Sharing Health Data Update May 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.

Industry and Contract News

DirectTrust Announces Finalized Criteria for Trusted Network Accreditation Program (TNAP)-Participant V2.0
DirectTrust (@directtrustorg), a non-profit healthcare industry alliance created to support secure, identity-verified electronic exchanges of protected health information, announced the release of new criteria for its TNAP-Participant program V2.0.

Commonwell: What’s the Scuttlebutt from HIMSS23: CommonWell’s Take – After a whirlwind week in the “Windy City” CommonWell Executive Director Paul L Wilder has a few key takeaways from HIMSS23.

eHealth Exchange: Alabama Medicaid Recipients To Benefit from Better Coordinated Care and Improved Health Data Exchange – One Health Record® (ALOHR) plans to participate in eHealth Exchange’s planned Qualified Health Information Network (QHIN) if the network achieves QHIN designation.

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

Gravity Pilots Affinity Group Meeting – The Gravity Pilots Affinity Group is a peer-to-peer learning forum for entities participating in the real-world testing of Gravity SDOH data standards. Our next Pilots Affinity Group meeting will be on Thursday, May 25 from 2:30 pm – 4:00 pm ET.

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.

2023 Civitas Networks for Health Annual Conference

When: August 20 – 23, 2023
Where: Gaylord National Resort & Convention Center, National Harbor MD
Hashtag: #Civitas2023

The Civitas Networks for Health 2023 Annual Conference, in Partnership with Chesapeake Bay Regional Members, will be taking place at the Gaylord National Resort and Convention Center in National Harbor, Maryland. The event will be held August 20 – 23 and will include presentations from industry experts and members as well as opportunities for networking and connections among all conference participants.

State HIE News

VITL Launches the State’s First Two-Way Immunization Data Sharing Connection with VT Dept of Health and NVRH
VITL (@VITLVT), the trusted source for securely delivering health data for Vermonters, announces the launch of Vermont’s first two-way immunization data sharing connection between the Vermont Department of Health and Northeastern Vermont Regional Hospital in St. Johnsbury. Using the two-way connection built with VITL, clinicians and the health department will be able to easily and efficiently exchange immunization data, back and forth, in real time.

Alaska’s Health Information Exchange Awarded State Contract to Expand Crucial Healthcare Data Exchange
healtheConnect Alaska (@akehealth), the State of Alaska’s official health information exchange (HIE), announced it has been awarded a new state contract with Alaska’s Department of Health to expand its HIE and data services across Alaska. The new contract will allow the HIE to continue its work across the state and reach more regions where access to quality care has been historically limited, such as underserved rural and urban Alaskan communities.

Hires and Openings

KONZA builds upon a proven model for the development of the technical infrastructure necessary to enable sharing of clinical information at the point of care while supporting transformative value-based payment models, care management, and data analytics. Patients, physicians, healthcare facilities, and other healthcare providers from across the country benefit from KONZA’s delivery of unequaled actionable intelligence. They have an opening for an Information Security Analyst.

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 an experienced HL7 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.

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.

Upcoming Events

2023 Sequoia Project Annual Meeting

When: November 15-17, 2023
Where: Town and Country Resort, San Diego CA

Once again, you are invited to attend the 2023 Sequoia Project Annual Meeting. This year, Carequality will join the Sequoia Project to host a joint annual meeting with a single registration. The Sequoia Project members and Carequality implementers will have exclusive early access to registration. They are traveling to San Diego, California, for the event, and they hope to see you there.

Anticipated Meeting Topics

  • Trusted Exchange Framework and Common Agreement (TEFCA)
    Public Health
  • Data Usability
  • Information Sharing
  • Security and Privacy
  • Qualified Health Information Networks (QHINs)
  • Consumer Engagement Strategies
  • Payment and Operations
  • Unconference Sessions
  • Patient Request / Patient Access
  • FHIR

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

QHIN Applications Moving Forward

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