ONC Awards The Sequoia Project as TEFCA’s Recognized Coordinating Entity

Sept. 3, 2019
The Sequoia Project was selected through a competitive process, noted Don Rucker, M.D., National Coordinator for Health IT

The nonprofit Sequoia Project—an organization devoted to advancing healthcare interoperability—has been awarded a cooperative agreement to serve as the Recognized Coordinating Entity (RCE) that will manage and oversee Qualified Health Information Networks (QHINs) under the Office of the National Coordinator for Health IT's Trusted Exchange Framework and Common Agreement (TEFCA).

Announced by ONC on Sept. 3, federal health IT officials said that the RCE will be responsible for developing, updating, implementing, and maintaining the Common Agreement component of the TEFCA. The Common Agreement will create the baseline technical and legal requirements for health information networks to share electronic health information and is part of ONC’s implementation of the 21st Century Cures Act, they noted.

“The Sequoia Project was selected through a competitive process to help with the interoperable flow of health information. We look forward to working in close collaboration with The Sequoia Project and across the broader health system to create a Common Agreement that best serves the needs of all stakeholders,” said Don Rucker, M.D., National Coordinator for Health Information Technology.

In 2012, The Sequoia Project was chartered to advance the implementation of secure, interoperable nationwide health information exchange. Since then, two of the group’s biggest tasks—managing the eHealth Exchange, which has become the largest health information network in the U.S., as well as supporting the Carequality initiative—has put The Sequoia Project right in the interoperability spotlight. Starting last year, The Sequoia Project updated its corporate structure so that it has two distinct subsidiaries, one for eHealth Exchange and one for Carequality.

As part of the Cures Act, Congress directed the Department of Health and Human Services (HHS) to advance trusted exchange of electronic health information among health information networks via TEFCA. “The Cures Act’s focus on trusted exchange is an important step toward fostering transparency and competition throughout the healthcare delivery system by addressing the technical barriers and business practices that impede the secure and appropriate sharing of electronic health information,” ONC has stated.

In addition to the Common Agreement, which will be published on HealthIT.gov and in the Federal Register, the RCE will collaborate with ONC to designate and monitor QHINs, modify and update accompanying QHIN technical requirements, engage with stakeholders through virtual public listening sessions, adjudicate noncompliance with the Common Agreement, and propose sustainability strategies to support TEFCA beyond the cooperative agreement’s period of performance, officials said.

“We have learned through our own operations that seamless nationwide sharing of health information is most readily enabled through trust agreements, consistent policy and technical requirements, and appropriate, balanced governance to provide assurance of trust and interoperability. We look forward to working alongside ONC as the Recognized Coordinating Entity,” Mariann Yeager, CEO of The Sequoia Project, said in a Sept. 3 statement.

Back in April, after receiving more than 200 comments on the first draft of TEFCA, HHS released the long-awaited second draft and a four-year funding announcement for the RCE.

The funding announcement for the RCE detailed the role HHS envisions it playing and noted that it must take steps to avoid conflict of interest. The program will be funded for the first year at $900,000, with funding in additional years contingent upon availability of funds and satisfactory completion of milestones, ONC said at the time of the second draft’s release. The comment period for this draft version closed in June, and one point made by stakeholders was that the RCE will need to be chosen before even considering whether or not to require participation in TEFCA.

Now, that entity has been named, as per ONC,  The Sequoia Project may not be affiliated with a QHIN as long as it is the RCE. Additionally, the RCE will employ organizational policies that prevent conflicts of interest.

Healthcare Innovation will update this story as it continues to unfold.