Regulatory Updates

Regulatory Updates

SOURCE: website

Trusted Exchange Framework and Common Agreement (TEFCA)

In the 21st Century Cures Act, Congress identified the importance of interoperability and set out a path for the interoperable exchange of Electronic Health Information. Specifically, Congress directed ONC to “develop or support a trusted exchange framework, including a common agreement among health information networks nationally.”

TEFCA outlines a common set of principles, terms, and conditions to support the development of a Common Agreement that would help enable nationwide exchange of electronic health information (EHI) across disparate health information networks (HINs). The TEFCA is designed to scale EHI exchange nationwide and help ensure that HINs, health care providers, health plans, individuals, and many more stakeholders have secure access to their electronic health information when and where it is needed.

The Trusted Exchange Framework (TEF) Version 1 — A common set of principles that are designed to facilitate trust between HINs and by which all HINs should abide in order to enable widespread data exchange. These principles are the foundational concepts that guide the development of the Common Agreement.

Common Agreement Version 1 – Will operationalize simplified electronic health information exchange for many across the US and will provide easier ways for individuals and organizations to securely connect. Most notably, the Common Agreement sets a new baseline for the exchange purposes that need to be supported. The Common Agreement is a new legal contract that ONC’s Recognized Coordinating Entity (RCE), The Sequoia Project, will sign with each Qualified Health Information Network (QHIN).

The QHIN Technical Framework (QTF) Version 1 — This document is incorporated by reference in the Common Agreement. It details the technical and functional components for exchange among QHINs. To review requirements to apply to become a QHIN, visit the RCE website at

The Trusted Exchange Framework builds on and recognizes the significant work done by the industry over the last few years to broaden the exchange of data to meet the needs of patients and the providers who serve them. It aims to scale interoperability nationwide by providing a single “on-ramp” to allow all types of healthcare stakeholders to join any health information network they choose and be able to participate in nationwide exchange, regardless of what health IT developer they use, health information exchange or network they contract with, or where the patients’ records are located. The Trusted Exchange Framework aims to ease the flow of information between healthcare stakeholders and expand patient access to their health data, while allowing for a competitive marketplace that fosters innovation and development of new technologies to improve care coordination, population health management, and patient outcomes.

The official website of The Office of the National Coordinator for Health Information Technology (ONC) shares extensive information about this framework including PDF downloads on the framework itself, user guides, and stakeholder-specific information. Learn more here.