Version 2.0 of TEFCA Common Agreement Requires FHIR Support

April 22, 2024
ONC also publishes the Participant and Subparticipant Terms of Participation for TEFCA

The Office of the National Coordinator for Health IT (ONC) has released Version 2.0 of the Common Agreement defining how different health information networks and their users securely share clinical information with each other. The most significant update is that Version 2.0 requires support for FHIR application programming interface (API) exchange.

The Common Agreement defines the baseline legal and technical requirements for secure information sharing on a nationwide scale. The Common Agreement also establishes the infrastructure model and governing approach to enable users in different health information networks (HINs) to securely share information with each other—all under commonly agreed-to expectations and regardless of which network they happen to be in. 

Under Version 1 of the Common Agreement, exchange only occurs via IHE protocols. ONC said the FHIR support will allow Trusted Exchange Framework and Common Agreement (TEFCA) participants and subparticipants to more easily exchange information directly between themselves and will enable individuals to more easily access their own healthcare information using apps of their choice via TEFCA. 

“We have long intended for TEFCA to have the capacity to enable FHIR API exchange. This is in direct response to the health IT industry’s move toward standardized APIs with modern privacy and security safeguards, and allows TEFCA to keep pace with the advanced, secure data services approaches used by the tech industry,” said Micky Tripathi, Ph.D., national coordinator for health information technology, in a statement. “I want to commend the effort put forth by the TEFCA and FHIR communities to help get us there with the release of CA v2.0.”

The seven designated Qualified Health Information Networks (QHINs) under TEFCA can now adopt and begin implementing the new version. 

ONC also published the Participant and Subparticipant Terms of Participation, which sets forth the requirements that each Participant and Subparticipant must agree to and comply with to participate in TEFCA.

ONC said the Terms of Participation would also greatly enhance the TEFCA framework by providing a stand-alone document that Participants and Subparticipants can incorporate into existing data use agreements, thus reducing legal costs and burden for organizations seeking to connect to TEFCA.
 “The initial exchange of clinical data began within 24 hours of the nation’s first Qualified Health Information Networks achieving designation in December 2023,” said Mariann Yeager, CEO of the Sequoia Project, the recognized coordinating entity for TEFCA, in a statement. “Today’s release includes framework enhancements, including greater use of FHIR, better support for use cases beyond treatment, and simplified onboarding for Participants like clinicians, digital health apps, public health agencies and other end users of health data.”

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