Sharing Health Data Update November 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.


eHealth Exchange and Virginia Health Information Announce QHIN Intentions
eHealth Exchange (@ehealthexchange), one of the nation’s oldest and largest health information networks, announced that Virginia Health Information (@VAHealthInfo), the Commonwealth’s non-profit health data organization, intends to participate in eHealth Exchange’s anticipated Qualified Health Information Network (QHIN) through its statewide Health Information Exchange (HIE) ConnectVirginia. eHealth Exchange is planning to undergo the application process to serve as a QHIN under the Office of the National Coordinator for Health IT’s (ONC’s) Trusted Exchange Framework and Common Agreement (TEFCA).

RCE Monthly Informational Call

Tuesday, November 15 | 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

Our TEFCA Playlist

Hear what HIE industry leader say about TEFCA.

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

Contexture Announces Unite Us as New Technology Partner for Arizona’s Social Determinants of Health Referral System
Contexture, Arizona’s HIE, announced that Unite Us will provide the technology powering CommunityCares, the statewide referral system designed to address social determinants of health (SDOH) needs in Arizona. Unite Us is the enterprise technology company providing the digital infrastructure to power connected health and social care ecosystems.

SYNCRONYS and Patient Centered Data Home (PCDH)
SYNCRONYS, New Mexico’s designated health information exchange (HIE), is pleased to announce it is receiving data from Patient Center Data Home (PCDH) participants in the Civitas Western Region via the SYNCRONYS clinical portal.

Industry and Contract News

MEDITECH Selects Health Gorilla to Power Canadian Interoperability Network
Health Gorilla (@healthgorilla), a Health Information Network and interoperability provider, has been selected by MEDITECH (@MEDITECH) as the technology platform for Traverse Exchange Canada — a first-of-its-kind interoperability network that will enable the seamless flow of health information between participating organizations across Canada.

Black Book Survey names Zen Healthcare IT as the Top-rated Healthcare IT Advisor for Interoperability and Integration
Zen Healthcare IT (@zenhealthcareit) is honored to have been named the top interoperability and integration advisor for 2023. Award-winning interoperability advisory services, robust integration technology, and unmatched client support all contribute to Zen Healthcare IT’s promise to provide the best possible technical advice and interoperability services to their clients.

PreciseMDX Achieves Record Year-Over-Year Growth Through New Partnerships and Innovation
PreciseMDX, an interoperable digital health platform that automates and simplifies every step of the diagnostic testing experience for labs, providers, and patients, continues to disrupt the industry through its commitment to innovation and customer satisfaction.

Edifecs Unveils Payer-to-Payer Data Exchange and Member App for FHIR® Solutions
Edifecs, Inc. (@Edifecs), a global health information technology solutions company, announced its cloud Payer-to-Payer Data Exchange and Member App for FHIR® solutions are approved and published on the Council for Affordable Quality Healthcare (CAQH) Endpoint Directory.

Hires and Openings

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