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

ONC has led a multi-year, public-private process alongside its Recognized Coordinating Entity®, The Sequoia Project, Inc., to implement TEFCA, which was envisioned by the 21st Century Cures Act. As a result, patients will have increased access to their records, and health care providers and plans can improve their secure exchange of electronic health information.

The interoperability framework, called TEFCA, was mandated by the 21st Century Cures Act back in 2016 and was designed to create an infrastructure to enable data sharing between health information networks. The framework provides the policies, procedures and technical standards necessary to exchange patient records and health information between providers, state and regional health information exchanges and federal agencies.

“In many ways, I feel like we’re watching the Big Bang occur in 2023,” said Health and Human Services (HHS) Secretary Xavier Becerra said during an event held at HHS headquarters in Washington, D.C. on Tuesday.

Five organizations were officially designated as Qualified Health Information Networks (QHINs) during the HHS event on Tuesday – eHealth Exchange, Epic Nexus, Health Gorilla, KONZA and MedAllies. Those five organizations have gone live with TEFCA exchange, and two others are completing their implementations

These designated QHINs can immediately begin supporting the exchange of data under the Common Agreement’s policies and technical requirements. QHINs are the pillars of TEFCA network-to-network exchange, providing shared services and governance to securely route queries, responses, and messages across networks for eligible participants including patients, providers, hospitals, health systems, payers, and public health agencies.

QHINs are the pillars of TEFCA network-to-network exchange, providing shared services and governance to securely route queries, responses, and messages across networks for eligible participants including patients, providers, hospitals, health systems, payers and public health agencies.

Epic customers, including 498 hospitals, have already pledged to join TEFCA.”As of this week, over 200 hospitals and around 3,000 clinics that use Epic plan to be early adopters of this framework,” Rob Klootwyk, director of interoperability for Epic Nexus, a subsidiary of Epic,said during the event. “At full rollout, we do expect to help around 2,700 hospitals and 70,000 clinics go live on TEFCA.”

In a Health Affairs Forefront blog, Micky Tripathi, Ph.D., national coordinator for health information technology and Mariann Yeager, CEO of The Sequoia Project, said TEFCA, going live marks “one of the most important milestones in our nation’s digital health history.”

“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, Ph.D., 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.”

“Designating these first QHINs is just the beginning,” said Mariann Yeager, CEO of The Sequoia Project and RCE lead. “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.“

“Collectively, these QHINs have networks that cover most U.S. hospitals and tens of thousands of providers; they process billions of annual transactions across all fifty states. With these QHINs working together under TEFCA, their users will now be able to connect with each other, regardless of which network they’re in,” Tripathi and Yeager wrote.

Common Agreement Version 2.0, which is anticipated to include enhancements and updates to require support for Health Level Seven (HL7®) Fast Healthcare Interoperability Resources (FHIR®) based transactions, is actively under development and scheduled to be adopted by the QHINs within the first quarter of 2024.

Attendees at the 2023 ONC Annual Meeting in Washington, DC on December 14, 2023, will have the chance to hear two plenary sessions providing TEFCA updates. Learn more at oncannualmeeting.com