TEFCA; on-ramp to interoperability for healthcare organizations

Experts discuss new program’s potential to increase connectivity and patient access to their health information.

The Trusted Exchange Framework and Common Agreement (TEFCA) gives healthcare stakeholders new opportunities to proactively plan to improve interoperability across the industry.

That’s the view of Chris Emper, regulatory advisor, and Muhammad Chebli, vice president of solutions for NextGen Healthcare.

“The entire idea behind TEFCA is providing an easier on-ramp.”

In a presentation at an HDM KLASroom session on clinician experience, Emper and Chebli provided advice to healthcare IT leaders on how to approach this new option for interoperability, while providing attendees with a description of the current state and projected impact of TEFCA.

Emper, who was involved in the development of TEFCA, offered some background on the 21st Century Cures Act and TEFCA and linked it to strategies that organizations should now pursue.

The US government “tasked the ONC to produce a framework — a common agreement and a trusted exchange framework — that would basically create some common rules of the road,” he said. “Now, organizations can voluntarily sign up with HIEs and national networks like CommonWell and Carequality. It was kind of Congress's way of saying to the stakeholders who were complaining about the lack of interoperability, ‘Here's one proactive approach you can take.’ ”

Chris Emper - 3 main interoperability policy provisions put into context

TEFCA will rely on accredited qualified health information networks (QHINs) to agree to a common set of standards and rules to provide a unified platform that enables information exchange.

“The entire idea behind TEFCA is providing an easier on-ramp,” adds Chebli. “Rather than an organization needing to participate in three or four or five different exchange mechanisms, one connectivity to a QHIN would enable broader-based access.”

Muhammad Chebli - TEFCA as on-ramp to interoperability

Chebli and Emper predict that the adoption of TEFCA will ultimately benefit not only provider organizations, but also patients.

“Patient access is a huge part of QHIN goals,” Chebli says. “Hopefully, in the next two years or so, a patient who is knowledgeable or familiar with the available technology and exchange frameworks should have a level of confidence when they visit their provider’s office that they will not only have direct access to that individual provider’s EHR system’s data, but that through a QHIN the provider may be participating in, the patient will be able to access and query data from other parts of the network via a mobile app.”

Many provider organizations, particularly those with a desire to qualify as a QHIN, are asking whether they should be waiting and watching or jumping on board with TEFCA. Recently, Epic, a healthcare systems technology provider, announced its intention to become a QHIN.

“That answer will certainly vary depending on exactly what your organization’s strategy is, what the demands are, and what would go into becoming certified in the program,” says Emper.

“I don't think I see TEFCA becoming a requirement as a condition of participation in Medicare and Medicaid over the next five years,” Emper continues. “But I could see [the government] saying you must enroll in order to participate in an alternative payment model, such as the new payment model from CMMI (the Center for Medicare & Medicaid Innovation), or the new ACO model.”

Whether or not the government ever issues mandates related to TEFCA, Chebli said he believes that healthcare leaders would be better prepared by taking advantage of TEFCA.

“I think a big part of being ready for the future is implementing the things that are available today,” said Chebli. “I'd really encourage organizations, especially healthcare delivery organizations, that are thinking about interoperability and data exchange to focus on the services and the activities that are available right now.”

TEFCA is only one example of how the interoperability landscape has matured in recent years, and Emper is eager to see TEFCA make its mark. “It is exciting, once the rules have been written, to see what the impact is five years later when they actually hit the market.”

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The HDM KLASroom learning series

The HDM KLASroom explores the people, process and technology strategies for improving clinician experiences including access to data ‘when I need it’ and how to fulfill the undelivered promises of enhanced clinical experiences through optimized digital health technologies.


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