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Hospitals joining TEFCA: Epic touts pledges from Kaiser Permanente, Mayo Clinic, Intermountain and more


More than 30 health systems have all agreed to join a nationwide framework for sharing health information. Epic’s Matt Doyle talks about why it’s a big step toward making interoperability a reality.

Epic, the electronic health records giant, has been championing the goal of exchanging data across the entire health ecosystem.

Now, with some large hospital systems making a commitment to join TEFCA, a nationwide interoperability framework, the company is touting a milestone in that effort.

In late May, Epic announced its first group of hospitals to take the step. Even since that initial announcement, more systems have made the pledge.

Now, more than 30 hospital systems have said they will join TEFCA, including big players such as Kaiser Permanente, Johns Hopkins Medicine, Mayo Clinic, Intermountain Health, Mount Sinai, and more.

“It’s a great landmark,” Matt Doyle, Epic’s interoperability software development lead, tells Chief Healthcare Executive®.

“I think it's really indicative of the community that we work with and their interest in helping to make sure that interoperability succeeds,” Doyle says.

TEFCA, the Trusted Exchange Framework and Common Agreement, is a public-private partnership that sets expectations and guidelines for the sharing of health information. While participation is voluntary, Epic and other advocates have said the framework will advance the exchange of data between hospitals, physicians, insurers, public health agencies, and consumers.

In an interview with Chief Healthcare Executive, Doyle talks about the importance of hospital systems pledging to join TEFCA, the path to interoperability, and what needs to happen to turn goals into reality.

Epic hopes to see the company’s 2,000 hospitals and 600,000 clinicians join the framework, Doyle says. “We're going to encourage our entire community to participate,” he says.

(See part of our conversation with Matt Doyle of Epic. The story continues below.)

‘The mindset is there’

Doyle says he has seen growing momentum for interoperability and the development of TEFCA.

“I think the mindset is there,” Doyle says. “It took some education. And we've been working with our community to help them understand the benefits of TEFCA.”

“As folks have come to understand the purposes and the use case and the value, then it becomes a pretty clear opportunity. And I think that's why people really are joining,” Doyle says.

The next major milestone comes when the Office of the National Coordinator for Health IT announces that tech organizations have completed their onboarding process and will be designated as Qualified Health Information Networks to implement the framework.

The networks have to meet high standards for privacy protections. In February, ONC named six approved applicants: Epic, CommonWell Health Alliance, eHealth Exchange, Health Gorilla, Kno2, and KONZA. When the networks complete their onboarding, Doyle says, “Then it goes from a plan to a real thing.”

Doyle hopes that the framework will go live sometime in 2023. The key is for other networks to be ready to join, but Doyle says, “Epic will be ready.”

“One person in a sandbox doesn't accomplish much,” Doyle says. ‘But Epic will definitely be ready. We will meet our commitment to have it ready.”

Doyle says he’s encouraged by the enthusiasm of others in the industry to make TEFCA succeed. He pointed to promising conversations about interoperability at the HIMSS Global Health Conference in April.

“I think what really struck me is the collaborative atmosphere,” Doyle says. “Really, folks are coming together to do this for the right reasons, to make sure physicians have the information they need to take care of patients, that you and I, as consumers, have access to our own health information, that we're looking ahead to new purposes, like public health. I think that's a great opportunity for our nation.”

Sense of urgency

There’s increasing solidarity and positivity around making TEFCA succeed, and Doyle says it’s time to move with a sense of urgency.

“We need to move quickly,” Doyle says. “This is a real problem. And we need to help providers, patients, public health, payers access appropriate information. And everyone really had an alignment of goals, that this is going to be the national framework that we're going to put our effort behind, and we're going to help this to be successful.”

With the easier exchange of data, Doyle says providers could see reduced burdens in prior authorization, the process of securing approval from insurers for treatments and medications.

Doyle says he sees “a great opportunity to really strike while the iron is hot to move quickly and solve these while they're front of mind.”

More patients want easier access to their health information, and Doyle says that’s a key driver in the growing support for interoperability.

“We live in a digital world, where you and I are accustomed as consumers to pull out our phone and to access really anything about ourselves, whether that's banking, whether that's credit rating, there's all sorts of stuff,” he says. “So healthcare should be equally accessible to patients.”

'Better and stronger together'

For those that are still not ready to make the pledge to join the framework, Doyle says it’s critical for organizations to see how it benefits them.

For health systems and physicians, Doyle says joining the framework offers the opportunity to get complete information to take care of patients. Public health agencies can get easier access to immunization records and case reports for infectious diseases.

“Interoperability works best when everyone participates,” Doyle says.

“So I always encourage everyone to find their role in this ecosystem,” he adds. “Whether you're a provider organization, whether you're a vendor, … you might be an intermediary. But whatever the right role is for you to play, find a way to participate, because we're all better and stronger together.”

For health organizations to join TEFCA and to move toward the nationwide exchange of health data, Doyle says it’s critical for top executives to make it a priority.

“It's very important that this is not just an IT project, that this is an operational and organizational project where they say there are real challenges that we can solve,” Doyle says. “We're going to make patients' lives better. We're going to make providers and nurses' lives better. That's why we're doing it and you need more than IT to make that happen.”

Participating organizations

Here’s the full list of EPIC’s health systems and organizations committing to TEFCA, as of June 1.

  • Alameda Health System
  • Ballad Health
  • Baptist Health (FL)
  • Baptist Health (KY)
  • BJC HealthCare and Washington University School of Medicine
  • Cedars-Sinai
  • Children’s Hospital Colorado
  • Community Health Network
  • Contra Costa Health
  • Duke Health
  • ECU Health
  • Erlanger Health System
  • Guthrie
  • Hawaii Pacific Health
  • Hill Physicians Medical Group
  • Houston Methodist
  • Intermountain Health
  • Johns Hopkins Medicine
  • Kaiser Permanente
  • KeyCare
  • Legacy Health
  • MaineHealth
  • Mayo Clinic
  • MetroHealth
  • Michigan Medicine
  • Mount Sinai Health System
  • NYU Langone Health
  • Pikeville Medical Center
  • Pediatric Physicians’ Organization at Children’s (PPOC)
  • Rush University Medical Center
  • St. Luke’s Health System (ID)
  • Stanford Health Care
  • UC Davis Health
  • University of Miami Health System
  • Weill Cornell Medicine
  • Yale New Haven Health
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