January 11, 2018

ONC Releases Draft Trusted Exchange Framework

The Health and Human Services (HHS) Office of the National Coordinator for Health IT (ONC) released a draft Trusted Exchange Framework and Common Agreement (TEFCA) for public comment on Jan. 5, 2018.

Health care providers now generally join multiple health information networks (HINs) of various types, and many HINs do not share data with unaffiliated HINs. 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.

For health care providers, this could mean joining one participating network and obtaining appropriate access to more robust data about their patients from other networks. Other stakeholders for a trusted exchange framework include patients/caregivers, regulatory and public health agencies, payers, clinical data registries and health IT developers.

The first part of the draft TEFCA outlines six general principles for trusted exchange: standardization, transparency, cooperation and non-discrimination, privacy/security/patient safety, access and data-driven accountability. The second part specifies terms and conditions for trusted exchange as applied to qualified HINs, participants and end users.

ONC discusses plans in the draft TEFCA to fund a private organization to serve as a Recognized Coordinating Entity (RCE) to operationalize the trusted exchange framework and to work with QHINs to ensure adherence to a common agreement of shared standards, practices and procedures for trusted exchange. The RCE would also be responsible for working with its stakeholders to update the TEFCA.

Congress mandated the development of TEFCA via heath IT provisions packaged into the 21st Century Cures Act in late 2016. TEFCA is one of several Cures-mandated new initiatives intended to encourage interoperability, along with information-blocking prohibitions endorsed by the American College of Radiology (ACR).

ONC’s public comment period for the draft TEFCA closes Feb. 18, 2018. Members interested in contributing to the ACR’s potential comment submission should contact Michael Peters, ACR director, regulatory and legislative affairs, at mpeters@acr.org | (202) 223 -1670 x4546.

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