ONC’s TEFCA Updates Encourage Seamless Data Exchange

The Office of the National Coordinator for Health Information Technology (ONC)’s second version of the Trusted Exchange Framework and Common Agreement (TEFCA) supports more interoperability measures for health care systems, including support for Fast Healthcare Interoperability Resources (FHIR) application programming interface (API) exchange and easier access to data for patients.

“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 National Coordinator for Health IT Micky Tripathi in a release announcing the Common Agreement update.

In the new version, participants can now join TEFCA with multiple qualified health information networks (QHINs), which gives patients more options and allows flexibility when exchanging their data.

The new version also includes a display with terms of participation that QHINs must use to pass down required terms to all its TEFCA participants. These terms also make the process easier to share information.

Deputy National Coordinator for Health IT Steven Posnack said the agency is continuing to pursue ways to streamline some of the processes by focusing on six different initial exchange purposes and to accomplish it at the national level for TEFCA.

“Where there’s some variability today from a policy perspective is that certainly the networks focus on treatment, and a lot of them do that as well but including public health, including payers, including other types of health operations, other business cases and benefits determination. Those are other exchange purposes that we’ve included now up front as part of the common agreements expectations,” said Posnack.

Implementation for the second version is scheduled for end of August.

During a recent HealthCast interview, Tripathi had noted ONC’s work to bring public health data systems live on the TEFCA network this year.

“What that will mean is that you’ll be able to have secure, on-demand availability of connections between health care delivery systems and public health agencies and between public health agencies themselves,” said Tripathi. “You want to be able to make sure that those adjacent agencies have the ability to share information with each other and to be able to do that securely and then also to the extent that there are things that have been agreed to share with the federal government … and then all of that just makes it much more efficient and much more secure.”

In addition to TEFCA, ONC is amid work on several policies, including the Health Data, Technology, and Interoperability: Certification Program Updates, Algorithm Transparency, and Information Sharing Final Rule (HTI-2) and United States Core of Data for Interoperability (USCDI).

Deputy National Coordinator for Health IT Steven Posnack said these efforts have all been different puzzle pieces in establishing new policy and new technical infrastructure.

“All these are really putting together a lot of pieces that we’ve been working on ever since the publication of the 21st Century Cures Act in 2016,” Posnack told GovCIO Media & Research. “It’s optimizing different policy and technical requirements as well as creating an opportunity for the market to innovate.”

Posnack added that ONC has received a large amount of positive feedback on TEFCA from government and industry.

“People are excited, though, which is great. You don’t normally hear that with regulatory work,” said Posnack. “A number of different sessions on TEFCA, as well, have been rewarding and I think it’s exciting for our team. A lot of hard work went into standing it up, so it’s great to see the industry really embrace what’s going on from a network capacity perspective.”