AHA concerned about FHIR removal from TEFCA
The American Hospital Association wants to see HL7’s Fast Healthcare Interoperability Resources standard put back into ONC’s Trusted Exchange Framework and Common Agreement.
TEFCA, drafted by the Office of the National Coordinator for Health IT, is intended to support nationwide interoperability by outlining a common set of principles—as well as minimum terms and conditions—for trusted data exchange.
However, in its second draft of TEFCA, ONC removed the requirement for Qualified Health Information Networks (QHINs) to support FHIR application programming interfaces as an exchange modality, according to AHA.
“While we understand that most potential QHINs currently use the Integrating the Healthcare Enterprise (IHE) standards to support data exchange, it is unclear to us why ONC would not require them to use the emerging FHIR standard, which it is requiring certified health IT products to implement,” states an AHA letter to National Coordinator for HIT Don Rucker, MD.
In a proposed rule released earlier this year, the agency—for the first time—made FHIR a requirement for developers participating in the ONC Health IT Certification Program.
As a standards framework, FHIR leverages RESTful APIs to enable data sharing among myriad health IT systems. By using the latest web standards, FHIR is seen as a simple-to-use format that can improve interoperability for a range of HIT technologies, including mobile apps, cloud communications and EHR-based data sharing.
However, the IHE standards included in ONC’s TEFCA are described by some critics as “old and very cumbersome” for supporting data exchange.
Part A of the TEFCA, the principles for trusted exchange, provides a set of core principles by which QHINs—as well as all HINs—and data sharing arrangements for data exchange should abide.
Part B includes the minimum required terms and conditions for trusted exchange that a Recognized Coordinating Entity (RCE)—selected through a competitive process—will use to develop a single common agreement that QHINs and their participants will voluntarily agree to adopt.
“We recommend that ONC or the RCE include FHIR APIs in the QHIN Technical Framework as a minimum requirement,” advises AHA’s letter to Rucker.