TEFCA: A National Framework and Common Agreement for Interoperability

Published On: February 28, 2018

In January, the Office of the National Coordinator for Health Information Technology (ONC) provided a proposed Trusted Exchange Framework and Common Agreement (TEFCA) for public review and comment. Responses and comments were due by February 20, 2018, and Health Current along with many organizations, associations and HIEs provided responses and comments. The following questions and answers describe what is proposed by ONC along with potential benefits and areas of concern, according to Health Current.

What is TEFCA?

TEFCA (Trusted Exchange Framework and Common Agreement) is a proposal from ONC that aims to increase and enhance interoperability and improve the ability of providers and their patients to securely access and use data from different sources. TEFCA includes two parts: a Draft Trusted Exchange Framework and a Draft Common Agreement.

What is the Draft Trusted Exchange Framework?

The Framework provides a set of principles and “guard rails” for organizations that exchange health information – health information networks (HINs) and qualified health information networks (QHINs). HINs are networks, like Health Current, that have in place the policies and operations to allow participants who are business associates to share and exchange patient health information. QHINs are regional entities that must meet all the requirements of an HIN and serve as neutral coordinators and brokers to help allow for a single “on-ramp” to interoperability to enable any healthcare stakeholder to participate in nationwide information exchange.

What is the Common Agreement?

The Common Agreement sets out specific terms and conditions for a Recognized Coordinating Entity (RCE), a single national entity that will be tasked with operationalizing the Trusted Exchange Framework. QHINs will voluntarily agree to the terms of the Common Agreement, and the RCE will operationalize the coordination of QHINs and compliance with the Common Agreement.

What are the goals of TEFCA?

There are five primary goals of TEFCA, according to ONC: 1) To build on an extend existing work done by the HIE industry, recognizing significant recent work and progress; 2) To provide a single “on-ramp” to interoperability for all, including allowing all types of providers to join any HIN they choose and participate in nationwide exchange; 3) To be scalable to support the entire nation, enabling exchange across disparate networks and sharing arrangements; 4) To build a competitive market allowing all to compete on data services, allowing new and innovative technologies to enter the market; and 5) To achieve long-term sustainability, providing a sustainable single “on-ramp” and allowing for variation around broad use cases.

For more information on TEFCA, click here.