Does true interoperability have a chance?

Interoperability is all about cooperation. Without aligned incentives and a culture of collaboration that transcends traditional competitive boundaries, true health information exchange is destined to fail. 

Regulators, providers, and technology companies have long struggled with how to best retool the industry to encourage interoperability and make it easier for patients to get the care they need whenever and wherever they need it.  

The latest and most promising attempt at a solution is TEFCA, the Trusted Exchange Framework and Common Agreement that stakes out a voluntary “universal floor for interoperability.” The Office of the National Coordinator (ONC) envisions a “network of networks” approach to developing seamless data exchange, with entities called Qualified Health Information Networks (QHINs) leading the way.

Related story: How TEFCA aims to change the face of health data interoperability

The newly published framework has been met with a mix of hope and skepticism as stakeholders balance the impact of past disappointments with growing belief that the post-pandemic healthcare community is finally prepared to make big changes. 

Fortunately for the optimists, EHR giant Epic Systems has just given TEFCA a huge boost. In late June, the company announced that it would be signing on to the framework as a QHIN, opening up opportunities for its 2,000 hospital customers and 45,000 clinic partners to participate in the new interoperability landscape. 

“Our fundamental goal is to help all patients receive informed, personalized care—regardless of where they go to receive it,” said Dave Fuhrmann, senior vice president of interoperability at Epic, in a press release. “Our customers have led the way with large-scale interoperability through Carequality, and we’re happy to help with the next stage in the evolution of interoperability.” 

Epic has been collaborating with the ONC and the Sequoia Project on the development of TEFCA, so the announcement isn’t wholly unexpected. However, with a history of rubbing the industry the wrong way on certain interoperability topics, it is encouraging to see the company fully engaged with pushing data exchange forward across the care continuum.  

Leadership from heavyweight entities like Epic and the eHealth Exchange, another early volunteer for the QHIN role, will be crucial for cementing the principles of TEFCA in the next generation of technologies and data exchange strategies. The more influential entities that embrace TEFCA, the better the chance that the framework can make a real dent in the complex and challenging financial and technical puzzle of the current interoperability environment. 

TEFCA will be rolling out slowly over the next couple of years as industry stakeholders and regulators continue to refine the roadmap for actionable health information exchange across disparate systems.

Related story: Sequoia Project seeks comment through July 15 on HHS security measures for healthcare interoperability

For example, the Sequoia Project is currently soliciting comments on its draft application process for becoming a QHIN. Interested parties can review drafts of the QHIN application, onboarding documents, and qualification requirements to share their opinions and suggestions. 

“The feedback we receive through our events, website, and email has been invaluable as we operationalize TEFCA and finalize implementation resources,” said Mariann Yeager, chief executive officer of The Sequoia Project. “We look forward to another robust round of engagement regarding the QHIN Onboarding and Designation SOP and the QHIN Application this month.” 

With so much positive activity, TEFCA appears to be on track for success – at least for now.  Operationalizing such a massive undertaking will be difficult, especially as the industry continues to recover from the COVID-19 pandemic and its toll on providers’ bandwidth to invest in new technologies and strategies. 

It will take sustained commitment, a retooling of traditional relationships, and engagement from key stakeholders to see tangible results. Hopefully, TEFCA will be the jumpstart that the industry needs to overcome its past challenges and enter a new era of seamless data exchange. 

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Jennifer Bresnick is a journalist and freelance content creator with a decade of experience in the health IT industry. Her work has focused on leveraging innovative technology tools to create value, improve health equity, and achieve the promises of the learning health system.