Carequality – the decade-old interoperability initiative whose information exchange framework comprises more than 45 networks linking more than 50,000 outpatient clinics and 4,200 hospitals – announced this past Friday that it will "thoughtfully align" with the federal-led Trusted Exchange Framework and Common Agreement, or TEFCA.

WHY IT MATTERS
Carequality was founded in 2014 – launched as one of the first nationwide interoperability frameworks, and a complement to the network of state and regional health information exchanges. A decade of steady growth later, the 501c3 nonprofit connects more than 600,000 individual care providers across its national footprint, supporting the exchange of some 940 million documents each month. In 2022, it expanded to enable participation of federal agencies.

TEFCA, which was implemented under law by the landmark 21st Century Cures Act and went live in 2023, was developed with stakeholder feedback by the Office of the National Coordinator for Health IT and is now spearheaded by the Sequoia Project, its recognized coordinating entity.

HIMSS, parent company of Healthcare IT News, recently made available an array of resources focused on TEFCA and other interoperability frameworks.

"The community-led Carequality Interoperability Framework and TEFCA share many characteristics," said officials from Carequality on Aug. 16. "As TEFCA forges its own path ramping up production rollout this year, the Carequality community is watching, learning and, in some cases, participating in TEFCA."

This includes new enhancements to its own framework to "bolster trust in the current connectivity, and plans to forge a strategic path of alignment" with TEFCA going forward, officials said. "Carequality’s framework is mature and supported by a deliberative governance structure. We are committed to further advancing interoperability while protecting patient data."

With TEFCA and its seven qualified health information networks, or QHINs, gaining a critical mass of participation, Carequality continues to fine-tune its own frameworks and procedures and aims to align with TEFCA where appropriate, it says, "with an eye towards future convergence of the two frameworks." New goals include:

• Leveraging existing Carequality policies now to address community concerns about required responses to queries.

• Accelerating the ongoing consideration and adoption of policy revisions to align with TEFCA’s approach to the definition of treatment.

• Instituting stronger directory integrity controls.

• Incorporating TEFCA Delegate policies into our existing On-Behalf-Of policies to increase transparency and controls.

Carequality has scheduled an informational webinar on Thursday, Aug. 29, at 1 p.m. for stakeholders to learn more.

THE LARGER TREND
One of Carequality's most notable participants is Epic, with fully 100% of its community taking part in the information exchange framework. The electronic health record giant issued its own statement, commending the group for aligning with TEFCA.

By the end of this year, the company – already a TEFCA participant – says it plans to have secured commitments from the entire Epic community to transition to TEFCA via the Epic Nexus QHIN, with plans for all of those customers to be live by the end of 2025.

"TEFCA is the nation’s best opportunity to get the remaining 30% of U.S. hospitals off the sidelines and reinforce trust between data exchange networks and care organizations," said Epic officials in a statement.

ON THE RECORD
"We know that when interoperability is done right, patients receive care that allows them to make informed decisions about their health journey," said Carequality leaders in announcing the realignment.

"Disrupting the existing frameworks of interoperability poses too great a risk on patient outcomes," they said. "This is why we are strategically and methodically evolving to meet the needs of our dynamic community now, while making a plan to converge with TEFCA in the future. Together, we can build upon our successes, ensuring that interoperability is trusted and continues to be a cornerstone of a healthier future for all."

Mike Miliard is executive editor of Healthcare IT News
Email: mike.miliard@himssmedia.com
Healthcare IT News is a HIMSS publication.