Sharing Health Data Update April 2023

We have now past the 19 year mark in our quest for healthcare interoperability. Under an executive order from president G W Bush, the ONC was established and Dr. David Brailer was dubbed “America’s first Health Information Czar.” The Meaningful Use program was then born out of the HITECH Act and Merit-Based Incentive Payment System was then born our of the MACRA legislation. And then information sharing from the CURES Act. And now the release of Trusted Exchange Framework and the Common Agreement (TEFCA). All trying to move our healthcare system to the digital age, better outcomes, controlling and reducing costs, and patient access to their health data. It has not been an easy road and the debate of the journey will never end.

Interoperability at HIMSS

HIMSS Interoperability Showcase

North Building | Hall B | Booth 7946

Experience real-time interoperability transactions with real-world scenarios at the highest attendee-rated destination on our exhibit floor. Watch demonstrations of standards-based technology with live health data exchange to support continuity of care and improve outcomes. Choose your path through the Showcase as connected care stories unfold in settings including:

  • Home Care
  • Inpatient
  • Long-Term Post-Acute Care (LTPAC)
  • Outpatient
  • Public Health

Witness the impact of competitive systems and products working together to improve clinical outcomes, quality, and patient experience. Engage with experts in our demonstration vignettes and interactive thought leadership theater presentations – and make the connections you need to transform care.

The Sequoia Project Speaking at HIMSS

The Sequoia Project will be presenting five times during HIMSS:

  • Monday, April 17 at 11:15 a.m.
    Didi Davis, vice president, informatics, conformance, and interoperability of The Sequoia Project, is moderating a preconference panel session on “Driving Interoperability in 2023: CURES, TEFCA, and Information Blocking” in Room S404.
  • Tuesday, April 18 at 1:30 p.m.
    Mariann Yeager is speaking about “ONC TEFCA Update from RCE” in Room S504.
  • Tuesday, April 18 at 4:15 p.m.
    Didi Davis is moderating a panel session on “The Sequoia Project: Interoperability Matters Process for Improving Data Usability” in Room S504.
  • Wednesday, April 19 at 11:30 a.m.
    Mariann Yeager is speaking about “TEFCA’s QHIN Applicants – Progress Toward Nationwide Interoperability Go-Live” in Room S100 C.
  • Thursday, April 20 at 11:30 a.m.
    Zoe Barber, policy director of The Sequoia Project, is presenting on “Securing TEFCA: Security Practices Promoting Nationwide Health Information Exchange” in Room S504.

Interoperability and HIE Forum: Driving Interoperability in 2023: CURES, TEFCA, and Information Blocking
Dr. Steven Lane, Health Gorilla Chief Medical Officer
The Trusted Exchange Framework and Common Agreement (TEFCA) has launched, and new rules are coming to prevent Information Blocking with penalties for non-compliance. In the Interoperability and HIE Forum, our panel will explore the compliance challenges and this evolving landscape.
South Tower, Room S103 – Monday, 4/17 – 11:15 AM – 12:15 PM CST

The Road to TEFCA – Perspectives from QHIN Candidates
Join us for an update on Qualified Health Information Networks (QHINs) under the Trusted Exchange Framework and Common Agreement (TEFCA). Hear directly from organizations officially approved for onboarding as QHINs, including…

Matt Doyle, Software Development Lead, Epic
Paul Wilder, Executive Director, CommonWell Health Alliance
Jay Nakashima, Executive Director, eHealth Exchange
Dave Cassel, Chief Customer Officer, Health Gorilla

West Building, Level 4 | W471 A
Wednesday, April 19 – 1:00 PM – 2:15 PM

In the Showcase at 7946

Spotlight on Community Networks

The Network for Regional Healthcare Improvement (NRHI) and the Strategic Health Information Exchange Collaborative (SHIEC) announced a formal affiliation between the two organizations to form a new organization named Civitas Networks for Health. The organization serves as a platform for local nonprofit health collaboratives and health information exchanges to grow and thrive. Follow them @civitas4health.

Civitas News

Collaboratives in Action: Health Data Partnerships for Public Health Improvement Webinar
Hosted by Civitas Networks for Health, featured from Colorado Community Managed Care Network (CCMCN), Colorado Department of Public Health and Environment (CDPHE), the Association of Immunization Managers (AIM), the American Immunization Registry Association (AIRA), and the Association of State and Territorial Health Officials (ASTHO), discussing their work on the Office of the National Coordinator for Health Information Technology (ONC) Immunization Data Exchange, Advancement and Sharing (IDEAS) program. View the recording.

