ONC Marks Milestone as TEFCA Goes Live

Dec. 12, 2023
Common Agreement Version 2.0, expected to require support for FHIR-based transactions, is scheduled to be adopted in the first quarter of 2024

The Trusted Exchange Framework and Common Agreement (TEFCA) is now operational. 

The Office of the National Coordinator for Health Information Technology (ONC) has led a multi-year process alongside its Recognized Coordinating Entity (RCE), the Sequoia Project, to implement TEFCA, which was envisioned by the 21st Century Cures Act. 

The idea is to create a “network of networks” for sharing health data across the country. The goal is that like wireless networks, electricity grids and ATMs, the user experience will become as if it's a single network.

The Common Agreement, released in September 2021, includes six exchange purposes that organizations must support to be designated as a  Qualified Health Information Network (QHIN). The exchange purposes include Treatment, Payment, Health Care Operations, Public Health, Benefits Determination, and Individual Access Services.

“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, in a statement. “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.”

The following organizations were officially designated Qualified Health Information Networks (QHINs) after successfully completing the TEFCA onboarding process.
• eHealth Exchange
• Epic Nexus
• Health Gorilla
• MedAllies

There are approximately 20 organizations formally seeking QHIN status. Several other health information networks, including CommonWell Health Alliance, Surescripts Health Information Network LLC and the United States Qualified Health Information Network (USQHIN), a subsidiary of Velatura Public Benefit Corp., are in the process of applying to become QHINs.

Cloud-based ambulatory EHR company eClinicalWorks also has announced today that it will seek QHIN status. 

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

Common Agreement Version 2.0, which is anticipated to include enhancements and updates to require support for FHIR-based based transactions, is under development and scheduled to be adopted by the QHINs within the first quarter of 2024.

So far, participation in TEFCA is voluntary, with no regulatory requirements or incentives yet tied to joining. But many health systems are signaling they are eager to take part in the interoperability framework.


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