Two organizations, Surescripts Health Information Network LLC and the United States Qualified Health Information Network (USQHIN), a subsidiary of Velatura Public Benefit Corp., are applying to become Qualified Health Information Networks (QHINs) under the Trusted Exchange Framework and Common Agreement (TEFCA).
There are now 20 organizations formally seek QHIN status and seven “candidate QHINS,” including: CommonWell Health Alliance, eHealth Exchange, Epic, Health Gorilla, Kno2, KONZA National Network and MedAllies. These are organizations that have had their applications accepted and are in the testing and project plan completion phase of the application process.
E-prescribing network company Surescripts said its network delivered clinicians 2.5 billion medication histories and 1.25 billion links to clinical documents at the point of care in 2022. Its Surescripts Network Alliance includes nearly all electronic health records vendors, pharmacy benefit managers, pharmacies and clinicians, plus health plans, long-term and post-acute care organizations, patient access vendors and specialty pharmacy organizations.
“We're the largest interoperability company in the country already,” Frank Harvey, Surescripts’ CEO, told Healthcare Innovation in a recent interview.
“We are very confident that we can serve everyone across the spectrum of healthcare. And if you think about the Qualified Health Information, Networks in TEFCA, it really does become a network of networks, as you will, because each one is going to be successful bringing in people who will be their customers,” Harvey added. “We really think the team at ONC has done a wonderful job. If you think about what's the importance of this, it comes back to the patient's ability to make sure they're getting the right treatment when they're in front of a care provider, because with an incomplete medical record, they’re never sure that the right decisions are being made.”
Surescripts was a member of the Common Agreement Workgroup and worked with the Sequoia Project and ONC to draft the Common Agreement that established the infrastructure model and governing approach for securely sharing basic clinical information between networks.
Additionally, Surescripts technology, including Surescripts Record Locator & Exchange, is based on the HL7 FHIR standard that helps clinicians find and retrieve clinical documents exchanged via Carequality—a nationwide, consensus-based interoperability framework that enables information exchange among health data sharing networks.
Surescripts noted that it has been a leader in the adoption of the FHIR standard, participating in HL7 accelerators, including the Argonaut Project, the DaVinci Project and FAST, aiming to meet the interoperability goals in the 21st Century Cures Act.
USQHIN and parent company Velatura are strategic partners for HIEs, health data utilities, providers, payers, labs, patients, and public health officials that share aggregated health data. If accepted, QHIN designation would allow USQHIN to further extend this capability nationwide.
Velatura was established to extend the Michigan Health Information Network Shared Services’ modular and scalable interoperability products and services for access and use outside of Michigan. For example, Velatura serves as the infrastructure for the New Jersey Health Information Network. It has worked with GaHIN, Georgia’s statewide HIE, to replace its legacy HIE system with Velatura’s cloud-based HIE platform. Also, the Wisconsin Statewide Health Information Network (WISHIN) selected Velatura to serve as the back-end technical platform for the state designated HIE.
USQHIN said it would submit its formal QHIN application in January 2024.
“Interoperability is essential for enhancing care coordination, improving the patient experience, and unlocking the full potential of whole-person healthcare," said Tim Pletcher, D.H.A., executive director of USQHIN, in a statement. "USQHIN is a leader in the safe, secure, and timely exchange of healthcare information, and becoming a QHIN is the next logical step in our journey to improve the care continuum by making valuable data available at the point of care. Achieving QHIN status would enable us to utilize our experience and expertise to influence policy and decision-making around interoperability and FHIR-based exchange."
The Common Agreement, released in September 2021, includes six exchange purposes that organizations must support to be designated as a QHIN. The exchange purposes include Treatment, Payment, Health Care Operations, Public Health, Benefits Determination, and Individual Access Services.
USQHIN notes that it currently provides several core services required by the ONC for QHIN certification, including Query and Response for EHI requests from participants, end user Message Delivery to assure that information is seamlessly passed to its final destination from QHIN to QHIN, Individual Access Services giving patients control of their information, Meaningful Choice for individuals to determine how their personal ePHI is disclosed and used, and ADT Hub, which is designed to increase the volume and quality of admission, discharge, and transfer messages available to public and private participants.