PODCAST: Brookings Fellow Yaraghi Slams ONC’s TEFCA

April 4, 2018
Niam Yaraghi and I discuss TEFCA, the evolution of HIEs and where things stand today, and the government’s push for a market-oriented healthcare that is centered around patient empowerment.

Back in January, the Office of the National Coordinator for Health IT (ONC) released its draft Trusted Exchange Framework and Common Agreement (TEFCA)—a plan to jolt the sluggish pace of progress on interoperability between providers.

Soon after the plan’s release, various associations took advantage of the 45-day public comment window to voice their concerns and suggestions with TEFCA, most notably having to do with its timeline, lack of details, and how it will be aligned with other 21st Century Cures Act provisions. While it remains to be seen how ONC will work this stakeholder feedback into future iterations of TEFCA, one health IT professional, Niam Yaraghi, Ph.D., a nonresident fellow in the Brookings Institution's Center for Technology Innovation and an assistant professor at University of Connecticut's School of Business, did not hold back in his thoughts about the federal interoperability plan.

Indeed, on the latest Healthcare Informatics podcast, Yaraghi opined (at the 9:30 mark) that TEFCA is “a nicely written document, but that’s it,” adding that he doesn’t expect it to “have any major influence on anything.” Yaraghi further specified that “there are a bunch of nice words in there but no ‘how-to’ involved in the draft framework.” He also expressed doubts that the Recognized Coordinated Entity (RCE) under TEFCA—whoever that may be—will be able to run things authoritatively, as ONC has outlined.

He asked, “Why will organizations who did not follow ONC’s recommendations—after 10 years and billions of dollars spent [on federal health IT and interoperability efforts]— now follow those recommendations of a third-party all of a sudden? That is wishful thinking. ONC had an obligation under the Cures Act to write that document and that is exactly what it did. People won’t take it seriously.”

Niam Yaraghi, Ph.D.

Beyond TEFCA, Yaraghi and I discussed the evolution of HIEs (1:30) and where things stand today, the government’s push for a market-oriented healthcare that is centered around patient empowerment (20:00) and much more as it relates to health information exchange and interoperability.

This podcast runs just under 30 minutes in length and keep in mind, you can listen to all Healthcare Informatics podcasts right here.

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