The joint agreement defines essential technical and legal requirements for health information networks, which are referred to as qualified health information networks (QHIN) as part of the TEFCA framework. ONC was tasked with developing or supporting a trusted exchange framework under the 21st Century Cure Act. The projects released today respond to stakeholder feedback by making substantial changes to the proposed requirements that health information networks that choose to participate must follow. These changes include updating the purposes for which information can be exchanged, adding a push method for data exchange, adding a technical framework for QHIN, and extending the time limits for participating companies to implement the necessary changes to the agreement. “TEFCA can introduce a new exchange paradigm that does not prevail on a network today,” says Dave Cassell, Executive Director of Carequality. “There are QHIN that provide services for a query model, and a push messaging model.” The NCE is essentially an authority responsible for keeping everything together. “We are entering a critical phase of the agreement development process and we need input from organizations that agree to participate in exchange activities within the framework of the common agreement. This ensures that the agreement is both practical and widely supported,” Yeager said. “This work offers the health IT community the opportunity to shape the future of interoperability via TEFCA. It is important that we include the implementation community and provide as many opportunities as possible for everyone to participate. 1) Minimum Operating Conditions Required (MRTC) – These are the basic conditions that qualified health information networks (HHHS) meet. 2) Mandatory Additional Operating Conditions (ARTCs) – These focus on the operational maintenance requirements of the agreement.
A recognized coordinating body (CEN) will develop CETs. Audit and approval are the responsibility of the ONC. 3) QHIN Technical Framework (QTF) – The technical and functional requirements for the exchange of the IUE between the QHIN. The NCE and THE ONC will work with stakeholders to update and maintain the QTF. One of the things I found confused was the language around the participant and the participant`s member. They are described as “a natural person or an organization that has an agreement.” While this seems to apply to a perceived need for flexibility, which is always appreciated in the health field, flexibility can also be introduced by Abmiguity. We seem to be focusing on the entity, not the role. Is a provider in a health care system a member, participant or individual user? Ambiguity is the foundation of the walls that prevent us from having judicious interoperability.