Trusted Exchange Framework and Common Agreement (TEFCA)

See the following -

AHRQ Releases Draft Guide for Registry Interoperability: Does Public Health Have a Role?

On January 11, 2019, the Agency for Healthcare Research and Quality (AHRQ) released a draft Addendum to the Third Edition of Registries for Evaluating Patient Outcomes: A User's Guide called Tool and Technologies for Registry Interoperability. AHRQ has long written about registries - largely from a research standpoint - and I have been following this from afar for some time. This new guide is focused on helping those who both create and use registries understand the issue surrounding leveraging external data to improve registry completeness, accuracy, and usefulness. This report covers lots of ground and does a good job of summarizing important subtopics. Each chapter is overflowing with footnotes and sources.

Read More »

An interoperability update: Do we need more carrots and sticks?

Earlier this year, the ONC released the Trusted Exchange Framework and Common Agreement (TEFCA), which responds to a mandate included in 2016’s 21st Century Cures Act and lays out principles, terms and conditions on which to base an interoperability framework that healthcare organizations can embrace. “This means patients who have received care from multiple doctors and hospitals should have their medical history electronically accessible on demand by any other treating provider in a network that signed the Common Agreement,” said National Coordinator for Health IT Donald Rucker in a recent blog post. To achieve that goal, TEFCA is divided into parts A, the principles, and B, the terms and conditions, which is also where the rubber meets the road for many who live in the healthcare IT world...

Read More »

HHS Releases Landmark Report: Reforming America's Healthcare System

On December 3, 2018, the Department of Health and Human Services (HHS) released an extensive, 120-page report on the administration's proposals to reform the healthcare system. The report, titled Reforming America's Healthcare System Through Choice and Competition, is divided into four major sections. The report that government policy of the last few years has suppressed competition, increased prices for healthcare, and limited choices for consumers. Though rich in detail as it tries to prove each of these points, the more than fifty recommendations are often broad and aspirational rather than practical. Since I am not a health economist, I will leave the market issues to others to discuss (many of the ideas in this report have been vetted and discussed by others previously). But there are two sections of the report which make direct mention of Health IT.

Read More »

ONC's Trusted Exchange: A Public Health Perspective

In January 2018 the Office of the National Coordinator for Health Information Technology (ONC) issued a draft Trusted Exchange Framework and Common Agreement (TEFCA), and related supporting documents, in response to a requirement imposed by Congress in the 21st Century Cures Act. The Act says that the TEF may include a common method for authenticating users, a common set of rules, enabling policies, and a process for managing non-compliance. Nowhere does the Act instruct ONC to determine an actual technical architecture in this process, though such a step is not precluded either. The primary document is in two parts: Part 1 is a set of principles that set the foundation for Part 2 which is a set if minimum terms and conditions for trusted exchange.

Read More »

The Evolving Landscape of Health Information Exchange

The original vision for nationwide health information exchange was a “network of networks” model where local HIEs would interact HIE-to-HIE to form a virtual national network. But notice that many of the new initiatives are essentially solving a different problem: they are enabling point-to-point connections across a wider geography and set of clinical sites. This seems more like a large, single national network rather than leverage of more distributed organizations or implementations. Only time will tell if these private sector initiatives will collaborate, converge or compete. And only time will tell of the limitations of ONC’s ability to influence and provide leadership will creates gaps or provide new opportunities for innovation.

Read More »