirements pertaining to cybersecurity, HITRUST accreditation, and financial reserves, among others. The challenge, in my opinion, is intentional and appropriate, because in effect, QHINs will be supplying critical national infrastructure. It’s imperative that data privacy and data security be guarded scrupulously. The vision of TEFCA will only succeed if QHINs–the backbone of TEFCA–commit to its rigorous safeguards.
As the healthcare system marches steadily toward universal interoperability, organizations in the industry have ample reason to support the implementation of TEFCA. Whether that means joining a QHIN or becoming one themselves, the driving force should be the best interests of the patients we all serve, an undertaking we are unwilling to postpone.
Jay Nakashima is executive director of eHealth Exchange, one of the nation’s largest health information networks connecting federal agencies and providers. Convening industry and government, eHealth Exchange is dedicated to addressing the challenges of secure, health information exchange to improve patient care.