April 25, 2019

ONC Releases Second Draft of Trusted Exchange Framework

On April 19, 2019, the U.S. Department of Health and Human Services (HHS) Office of the National Coordinator for Health IT (ONC) released for public feedback its second draft of the Trusted Exchange Framework and Common Agreement (TEFCA), focusing on new and revised supporting components.

The deadline for public comments is June 17. When finalized, TEFCA will create a technical and governance infrastructure connecting various types of health information networks (HINs) through a core of directly connected qualified HINs (QHINs) to facilitate nationwide health information exchange and interoperability. The first draft TEFCA was released for comment in January 2018.

The draft components for comment are accessible in Appendices 1, 2 and 3 of the draft TEFCA:

  1. Draft 2 of the Trusted Exchange Framework: common set of principles for HINs to participate in the initiative and enable data exchange
  2. Draft 2 of the Minimum Required Terms and Conditions for trusted exchange: mandatory terms and conditions that QHINs agree to follow
  3. Draft 1 of the QHIN Technical Framework: technical and functional components for exchange among QHINs

To support TEFCA oversight, ONC also released a notice of funding opportunity for a recognized coordinating entity (RCE) to maintain the Common Agreement, monitor QHINs and various other governance responsibilities. The deadline for RCE application submissions is June 17.

ONC and the Centers for Medicare and Medicaid Services have also extended public comment periods associated with the March 4, 2019, proposed rules to implement “interoperability” mandates from the 21st Century Cures Act. The new public comment deadline is June 3. These proposed rules were addressed in ACR Advocacy in Action on February 14, 2019 and the ACR Voice of Radiology blog on March 29, 2019.

ACR members with an interest in interoperability rulemakings, draft TEFCA or other ONC initiatives should contact Michael Peters, ACR director of legislative and regulatory affairs, at mpeters@acr.org or (202) 223-1670, ext. 4546.