Chad Peterson VP State Health Data Centre of Excellence

Achieving universal interoperability is something health systems across the globe are striving to achieve. By breaking down data silos and promoting information sharing, healthcare providers can ensure better outcomes through connected, efficient, and patient-centred healthcare ecosystems.

In the United States, the Office of the National Coordinator for Health Information Technology (ONC) has made interoperability a priority and put regulations in place such as the 21st Century Cures Act and CMS Interoperability and Prior Authorization Final Rule, which advance interoperability and support the access, exchange, and use of electronic health information across disparate systems

The ONC has also established protocols such as the Trusted Exchange Framework and Common Agreement (TEFCA). TEFCA serves as a foundational framework for enabling nationwide interoperability by establishing common standards, principles, and practices for the secure exchange of electronic health information.

Taking the next steps towards interoperability 

Recently, the ONC announced the release of version 2.0 of the TEFCA, which marks a significant milestone in the ongoing efforts to promote interoperability and advance the exchange of health information across the US healthcare ecosystem. Version 2.0 builds upon the progress made with the initial release, incorporating feedback from stakeholders and addressing key challenges and opportunities identified during implementation. 

One key highlight of TEFCA Version 2.0 is its emphasis on enhancing trust and confidence among participants in health information exchange. By defining clear rules of engagement and establishing mechanisms for enforcing compliance, TEFCA aims to foster a culture of trust and collaboration among healthcare stakeholders, including healthcare providers, health IT developers, payers, and patients.

Furthermore, TEFCA Version 2.0 introduces several new features and enhancements designed to improve the scalability, flexibility, and sustainability of health information exchange. These include:

  1. Expanded Participation Options: New participation options are introduced to accommodate a broader range of stakeholders, including health information networks, health information exchanges, and other qualified entities. This expanded participation framework promotes inclusivity and ensures that all relevant entities have the opportunity to participate in health information exchange activities.
  2. Streamlined Data Sharing Agreements: The process for establishing data sharing agreements between participating entities has been streamlined, reducing administrative burden and accelerating the implementation of health information exchange initiatives. By providing standardized templates and guidance for data sharing agreements, TEFCA facilitates the efficient and secure exchange of electronic health information.
  3. Enhanced Privacy and Security Protections: Privacy and security protections for health information exchanges have been strengthened, incorporating best practices and standards for data encryption, authentication, and access control. These enhancements help mitigate the risk of unauthorized access or disclosure of sensitive health information, thereby enhancing trust and confidence among participants.
  4. Enhancements and updates to require support for Health Level Seven (HL7®) Fast Healthcare Interoperability Resources (FHIR®) based transactions which will provide “the network infrastructure to support FHIR API-based exchange between TEFCA Participants and Subparticipants from different QHINs.”

Support from technology vendors is key 

In addition to these advancements, it’s crucial to acknowledge the role of technology vendors in supporting the implementation and adoption of TEFCA Version 2.0. Orion Health is well-positioned to meet the needs of clients seeking to comply with TEFCA and Qualified Trust Framework (QTF) requirements. With a robust portfolio of interoperability solutions and deep expertise in health information exchange, Orion Health offers a comprehensive suite of tools and services to facilitate seamless data exchange and collaboration among healthcare stakeholders.

As stakeholders continue to implement TEFCA Version 2.0 and leverage its capabilities to drive innovation and improve healthcare delivery, Orion Health stands ready to support by providing reliable, scalable, and interoperable solutions that meet the evolving needs of the healthcare industry.

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