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In February of this year, HHS announced the first six organizations approved as QHINs. These organizations committed to begin exchanging data in late 2023/early 2024. The initial QHINs include:
- CommonWell Health Alliance
- eHealth Exchange
- Epic Systems
- Health Gorilla
- Kno2
- KONZA National Network
GaHIN and TEFCA
The Sequoia Project, which serves as the Recognized Coordinating Entity (RCE) under TEFCA, points out that a key question HINs will need to consider is whether to become a QHIN or connect to a QHIN. GaHIN decided to focus on its core mission of serving Georgia and will be a participant HIN.
At this time, GaHIN is still researching options. Participants are able to opt out or change their QHIN affiliation at any time.
According to The Sequoia Project, “The Participant HINs will deliver the value of the TEFCA throughout the healthcare system by connecting their own participating providers, health care organizations, public health agencies and consumers to this efficient and broad scope of nationwide exchange.”
It is important to note that TEFCA/QHIN participation is optional and that healthcare organizations can only belong to one QHIN. For example, a health system using Epic may choose to be a part of the Epic QHIN. However, they can still be a member of GaHIN and benefit from local connections to facilitate non-QHIN query-based exchange and other services such as ADT alerts and registries.
GaHIN does not anticipate any cost for members to participate in a QHIN through GaHIN and members will be able to satisfy certain MIPS requirements.
TEFCA/QHIN participation comes with operational, legal/flow-downs and technical requirements that participants must meet. Organizations are encouraged to work with their technology partners and internal leadership to ensure readiness.
Deciphering TEFCA Terms and Acronyms
Trusted Exchange Framework and Common Agreement (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).
Trusted Exchange Framework (TEF) – describes a common set of non-binding, foundational principles for trust policies and practices that can help facilitate exchange among HINs.
Recognized Coordinating Entity (RCE) – the nonprofit Sequoia Project was selected to serve as the RCE to support TEFCA’s implementation and determine the process and requirements for becoming a QHIN.
Common Agreement – establishes the infrastructure model and governing approach for users in different networks to securely share basic clinical information with each other.
Qualified Health Information Network (QHIN) – the central connection points within the TEFCA, responsible for routing queries, responses and messages among participating entities and individuals.
Required Flow-Down(s) – the rights and obligations set forth within the Common Agreement must be adhered to by all QHINs, their Participants (e.g. GaHIN) and Subparticipants (e.g. GaHIN members who choose to use its TEFCA/QHIN services).
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