The Network has continued to grow throughout its’ inaugural year. They have welcomed 14 additional new members since the last update on membership growth in May.

State HIE News

Delaware Health Information Network Announces New Technology Partner for Community Health Record
Delaware Heath Information Network (@DHIN_HIE), the First State’s health information exchange, is pleased to announce its technology partnership with Outcome Healthcare to develop the next iteration of DHIN’s Community Health Record, scheduled to go live later this year.

Contexture Upgrades to Unified HIE Technology Platform for Improved Interoperability in Arizona and Colorado
Contexture (@ContextureHIT), the largest health information organization in the western U.S. serving Arizona and Colorado, announced plans to transition to a unified technology platform for all its health information exchange (HIE) markets.

Industry and Contract News

Two Key Players in Ohio’s Health Information Exchange Announce New Partnership
The Health Collaborative (@hcollaborative) has strategically partnered with the Ohio Health Information Partnership (OHIP), also known as CliniSync, to improve the delivery of statewide health information exchange (HIE) services. The Health Collaborative will transition its HIE customers to CliniSync by the end of 2023.

East Tennessee Health Information Network reduces duplicate patient records with 4medica
4medica (@4medica) is proud to have recently added East Tennessee Health Information Network (etHIN) as a 4medica client. Established in 2005 and headquartered in Knoxville, etHIN reaches 80% of communities within its geographic market and contains records of patients from all 95 Tennessee counties who have been treated in the eastern part of the state, along with those of patients from other states who were treated in the area.

Health Gorilla Launches HG Accelerator Program, Offering Free Access to Health Data APIs for Early-Stage Startups
Health Gorilla (@healthgorilla), a Health Information Network and interoperability provider, has announced the launch of the HG Accelerator Program, enabling early-stage healthcare startups to access Health Gorilla’s portfolio of healthcare data APIs, software, and services free of charge, subject to certain use cases and guidelines.


Hires and Openings

VITL is the legislatively designated operator of the Vermont Health Information Exchange (sometimes written VHIE and pronounced Vee-high), a secure infrastructure that gives health care organizations in Vermont the ability to electronically share and access their patients’ health information in order to improve the quality, safety, and cost of patient care. They have an opening for Interface Integration Data Analyst.

Common Ground Health
Founded in 1974, Common Ground Health is one of the nation’s oldest and most effective regional health planning organizations. Located in Rochester’s Neighborhood of the Arts, the nonprofit serves the nine county Finger Lakes region. They currently have an opening for a Data Administrator.

Delaware Health Information Network (DHIN)
The Delaware Health Information Network (DHIN) is the nation’s first statewide health information exchange. Established by statute as a not-for-profit public instrumentality, DHIN’s primary mission is to facilitate the design and implementation of an integrated, statewide health data system to support the information needs of consumers, health plans, policymakers, providers, purchasers and researchers to improve the quality and efficiency of health care services in Delaware. They have an opening for Director of Data Analytics.

San Diego Health Connect
San Diego Health Connect is the health information utility that unifies the San Diego & Imperial Counties healthcare ecosystems. They securely connect providers, patients, private health information exchanges (HIEs) and others to improve the quality and cost of care in our community. They have an opening for CEO/Executive Director.

NYeC – New York eHealth Collaborative
New York eHealth Collaborative (NYeC) is a not-for-profit organization working in partnership with the New York State Department of Health to improve healthcare by collaboratively leading, connecting, and integrating health information exchange across the State. They have openings for the following position: Healthcare Data Analyst, Software Engineer, Systems Analyst, Master Data Management, Enterprise Architect

Civitas is Hiring!
Development Manager – Civitas has identified a need for a full-time Development Manager to assist the organization in both maintaining and growing funding while increasing membership.

The ideal candidate will have a working knowledge of the non-profit sector, member-based organizations/associations, grant acquisition and management, and project-based funding.

Reporting to the Senior Director, Business Development and Programs, the Development Manager will assist the organization in developing diverse and ongoing sources of financial support while managing and developing relationships with funders and sponsors.  As membership development is essential to the long-term growth of the organization, the Development Manager will also develop and oversee membership recruitment and retention strategies.

Associate Director of Advocacy and Public Policy – As the Associate Director of Advocacy and Public Policy, you will be responsible for developing and executing on our comprehensive policy agenda that supports the organization’s mission and strategic goals. You will report to the Sr. Director, Network Engagement to develop advocacy strategies that align with our mission, our members, and the organization.

