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TEFCA is up and running. Here’s why it’s a big deal for the exchange of health data.


After years of planning, the Department of Health and Human Services hailed the milestone. Five organizations have been approved as the initial data exchange networks.

Federal officials said they wanted to get a nationwide health data exchange operational by the end of 2023.

Photo: HHS

U.S. Health and Human Services Secretary Xavier Becerra said TEFCA going live is a "major milestone." (Photo: HHS)

It may have come toward the end of the year, but that goal was realized, and federal officials hailed it as a “milestone.”

This week, federal officials announced that the Trusted Exchange Framework and Common Agreement (TEFCA) is live. Federal officials and healthcare leaders say the interoperability framework will advance the exchange of health information between hospitals, healthcare organizations, insurers and patients.

Micky Tripathi, national coordinator for health information technology, hailed the accomplishment.

“In February 2023 we announced that TEFCA would be operational by the end of the calendar year, and we are delighted to achieve this goal,” Tripathi said in a statement.

Officials noted there are other steps to make full interoperability a reality, but they celebrated a watershed moment.

U.S. Health and Human Services Secretary Xavier Becerra touted the significance of TEFCA going live.

“After over a decade of very hard work, today marks another major milestone in our march towards a 21st century digital health care system,” Becerra said in a statement. “TEFCA allows patients, providers, public health professionals, health insurers, and other health care stakeholders to safely and securely share information critical to the health of our country and all of our people.”

The health department also announced that five organizations had achieved the sought-after designation as Qualified Health Information Networks. They’ve been recognized as having met the requirements to support the exchange of data under TEFCA, which establishes guidelines for sharing health information.

The five organizations are eHealth Exchange; Epic Nexus, a subsidiary of Epic; Health Gorilla; KONZA; and MedAllies. They’re entrusted with sending information across networks to hospitals, providers, payers and public health agencies.

Epic, the electronic health records giant, is encouraging all its hospitals and clinicians to participate in the network, and has secured commitments from major systems such as Kaiser Permanente, Johns Hopkins Medicine, Mayo Clinic, Intermountain Health, Mount Sinai, and more. So far, nearly 500 of Epic’s hospitals have pledged to join TEFCA.

Matt Doyle, Epic’s interoperability software development lead, talked with Chief Healthcare Executive® in June about the growing interest in TEFCA.

“I think the mindset is there,” Doyle said in June. “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,” he added.

Steven Lane, chief medical officer of Health Gorila, said there’s been wider acknowledgement of the need for greater interoperability in the health system. Lane told Chief Healthcare Executive® in February that he’s encouraged by the recognition of health leaders to support the exchange of health data nationwide.

“I think we're sort of coming to a new place, where people really appreciate the value of interoperability, certainly in value-based care for public health purposes, you know, and so many other use cases, and they're really seeing this as critical to how they move forward,” he adds.

The Office of the National Coordinator for Health Information Technology (often called “ONC”) has worked on the effort for years. The Sequoia Project has received a five-year contract to implement the data exchange and spur more public and private involvement.

Mariann Yeager, CEO of The Sequoia Project, said she hopes to soon see other organizations tabbed as Qualified Health Information Networks. She hailed the work of the first five organizations in earning the designation, saying the process was “necessarily arduous to ensure the pioneering organizations were prepared to be the nation’s backbone for health information sharing.”

In a statement, Yeager said she’s excited to move from the planning stages to expanding an operational, nationwide data exchange.

“We encourage wide participation by providers, payers, app developers, and others to ensure that health data is shared when needed to improve health and care,” Yeager said.

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