The Trusted Exchange Framework and Common Agreement (TEFCA) has been launched on January 18, 2022, by the Office of the National Coordinator (ONC). In previous decades, it has become increasingly obvious that healthcare data should be stored and exchanged online. With an efficient system in place, electronic healthcare data improves the general welfare of patients by giving their healthcare providers a greater insight into their medical history, which allows them to make an informed decision on how to proceed. Electronic healthcare data also allows individuals to receive a higher standard of healthcare when they are away from their usual provider.
Origins of TEFCA
The process of transferring healthcare data begun many years ago and was developed through the HITECH Act 2009. Also contributing, was the 21st Century Cures Act 2016 which was implemented to quicken the rate of which an exchange network could be formed. The first steps towards the formation of TEFCA took place in 2018, where ONC published the first draft of the Trusted Exchange Framework which was mandated by the act. Although many tweaks have been made to TEFCA in the last four years, the objective of eliminating the inefficiency that entity to entity communication causes was present in this first draft. Since then, TEFCA has been a prominent feature of ONC releases and nearly half a decade later is now ready for release.
With TEFCA implemented, healthcare entities can become Qualified Health Information Networks (QHIN) through an application process. When an entity becomes a QHIN, it can collaborate other QHINs and receive or send information through health information exchange. There are three main goals for TEFCA, outlined by The Sequoia Project:
- To implement a global common policy and structured foundation for a national exchange of information through interoperability.
- To ensure entities can exchange information between one another in a secure and efficient manner, to increase the levels of patient care and improve the general welfare of all regions.
- Give patients the ability to retrieve any of their personal health care information from all sources
Breaking Down TEFCA
The Trusted Exchange Framework
The Trusted Exchange Framework is a set of rules that detail the exchange of health information. These principles outline the requirements of healthcare entities when attempting exchange information with another entity. Many healthcare organizations across different branches of medical provision have varying terms and conditions, which may hinder the exchange of healthcare data. With a clear set of rules, the transferring of data can be carried out with less difficulty, as was the case prior to TEFCA. These rules are seen as non-binding.
The Common Agreement
The Common Agreement is the lawful agreement that regulates the process of healthcare entities exchanging their information. This agreement allows different individuals and organizations to associate with one another. With this in place, a standard is set for what forms of exchange should be backed. Included within the Common Agreement are the determination of government benefits and details of payment. When a newly appointed QHIN organization is announced, they must sign the Common Agreement with the Sequoia Project. The Sequoia Project is the Recognized Co-ordinating Entity (RCE) of QHINs, with any prospect QHINs being organized under them moving forward. The project was chosen due to its dedication to improving the interoperability of the healthcare industry. Following this, the new QHIN can enact a set of their own procedures within their organization. Finally, the entity must avail of the QHIN Technical Framework to ensure they can make their new features operational.