”The necessary infrastructure is critical to the rapid and efficient exchange of information,” said Steven Lane, panel moderator and director of clinical informatics at Sutter Health. ”The release of the draft QTF for feedback is an important milestone as we aim to live in production and exchange under the Joint Agreement in 2022,” Micky Tripathi, Ph.D., National Health Information Technology Coordinator, said in a statement. ”The QTF will also evolve to support new standards such as FHIR in the future, and we welcome industry feedback on a proposed FHIR roadmap to be released in the near future. Since its appointment as TEFCA Coordinator two years ago – a partnership that was extended in May 2020 with new funding of $1.1 million – the Sequoia project has taken a number of initiatives to build data-sharing capacity. Many expressed concern about the success or extent of the adoption of the standards and framework. The HITAC Advisory Board has created various incentives to rally the industry, including requiring participation in participation standards in other federal programs such as Medicare, Medicaid or Veteran Community Care; or the government that considers a company`s participation in TEFCA (or lack thereof) to determine whether or not the organization is guilty of information blackouts. But significant gaps remain in this system, gaps that have been highlighted by the coronavirus pandemic, Tripathi wrote in Tuesday`s post. Many HIEs only operate in local markets without connection to other networks, while inter-network exchanges still face countless problems. For the second year, ONC has provided approximately $1.1 million for our collaboration agreement with The Sequoia Project, the recognized coordinating body (RCT) that supports the implementation of TEFCA. Under the Cooperation Agreement, RCE is responsible for developing, updating, implementing and updating the Joint Agreement and the Technical Framework of the Qualified Medical Information Network (QTF). This funding will support RCT activities from August 2020 to August 2021. Learn more about this announcement. The objective of this program is to support efforts to advance the development of an interoperable health system that (1) enables individuals to make full use of their eHealth information, (2) enables providers and communities to ensure smarter, safer and more efficient care, and (3) fosters innovation at all levels.

The draft Trust Exchange Framework, published on 5 January 2018, promotes the objectives of the 21st Century Remedies Act (Remedies Act) to promote interoperability at the national level by creating a common set of principles, modalities and conditions that facilitate trust between Health Information Networks (NINs). The design of the Trusted Exchange infrastructure consists of two parts: Part A – Principles for Trusted Exchange and Part B – Minimum Requirements for Trusted Exchange. Part A contains guidelines and general principles that qualified HINs and HINs should follow to build trust between participants and end users. Part B contains specific minimum conditions to be included by an RCT in a single joint agreement. ONC will review the comments received on Parts A and B to develop a final trust-sharing framework that would support the NCE in its implementation. Part B of the draft Trusted Exchange framework is not intended to be a global participation agreement, but contains provisions to address certain areas of variation between existing network agreements. This funding opportunity announcement aims to identify a unique NCE that, in collaboration with ONC, incorporates the final requirements of Part B into a single joint agreement that qualified HINs and their participants can voluntarily agree to comply with. Developing a single, comprehensive agreement with a national scope will significantly reduce the need for point-to-point or point-to-point interfaces that are expensive, complex to build and maintain, and the inefficient use of healthcare providers` and IT developers` resources. People who don`t want to share their information can express their wish that their data not be shared on the network, said rancourt, who stressed that ”applicable law applies” in terms of privacy protection.

”We welcome contributions on all aspects of the TEFCA model, including topics such as mandatory and optional exchange targets, privacy and security policies, mandatory and optional exchange models, and the inclusion of the Health Level Seven International Fast Healthcare Interoperability Resources standard in the QTF roadmap,” wrote Tripathi and Yeager. In August 2019, ONC selected the non-profit Sequoia project, a public-private partnership engaged in healthcare IT exchanges nationwide, as a recognized coordinating body that oversees the implementation of TEFCA. As an NCE, project Sequoia oversees how various health information networks communicate in exchange for approximately $1 million in federal funding per year. ”The joint agreement will establish the infrastructure model and authoritative approach for users of different networks to securely share basic clinical information with each other – all according to mutually agreed expectations and rules, and regardless of the network they are currently on,” Tripathi and Yeager wrote. In addition, the NCE maintains a directory of exchange participants associated with each QPI so that other QINs and participants can forward their requests or message delivery accordingly. QINs must support QTF directory requirements for managing their directory entries. In 2019, ONC granted a collaborative agreement to the Sequoia project to act as a Recognized Coordinating Body (RCT) for the development, updating, implementation and updating of the Common Agreement and Technical Framework of the Qualified Medical Information Network (QTF). Learn more about this announcement.

The TEFCA and the proposed rules for blocking information will require existing HINs and SIIs to make changes to their existing agreements, policies and procedures for the use of data to meet requirements. Participation in TEFCA is voluntary, so HINs and EIHs who wish to participate want to actively examine areas where the two sets of requirements overlap when updating their existing agreements. It will also be important to monitor and review the timelines for implementing the information freeze and TEFCA. The Office of the National Health Information Technology Coordinator, Senior Assistant National Coordinator Genevieve Morris, will be inaugurated on August 8. Come to the AHA at 4.m p.m. ET to .m a special webinar to review the recently released draft of the Trust Exchange Framework and The Common Agreement. The 21st Century Remedies Act requires the ONC to develop or support a reliable exchange framework, including a joint agreement between health information networks at the national level. The draft TEFCA focuses on policies, procedures and technical standards that build on the existing capabilities of the health information network and allow them to work together to provide information to patients with a single ”ramp, regardless of the healthcare IT developer they use, the exchange of health information or the network with which they contract, or how well patient records are growing across the country.” condition. The Sequoia project also selects and monitors qualified health information networks, networks that accept the common exchange conditions set out in the joint agreement and the exchange requirements set out in the RQIS Technical Framework (QTF). In general, the information to be exchanged within the TEFCA ecosystem is based on the HL7 Guide for CDA Release 2: Consolidated CDA Templates for Clinical Notes (US Realm) Draft Standard for Trial Use Release 2.1 (C-CDA 2.1) document format.

This includes data defined as part of U.S. Interoperability Master Data Version 1 (USCDI v1), with the ability to further extend message content to support various use cases. ”TEFCA could introduce a new exchange paradigm that is not prevalent in a network today,” said Dave Cassell, Executive Director of Carequality. ”It allows QINs to provide services for a query model as well as a more advanced messaging model.” The technical framework focuses primarily on LHIN to QHIN exchange requirements. .