Sharing Health Data Update December 2022

We have now past the 18 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.

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

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

Eight Social Care Platform Organizations Collaborate to Improve Interoperable Referrals in Michigan
Building off the momentum created by the Michigan Health Information Network’s (@MiHIN) Interoperable Referrals Pledge, eight of the nation’s social care platform vendors, Care Advisors, CareConvene, Findhelp, Holon, PCE Systems, Riverstar, Unite Us and WellSky, have formed a Community of Practice (CoP) hosted by MiHIN. Collaboratively governed and facilitated, the CoP is dedicated to the statewide sharing of data that documents social need identification, referrals, interventions, and outcomes amongst care teams that span health and social care.

DHIN Recognized as a DirectTrust Interoperability Hero
Delaware Heath Information Network (DHIN), the First State’s health information exchange, is pleased to announce its recognition as a DirectTrust Interoperability Hero. The nation’s first operational statewide health information exchange, DHIN shares real-time clinical information to improve patient and clinician experience, lower costs and promote better outcomes. DirectTrust is a non-profit healthcare industry alliance created to support secure, identity-verified electronic exchanges of protected health information.

Industry and Contract News

DirectTrust and EHNAC Announce Merger Agreement
DirectTrust (@DirectTrustorg) and the Electronic Healthcare Network Accreditation Commission (@EHNAC) announced an agreement to merge EHNAC with and into DirectTrust, effective January 4, 2023.

The Sequoia Project Awarded Northern Virginia Champions for Accountability Badge – The Sequoia Project, a non-profit and trusted advocate for nationwide health information exchange, was awarded the Northern Virginia (NOVA) Champions for Accountability badge by The Community Foundation for Northern Virginia, a trusted public charity that helps grow philanthropy to respond to need, seed innovation and lead and convene the community.

DirectTrust Interop Heroes for Q3 2022 – An initiative introduced in 2021 by DirectTrust which recognizes individuals that are advancing interoperability every day to make a difference in the lives of patients. See the newest heroes.

A Decade of Connections: The CommonWell Fall Summit 2022 – A fine prelude to CommonWell’s upcoming 10-year anniversary in March. Paul L Wilder, Executive Director, CommonWell Health Alliance recaps the key themes throughout the recent 3-day summit.

A Glimpse Into the Future of HIE and National Network Connectivity | NextGen Healthcare

Net Health Expands Partnership with Kno2 to Help Rehab Therapists Meet Demands for Care Coordination – Kno2® and Net Health® announced the expansion of a partnership to provide an integrated solution for outpatient rehabilitation therapy clinics. Through this agreement, clients using the Net Health Therapy for Clinics EHR will be better able to seamlessly exchange patient information and improve care coordination and meet the demands for new care models, including value-based care.

AcademyHealth 2023 Health Datapalooza
February 23, 2023 – February 24, 2023
Register for this event

The 2023 Health Datapalooza will once again bring together attendees from across the health care landscape to discuss the future of health data and the policies and innovations that will spark real transformation in health care.

eHealth Exchange Annual Meeting
December 15, 2022, Grand Hyatt Washington, DC
Register for this event

Event will cover eHealth Exchange updates and accomplishments for 2022, and what is in store for 2023.

Hires and Openings

Mountain-Pacific Quality Health
Chief Executive Officer – Mountain-Pacific Quality Health, headquartered in Helena, Montana, is seeking a dynamic, distinguished executive to serve as its next Chief Executive Officer. This is an exciting opportunity to lead a progressive and forward thinking Quality Improvement Organization, serving one of the largest geographic footprints in the country. Under the direction of the Centers for Medicare & Medicaid Services (CMS), Mountain-Pacific Quality Health is the Quality Innovation Network-Quality Improvement Organization (QIN-QIO) for Montana, Wyoming, Hawaii, Alaska and the U.S. Pacific Territories of Guam and American Samoa and the Commonwealth of the Northern Mariana Islands.

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.

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.

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 Players

ONC Recognized Coordinating Entity (RCE)

The Recognized Coordinating Entity (RCE) 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.

2022 TEFCA Timeline

Q1 of 2022

  • Publish Common Agreement Version 1
  • Publish QHIN Technical Framework (QTF) – Version 1 and FHIR Roadmap
  • Initiate work to enable FHIR-based exchange
  • Public education and engagement

Q2 of 2022

  • QHINs begin signing Common Agreement and applying for designation

Q3 and Q4 of 2022

  • Onboarding of initial QHINs
  • Additional QHIN applications processed
  • RCE establishes Transitional Council
  • RCE begins designating QHINs to share data
  • Prepare for TEFCA FHIR exchange pilots

Qualified Health Information Networks (QHIN)

To apply for QHIN Designation, a Health Information Network (HIN) must meet certain prerequisites, including already operating a network that provides the ability to locate and transmit EHI between multiple persons or entities electronically, with existing persons or entities exchanging EHI in a live clinical environment; and providing the RCE with a written plan of how it will achieve all of the requirements of the Common Agreement within a specified time period.

As of October 3, 2022 QHIN Application is open.

QHIN Application, Onboarding, and Designation Phases – The prospective QHIN Application, Onboarding, and Designation process has been divided into a series of five phases. See the phases.

QHIN Contenders

Healthcare NOW Radio Interoperability Playlist