TEFCA: Understanding the Framework and the Common Agreement

The healthcare sector has had quite a run the last few years: 

• • Non-stop privacy regulations have been thrown at the industry from nations and states 
  • Resourcing and operational issues related to the pandemic 
  • Accelerated digital transformation as patient care moved further outside the traditional hospital, doctor’s office, and clinic walls 

And now, there’s TEFCA: The Trusted Exchange Framework (1) and Common Agreement. (2)  

Here are a few of the many benefits that health interoperability could bring, as identified by HealthIT.gov’s Health Interoperability Outcomes 2030: (3) 

• • The health system will enable evidence-based, precision care that accounts for each patient’s social and health conditions, including links between health and human services. 
  • The health system will more quickly identify high-risk conditions, chronic diseases, and disparities in health equity. 
  • The data used for clinical and administrative processes will be electronically integrated to support decisions about payment, eligibility, and benefits. 
  • Public health response and preparedness will be driven by real-time data that allow public health agencies to quickly identify when and where infectious disease outbreaks occur and maintain insights about health system capacity. 
  • Researchers will use inclusive, representative datasets to compare the real-world performance of treatments, procedures, devices, and drugs. 
  • Health professionals will spend less time on administrative tasks and more time caring for their patients. 

The official goals for TEFCA are: (4)  

• • Goal 1: Establish a universal policy and technical floor for nationwide interoperability. 
  • Goal 2: Simplify connectivity for organizations to securely exchange information to improve patient care, enhance the welfare of populations, and generate health care value. 
  • Goal 3: Enable individuals to gather their health care information. 

To meet these goals and deliver these scenarios, TEFCA has been comprised of 2 core elements: (5) 

1. The Trusted Exchange Framework is a set of non-binding but foundational principles for health information exchange. 
2. The Common Agreement establishes the technical infrastructure model and governing approach for different health information networks and their users to share clinical information securely – all under commonly agreed-to rules of the road. 

As organizations begin to unpack the details within both the framework and the agreement, they will likely realize that TEFCA is so much more than just being able to “share data.” TEFCA will introduce numerous high-scale data collection, storage, transport, and processing requirements for organizations to meet. It will also bring some sobering cyber risks that will require mitigation as the networks, systems, and data sets are exposed to other networks and systems. Organizations also get a tremendous amount of technical challenges and operational headaches. 

Citations: 

1 – “The Trusted Exchange Framework (TEF): Principles for Trusted Exchange,” HealthIT.gov, January 2022 

2 – “Common Agreement for Nationwide Health Information Interoperability,” HealthIT.gov, January 2022  

3 – “Health Interoperability Outcomes 2030,” HealthIT.gov, January 2022 

4 – “3…2…1…TEFCA is Go for Launch,” HealthIT.gov, January 2022 

5 – “ONC Completes Critical 21st Century Cures Act Requirement, Publishes the Trusted Exchange Framework and the Common Agreement for Health Information Networks,” HHS, January 2022