The Associate Director of Advocacy and Public Policy should be a strategic thinker, capable of developing and executing complex policy initiatives in a fast-paced environment. Strong project management and communication skills are also essential, as you will be collaborating with the Civitas team, our members, and with external partners.

ONC's Cures Act Final Rule

In May of 2020 the 21st Century Cures Act: Interoperability, Information Blocking, and the ONC Health IT Certification Program released by the ONC and published in the Federal Register. Here is a quick timeline.


  • 6/30/20 – General Effective Date
  • 4/5/21 – Compliance requirements start for information blocking, assurance, and API
  • 4/5/21 – HIT developers prohibited from restricting certain communications
  • 12/15/21 – Submit initial real world testing plans
  • 4/1/22 – 1st attestation to conditions of Cert required
  • 12/31/22 – New HL7 FHIR API capability and other update criteria must be made available
  • 3/15/23 – Submit initial real world testing results
  • 12/31/23 – EHI export capability must be made available


The TEFCA Recognized Coordinating Entity Releases Draft Payment: Risk Adjustment Exchange Purpose Implementation SOP and Draft Health Care Operations: Limited Exchange Purpose Implementation SOP for Public Feedback

The TEFCA Recognized Coordinating Entity (RCE), The Sequoia Project, released two draft Standard Operating Procedures (SOPs) for stakeholder feedback:

The Draft Payment: Risk Adjustment Exchange Purpose Implementation (Risk Adjustment) SOP and the Draft Health Care Operations: Limited Exchange Purpose Implementation (HCO Limited) SOP define the Exchange Purposes of Risk Adjustment and HCO Limited and identify specific requirements that QHINs, Participants, and Subparticipants must follow when exchanging information for these purposes. It also specifies the conditions under which the Exchange Purposes require a Response.

The RCE is seeking stakeholder input on the Draft Risk Adjustment SOP and the Draft HCO Limited SOP through Wednesday, May 3, 2023. View the draft SOPs and submit feedback via the online submission form on the RCE website.

RCE Monthly Informational Call

Tuesday, May 16 | 12:00 p.m. – 1:00 p.m. ET
The Recognized Coordinating Entity (RCE) hosts a public informational call as an opportunity to share information about the progress to-date on the third Tuesday of each month. View previous calls.
Register Here

The TEFCA Players

ONC Recognized Coordinating Entity (RCE)

The Recognized Coordinating Entity (RCE) – The Sequoia Project (@sequoiaproject)is responsible for developing, implementing, and maintaining the Common Agreement component of the Trusted Exchange Framework and Common Agreement (TEFCA). The Common Agreement is the baseline technical and legal requirements for health information networks to share electronic health information and is part of the 21st Century Cures Act (Cures Act).

In addition they will collaborate with ONC to designate and monitor Qualified Health Information Networks (QHIN), modify and update an accompanying QHIN Technical Framework, engage with stakeholders through virtual public listening sessions, adjudicate noncompliance with the Common Agreement, and propose sustainability strategies to support TEFCA beyond the cooperative agreement’s period of performance.

TEFCA Timeline

RCE Releases TEFCA Facilitated FHIR IG Draft 2, and Updated Versions of QHIN Onboarding & Designation SOP and QHIN Application

Initial 6 Announced QHINs

Interoperability Market

According to Allied Market Research, the healthcare interoperability solutions market size was valued at $5,320.0 million in 2020, and is expected to reach $21,544.6 million by 2030, registering a CAGR of 14.9% from 2021 to 2030. Interoperability in healthcare refers to timely and secure access, integration and use of electronic health data so that it can be used to optimize health outcomes for individuals and populations. As populations around the world age and people live longer, interoperability and data sharing are going to become increasingly critical for delivering effective healthcare. Interoperability is the ability of two or more systems to exchange health information and use the information once it is received.

According to the report published by Fior Markets, the global healthcare data interoperability market is expected to grow from USD 2.83 billion in 2020 and to reach USD 5.80 billion by 2028, growing at a CAGR of 9.38% during the forecast period 2021-2028. The primary reasons driving healthcare interoperability market growth include a growing focus on patient care, a growing need to tighten healthcare costs, and government measures to improve patient experience of treatment. System interoperability, information interchange, and data availability are all important factors in improving health outcomes. Individual health data is mobilized throughout the whole range of care providers in health organizations, enabling coordinated, safe, and high-quality treatment that supports payment reforms, transparency efforts, and individuals’ ability to control their health.

Healthcare NOW Radio Tuning In To TEFCA Playlist