The Trusted Exchange Framework and Common Agreement (TEFCA) is an agreement that was created in 2022, with the aim of achieving a high level of interoperability across the healthcare industry. With the implementation of TEFCA, there is now a clearly mapped path which will look to ensure healthcare organizations can exchange information with one another in a regulated fashion. TEFCA outlines fundamental rules for procedures and regulations that facilitate the exchange of information. These rules, outlined in the Trusted Exchange Framework of TEFCA, are non-binding.
Background to The Sequoia Project
The Sequoia Project is an organization that works to make healthcare information more accessible in the United States, and generally improve the health of citizens. The project was founded ten years ago, in 2012, and was soon granted authorization to oversee and coordinate the eHealth Exchange by the U.S. Department of Health and Human Services. At present, the eHealth Exchange is the biggest health information exchange in the U.S. The Sequoia Project places a heavy focus on interoperability in the context of healthcare data. Since its founding, the initiative has strived towards making healthcare information not only more accessible, but easily exchanged, stored, and utilized between healthcare entities.
The Sequoia Project involvement in TEFCA
Following the publishment of the two drafts of TEFCA, it was clear that a Recognized Coordinating Entity (RCE) was needed for the agreement to take flight. The National Coordinator for Health IT (ONC), an organization that works to improve the exchange of health information within the United States, took on the role of finding a suitable RCE to oversee TEFCA. ONC decided The Sequoia Projected would be best suited to coordinate TEFCA from 2022 onwards, due to their notable work in the development of interoperability of healthcare information. The agreement with The Sequoia Project was alluded to in the second draft of TEFCA, where a suggestion to appoint them was made. ONC and The Sequoia Project have made progress thus far with TEFCA, having published v.1.0 of TEFCA, however, there is still years of progress to be made. The goal for TEFCA is for it to become the singular connector for the exchange of healthcare information between entities.
For this to be achieved, there are several areas of improvement that The Sequoia Project may look to focus on:
- The Sequoia Project and ONC should look to swiftly carry out operations to publicize Standard Fee Schedules and SOPs that are yet to be published, in addition to QHIN Application Onboarding Requirement documents to give stakeholders an insight into how the completed framework should look.
- To finalize a protocol for taking on new organizations to mitigate worry towards the implementation of TEFCA while an exchange already exists within the organization.
- To clearly outlie of what is required of organizations upon them joining TEFCA
- ONC and The Sequoia Project should c work with stakeholders throughout the health ecosystem as TEFCA is progressively introduced. This can be done through QHI Networks as well as both Participants, and Sub-participants. This step further adds to the clarity needed while TEFCA is still being introduced in the healthcare ecosystem.
Additionally, it may be beneficial for the Sequoia Project and ONC to further develop a unique selling point, to attract organizations to amalgamate with TEFCA
