Qualified Health Information Network (QHIN) application process details released

The Sequoia Project has released new details on the process and requirements for becoming a Qualified Health Information Network (QHIN), inching forward toward launching the QHIN application process later this year.

The Office of the National Coordinator for Health Information Technology (ONC) made the Trusted Exchange Framework and Common Agreement available in January this year. The Sequoia Project was selected to serve as the recognized coordinating entity (RCE) to support the implementation of TEFCA. created to facilitate nationwide interoperability as required under the 21st Century Cures Act to, TEFCA calls for forming QHINs to facilitate nationwide data exchange among a wide variety of organizations in an effort to improve care.

The effort will establish a universal policy and technical floor for nationwide interoperability to simplify connectivity and enable individuals to more easily obtain their healthcare information. The QHINs are expected to be the backbone of interoperability, connecting to each other and to their participants and subparticipants.

The Sequoia Project on May 16 released drafts of:

Sequoia will accept comments on the drafts through June 15.

Mariann Yeager, CEO of The Sequoia Project

“Since TEFCA’s release on Jan. 18, 2022, we’ve been entirely focused on hitting our promised timeline of potential live exchange before the year’s end,” said Mariann Yeager, CEO of The Sequoia Project. “We look forward to the thoughtful input of potential QHINs and other stakeholders to carefully consider these drafts.”

Also released May 16 were an updated SOP on QHIN security requirements for the protection of TEFCA information, as well as a list of approved cybersecurity certifications for QHINs that are under consideration – so far, the list only includes HITRUST’s r2 Validated Assessment.

The Sequoia Project said it would issue an SOP on exchange purposes in June, an SOP on security incidents and reportable events in October, and an SOP for public health exchange early next year.

QHIN application process update

The application process for organizations seeking QHIN designation is now slated to begin in late summer or early fall, according to a blog post issued by ONC and the Sequoia Project. “This is aligned with our goal of QHINs beginning to onboard as early as fall of this year,” the blog states.

Earlier, authorities had said they expected to begin the application process in the second quarter.

Questions raised

The drafts issued May 16 raise some questions, such as how “provisional status” will work, because the first QHINs won’t yet have the technical capability for full compliance, says Paul Wilder, executive director of the CommonWell Health Alliance, which plans to apply to become a QHIN.

Also still unknown is how individuals will access their own health records from TEFCA-connected sources and what fees the RCE will charge QHINs for participating.  SOPs for these requirements are expected to be released later this year.

Another organization – eHealth Exchange – that plans to apply to become a QHIN is “reviewing the latest releases from the RCE and ONC and will submit feedback as appropriate,” says Jay Nakashima, executive director. “More importantly, we will incorporate these releases, and all forthcoming details, into our QHIN strategy to best support our network participants in this new TEFCA paradigm.”

Steve Yaskin, CEO and co-founder of Health Gorilla, notes: "Since announcing our intention to pursue a QHIN designation last October, we've worked diligently to ensure that our legal, functional, and technical requirements are aligned with TEFCA and feel more than prepared to begin the application process.”

“We appreciate the fact that [the QHIN formation process] is moving along and ask how we can help,” Wilder adds.

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