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Epic is joining TEFCA, and urging others to follow: 'We need everyone'


America’s largest electronic health record company will be a part of the Trusted Exchange Framework and Common Agreement. Epic’s Matt Doyle says the company will encourage its thousands of partners to follow suit.

For years, healthcare leaders have been touting the importance and potential of interoperability, the exchange of patient data between organizations.

Matt Doyle, Epic’s R&D team lead and software development team leader for interoperability, said it’s not just a lofty goal.

“Interoperability is already happening,” Doyle tells Chief Healthcare Executive.

Epic, the nation’s largest electronic health record company, launched its first interoperability platform, Care Everywhere, in 2008. Epic says providers use the platform to exchange 10 million patient charts every day. More than 70% of U.S. hospitals are using Epic’s second generation framework, Carequality, to exchange data.

“That is a fantastic success story,” Doyle says. “That’s something we should all be celebrating.”

However, Epic is looking to take the next step. The company said last month it would be the first electronic health record company to join a new health information exchange framework: the Trusted Exchange Framework and Common Agreement, or TEFCA.

The new framework is designed to make interoperability truly nationwide. EPIC has collaborated with the Office of the National Coordinator for Health Information Technology (ONC), the Sequoia Project and industry leaders in the development of the framework. When the application process begins later this year, Epic will apply to be an inaugural Qualified Health Information Network.

In an interview with Chief Healthcare Executive, Doyle talked about the importance of the national health information network and why it could help patients and providers.

“TEFCA is a significant opportunity to improve interoperability for everyone in the healthcare ecosystem,” Doyle said. “And for Epic specifically, it’s the next logical step in our long history of supporting health information exchange. And that’s really why we’re excited.” (The story continues after the video.)

‘The next logical step’

With Epic joining TEFCA, the company’s customer base, including 2,000 hospitals and 45,000 clinics, will have the opportunity to join that national health information exchange.

While Doyle notes Epic is already working with 70% of America’s hospitals, that leaves a significant number of hospitals that aren’t easily exchanging data with other providers, or payers.

“TEFCA, as the next step in interoperability, is the opportunity to reach out to that remaining 30% and help them see the same success of exchanging data that their peers have seen.

“That’s why Epic is participating,” Doyle says. “We see this as the next logical step.”

Even with more health data being exchanged between systems, Doyle acknowledges it’s going to take a great deal of work and cooperation to get to nationwide interoperability.

“The question is, how do you take those things that have worked and scale them up, both in size and volume as well as participants?” Doyle says. “We need not just providers and hospitals. We need public health authorities, we need patients, we need everyone to be part of the ecosystem of health information exchange.”

“I think when we get that diversity of participants and the breadth of participants, that’s where we have the most opportunity to succeed,” he says.

TEFCA is going to bring the industry a lot closer to offering “easy access to the health information, at the point of care, when docs need it,” Doyle says.

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Reaching critical mass

With better exchange of health information, hospitals can treat patients more effectively and patients can have shorter stays in the hospital, Doyle explains.

“We know interoperability … can drive great outcomes,” he says.

Epic will urge its thousands of healthcare providers to join the national framework.

‘“We will be doing everything we can to encourage our community to use the tools that we’re creating for TEFCA,” Doyle says. “There’s an opportunity to use our voice to help our customers, providers, hospitals, clinics, to understand the value that this program has, and how it’s going to help their patients and their providers.”

When he thinks about the potential obstacles toward more providers and healthcare organizations joining TEFCA, Doyle says, “it’s really about following open standards and also about reaching critical mass or adoption as quickly as possible.”

“If you just invented telephones, and you’re the only guy in your neighborhood who has a telephone, that doesn’t actually do you much good,” Doyle says. “You need enough of your neighborhoods to have one as well for you to get the value out of it.”

“That’s where EPIC can really play a role. I’m hoping that our announcement inspires others, EHR vendors, hospitals, clinics, public health authorities, to want to participate,” he says. “I hope that we help folks see why this is going to be so valuable to them so we can get to that critical mass as quickly as possible.”

Some health providers may take longer to join the framework. Doyle says there are bound to be late adopters. Smaller health providers, including rural hospitals and Federally Qualified Health Centers, don’t have the staff and resources of other systems.

Epic plans to do what it can to shorten the adoption curve, Doyle says. “One, make sure people know the value, and that’s one of our responsibilities, and then second, make it as easy as possible,” he says.

Doyle says Epic’s software will include a module for TEFCA, “so customers really have a low barrier of entry to participate.”

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