Wednesday 19 December 2018
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Interoperability and the Trusted Exchange Framework

Interoperability and the Trusted Exchange Framework

Trusted Exchange Framework and Common Agreement (TEFCA)

In the 21st Century Cures Act (Cures Act), Congress identified the importance of interoperability and set out a path for the interoperable exchange of Electronic Health Information. Specifically, Congress directed ONC to “develop or support a trusted exchange framework, including a common agreement among health information networks nationally.”

The Draft Trusted Exchange Framework, released on January 5, 2018, outlines a common set of principles for trusted exchange and minimum terms and conditions for trusted exchange. This is designed to bridge the gap between providers’ and patients’ information systems and enable interoperability across disparate health information networks (HINs).

  • Principles for Trusted Exchange (Part A)—guardrails and general principles that Qualified Health Information Networks (QHINs) and Health Information Networks (HINs) should follow to engender trust amongst Participants and End Users.
  • Minimum Required Terms and Conditions for Trusted Exchange (Part B)—specific terms and conditions that will be incorporated into a single Common Agreement by a Recognized Coordinating Entity (RCE).

The final Trusted Exchange Framework and Common Agreement (TEFCA) will include Parts A and B, as well as the Common Agreement, and will be published in the Federal Register and on this website in late 2018.

A minimum set of terms and conditions for the purpose of ensuring that common practices are in place and required of all participants who participate in Trusted Exchange Framework, including:  


Principles for Trusted Exchange

Minimum Required Terms and Conditions for Trusted Exchange

Download:  A User’s Guide to Understanding the Trusted Exchange Framework

Additional resources to find out more about the TEFCA and how it effects your healthcare IT product:

AAFP Advises ONC, Continues Fight for Interoperability

To advance health information exchange, we need a health IT consortium

Groups weigh in on ONC data exchange plan

Pew, HIMSS press ONC to modify planned trusted exchange framework to ensure interoperability

CHIME, HIMSS, Premier Tackle Health Data Exchange Framework



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