Toward Nationwide Interoperability: A 2-Minute TEFCA Explainer

TEFCA grew out of the 21st Century Cures Act of 2016. It exists to promote nationwide interoperability by providing the infrastructure to help different health information networks securely share clinical data—under a common agreement of expectations and rules.

The 21st Century Cures Act directed the Office of the National Coordinator for Health Information Technology, or ONC, to create a trusted exchange framework for advancing interoperability and the exchange of health information nationwide. Why is this important? Because no matter where the patient is on their care journey, providers should have access to a comprehensive view of the patient’s care history, so the patient can receive better, safer, more cost-effective care.

In 2019, ONC selected the Sequoia Project to be TEFCA’s recognized coordinating entity, or RCE. As the RCE, the Sequoia Project will act as an “umbrella” under which qualified health information networks (QHINs) operate and exchange patient electronic health information. The RCE is responsible for developing and implementing the Common Agreement as well as overseeing activities conducted under TEFCA.

Participating in TEFCA is intended to allow healthcare organizations to join a network under one set of terms and conditions—set by the Common Agreement, the QHIN Technical Framework and standard operating procedures—and gain access to information from a variety of sources and locations. Healthcare organizations and end users will access information through these QHINs, and the QHINs will connect to each other using the principles documented in the trusted exchange framework.

Participation in TEFCA is voluntary, but organizations who wish to participate must apply to be recognized as QHINs. ONC is expected to begin reviewing applications and onboarding QHINs in 2022.