This appeared last week:
Contact: HHS
Press Office
202-690-6343
media@hhs.gov
ONC Completes Critical 21st Century Cures Act Requirement, Publishes the Trusted Exchange Framework and the Common Agreement for Health Information Networks
The U.S. Department of Health and Human Services’ (HHS) Office of the National Coordinator for Health Information Technology (ONC) and its Recognized Coordinating Entity (RCE), The Sequoia Project, Inc., today announced the publication of the Trusted Exchange Framework and the Common Agreement (TEFCA). Entities will soon be able to apply and be designated as Qualified Health Information Networks (QHINs). QHINs will connect to one another and enable their participants to engage in health information exchange across the country.
The 21st Century Cures Act, passed in 2016, calls for the development of a trusted exchange framework and a common agreement. The Trusted Exchange Framework is a set of non-binding but foundational principles for health information exchange, and the Common Agreement is a contract that advances those principles. The Common Agreement establishes the technical infrastructure model and governing approach for different health information networks and their users to securely share clinical information with each other – all under commonly agreed-to rules-of-the-road.
The Common Agreement supports multiple exchange purposes critical to improving health care and has the potential to benefit a wide variety of health care entities. This flexible structure allows stakeholders—such as health information networks, ambulatory practices, hospitals, health centers, federal government agencies, public health agencies, and payers—to benefit from TEFCA through improved access to health information. Individuals will also be able to benefit from TEFCA and seek access to their health information through entities that offer individual access services.
Also available today is the TEFCA Health Level Seven (HL7®) Fast Healthcare Interoperability Resource (FHIR®) Roadmap (TEFCA FHIR Roadmap), which outlines how TEFCA will accelerate the adoption of FHIR-based exchange across the industry.
“Operationalizing TEFCA within the Biden Administration’s first year was a top priority for ONC and is critical to realizing the 21st Century Cures Act’s goal of a secure, nationwide health information exchange infrastructure,” said Micky Tripathi, Ph.D., national coordinator for health information technology. “Simplified nationwide connectivity for providers, health plans, individuals, and public health is finally within reach. We are excited to help the industry reap the benefits of TEFCA as soon as they are able.”
The Sequoia Project serves as the TEFCA RCE under a cooperative agreement with ONC. The RCE is charged with developing, updating, implementing, and maintaining the Common Agreement and stewarding the QHIN Technical Framework, which is the technical specification for how QHINs connect to one another. In addition, the RCE plays a central role in designating, onboarding, and providing oversight of QHINs.
“The release of TEFCA today marks the beginning of the implementation phase,” said Mariann Yeager, CEO of The Sequoia Project. “This is a very exciting milestone that reflects the thoughtful feedback of public and private stakeholders throughout the process. We look forward to supporting everyone as they review the Common Agreement and identify their role in this new public-private paradigm advancing health information exchange nationwide.”
The
RCE will be hosting a series of public
engagement webinars 
to
provide further information about TEFCA (the first of which will be on January
18 at 12:00 ET). This will help entities interested in participating in or
leveraging the benefits of TEFCA fully understand how it works and help
prospective QHINs decide whether they should sign the Common Agreement.
Following an application and review process, entities that have signed may be
designated QHINs. It is anticipated the initial QHINs will onboard to the
network-of-networks to begin sharing data with one another this year.
To
register for the RCE’s upcoming webinars and to sign up for their contact list,
please visit RCE.SequoiaProject.org
.
For more information from ONC about TEFCA, please visit HealthIT.gov/TEFCA.
Here is the link to the release.
It is interesting that FHIR is to play such a central role!
FHIR to play crucial role in long-term TEFCA strategy
While the coding standard is still moving along a path to maturity, industry expects it to be fully ready when timeline specifies its use.
Jan 20 2022
Healthcare leaders weighed in optimistically on the newly released federal Trusted Exchange Framework and Common Agreement, a plan to facilitate nationwide health information-sharing that will rely heavily on HL7’s Fast Healthcare Interoperability Resources (FHIR) standard within three years.
Mandated by the 21st Century Cures Act, the Trusted Exchange Framework and Common Agreement (TEFCA), creates the baseline legal and technical requirements that will enable secure digital health information exchange, leaning heavily on FHIR for data exchange.
The set of standards, including both a coding framework to automate information exchange, as well as bundles of pre-accepted coding that facilitate “use cases” or types of transactions, are in various stages of maturity and gaining widespread acceptance and being universally applied.
ONC National Coordinator Micky Tripathi said FHIR isn’t fully ready, but it will be by the time TEFCA’s roadmap for its incremental adoption is achieved. “[It’s] not at a point of maturity for network enablement,” he said at an event introducing TEFCA. “But that said, there are a number of networks across the country that are starting to either run pilots or actually starting to think about putting (FHIR capabilities) into production that would help with the scalability of a FHIR-based exchange.
“Most of the FHIR activity out in the market today is point to point, using FHIR APIs, and scalability of those is hard,” Tripathi said. The problem becomes how to locate where records are so that an end user knows which points to connect.
In writing TEFCA, ONC framers tried to focus on where FHIR is mature and asked, “How do we help energize that and help to scale that as quickly as possible; and then how do we accelerate the maturity of it for network-level exchange, where it's least mature right now?” Tripathi said.
More here:
From this it really seems a Standards set is coming together that is going to go a long way towards making information for patients way more accessible across the whole country. This is really some achievement I reckon. It will be interesting to see how the national network beds down over the next few years.
David.
2 comments:
No desire to be negative but objectivity and pragmatism justify one holding a high level of scepticism.
We have seen such enthusiastic confidence and promises more than once over the last few decades. Optimistic futurism is well and good, something to aspire to, but don't hold your breath, promises indeed - nothing more. No disrespect to FHIR just plain, simple, good old common sense.
"Most of the FHIR activity in the market today is point to point .."
Davd, given how lethargic and resistant to change is the health market, and the complexity of implementing new technology in such a market which inevitably has to displace well entrenched legacy systems, it is more than a little reasonable to suggest that Anon 7:37PM is pretty well spot-on .... seeing results emerge from this opportunistic futurism and hype will be a long time coming, certainly considerably longer than "3 years", more like 3 decades.
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