Sharing Health Data Update February 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.


Six Organizations Designated as QHINs
On Monday, February 13th the ONC and HHS Secretary Xavier Becerra recognized the first set of applicant organizations that are approved for onboarding as QHINs under TEFCA. Congratulations:

eHealth Exchange, CSRI Announce QHIN Partnership Intentions
eHealth Exchange (@eHealthExchange), one of the nation’s oldest and largest health information networks, announced that the Consortium for State and Regional Interoperability (@HlthDataUtility), a collection of five of the nation’s largest and most robust nonprofit health data networks, intends to partner with eHealth Exchange’s anticipated Qualified Health Information Network (QHIN) to participate in the Office of the National Coordinator for Health IT’s (ONC’s) Trusted Exchange Framework and Common Agreement (TEFCA).

RCE Releases Updated Versions of QHIN Onboarding & Designation SOP and QHIN Application
The Sequoia Project, selected by the Office of the National Coordinator for Health Information Technology (ONC) as the Recognized Coordinating Entity (RCE) to support the implementation of the Trusted Exchange Framework and Common Agreement (TEFCA), released Version 2 of the Qualified Health Information Network (QHIN) Onboarding & Designation Standard Operating Procedure (SOP) and Version 2 of the QHIN Application.

The RCE released draft versions of these documents in December and collected stakeholder feedback through January 11, 2023. The updated documents are now available on the RCE website.

View QHIN Onboarding & Designation SOP and QHIN Application

The RCE also released the RCE Directory Service Implementation Guide, which can be found here.

RCE Monthly Informational Call

Tuesday, February 21 | 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

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

CyncHealth Achieves Advanced Certification for Security of Health Data
CyncHealth (@CyncHealth), the designated health information exchange (HIE) for Nebraska and Iowa, is proud to announce it recently underwent a review process and has effectively demonstrated its ability to meet the rigorous standards required for HITRUST Risk-based, 2-year (r2) certification.

CliniSync and Unite Us Team Up to Expand Coordinated Care Throughout the Buckeye State
The Ohio Health Information Partnership, operating CliniSync (@CliniSync), Ohio’s statewide HIE and Unite Us, a national cross-sector collaboration software company connecting health and social care services, are partnering to expand the coordinated care network known as Unite Ohio. This five-year collaboration will allow providers, managed care organizations and Community Service Organizations across the state to access the network, allowing Ohioans to easily connect to much-needed wraparound supportive services.

Industry and Contract News

DirectTrust Announces TNAP-Participant V2.0 Accreditation Criteria Available for Public Review through March 20
DirectTrust™, a non-profit healthcare industry alliance created to support secure, identity-verified electronic exchanges of protected health information, announced TNAP-Participant program, Version 2.0 criteria is available for public comment.

Health Gorilla Launches Pharmacy Data with DrFirst Partnership, Becoming One-Stop Shop for Patient Data
Health Gorilla (@healthgorilla) has launched Pharmacy Data, a new product enabling seamless access to complete medication history data from most major pharmacies. Pharmacy Data is powered by a new partnership with DrFirst and its MedHx Population Risk Management (PRM) solution to provide deduplicated medication history from local and national data sources, including prescribing data, pharmacy dispensing data, and pharmacy benefits manager claims.

Interoperability and Methods of Exchange among Hospitals in 2021
There is a new data brief out from ONC’s Yuriy Pylypchuk and Jordan Everson which presents trends on information exchange and the availability and use of information at the point of care, while also highlighting key barriers to interoperability.

Big Sky Care Connect Selects Rhapsody Interoperability Suite from Lyniate
Big Sky Care Connect (BSCC), Montana’s designated HIE, has selected the Rhapsody Interoperability Suite from Lyniate (@lyniate), a global company in healthcare data interoperability. BSCC will leverage Rhapsody health solutions as a key component of its architecture to connect, classify and cleanse data from its partners, which include providers, payers, and government programs. This partnership will ultimately improve health across BSCC’s vast, distributed healthcare network in Montana.

Hawai’i Health Information Exchange Selects 4medica To Improve Data Quality
4medica® (@4medica), a company in healthcare data quality and matching technology, announced that Hawai’i Health Information Exchange (HHIE) has selected 4medica to work both with the HIE and with contributing data sources such as hospitals, labs, and health centers to improve data quality. Uniquely under this program, 4medica and HHIE will offer 4medica’s technology to each health organization under a shared service program.

Hires and Openings

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

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.

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) – 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

Designated 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 Interoperability Playlist