HHS Spotlights Early Adopters of Its Health Info Exchange Network

— The six organizations participating in TEFCA will go live by the end of the year

by
Joyce Frieden, Washington Editor, MedPage Today
February 13, 2023

WASHINGTON — Sunday night’s Super Bowl game, in which the Kansas City Chiefs defeated the Philadelphia Eagles 38-35, was very much on HHS Secretary Xavier Becerra’s mind Monday morning.

Becerra was speaking at an event in the HHS building’s Great Hall honoring six organizations that have agreed to participate in the Trusted Exchange Framework and Common Agreement (TEFCA), a network the federal government is building to make it easier for health plans, providers, public health agencies, and patients to exchange health information.

“Yes, [Chiefs quarterback Patrick] Mahomes got the MVP [Most Valuable Player] award, but had there not been that block, that tackle, the interference created to let that runner go through, it would have been a different 38-35 score,” Becerra said. Similarly, because of the work of the six organizations, “someone’s going to get information on that brain tumor quicker … someone’s not going to have the wrong medication injected into their body. You did that block; you ran that interference.”

“You’re actually going to figure out a way to connect people across the country,” he continued. “You’re going to get something done that should have been done years ago, and going to get it done soon. You’re going to get it done in a partnership, with collaboration … I don’t know if you’ve looked at government these days, but it doesn’t happen a whole lot.”

Providers might not realize right away how TEFCA has improved their information exchange, “but at some point it’s going to click that something has changed; all of a sudden the specialist instantly got the information they needed to keep you alive,” said Becerra. “They’ll realize something has changed in the way we do healthcare … It’s a game changer.”

TEFCA grew out of the 21st Century Cures Act, a law passed by Congress in 2016 that required that HHS establish a framework and model for health information to be exchanged seamlessly nationwide. Unfortunately, however, “TEFCA is purely voluntary, and [HHS] was not given any funding to do its work,” Becerra said. “Congress, in its wisdom, decided to pass a law but didn’t have any money following that new law … [and despite that] we saw people step up and get the work done.”

The six organizations — CommonWell Health Alliance, eHealth Exchange, Epic, Health Gorilla, KONZA, and Kno2 — were the first to voluntarily meet the requirements to become prospective Qualified Health Information Networks (QHINs), data exchange platforms that are eligible to participate in TEFCA.

“Collectively, the QHIN applicants have networks that cover most U.S. hospitals, tens of thousands of providers, and process billions of annual transactions across all 50 states,” wrote Micky Tripathi, PhD, MPP, head of the Office of the National Coordinator for Health Information Technology, and Mariann Yeager, CEO of the Sequoia Project, the group coordinating TEFCA, in a blog post. Once fully on-boarded, the organizations will officially be “designated” as QHINs, they noted.

At a press conference following the event, Tripathi announced that all six organizations had agreed to “go live” by the end of 2023. Asked by MedPage Today how providers would know that TEFCA was “clicking” for them — as Becerra had suggested — he said that “it’s not going be a ‘lights on’ kind of thing … Over time, what we’ll start to see is that people stop thinking about interoperability … More and more information just starts flowing to them, and they’re thinking less and less about ‘Which network am I in? Am I connected to those other ones?’ It just starts appearing and gets connected to your workflows.”

TEFCA will help public health agencies too, CDC Director Rochelle Walensky, MD, MPH, said at the event. “Every day, millions of health records flow through nationwide health networks, yet most public health agencies have no access to them,” she said. “I can’t tell you how frustrating it is to be in a position when you know data exist to help you make a better decision and you don’t have access to them. We are all better off when our data are better.”

“The cost of our current way of operating, both in time and in dollars, is just far too high,” she added. “We often have records that are missing or incomplete, and we lack a shared governance for public health systems and public health data.”

TEFCA “gives us common rules of the road for data sharing, for use and governance … Providers will be able to share information on public health using the same infrastructure they use to share information with each other for clinical care,” she continued. “Public health agencies will be able to share information back to providers, and patients will have modern apps to directly send to and receive information not only from their healthcare providers but their public health agencies.”

During a panel discussion, Paul Wilder, executive director of CommonWell Health Alliance, noted that “providers are going to be key” to adopting TEFCA. Many of the uses for TEFCA involve “administrative tasks that distract [providers] from being a good provider; they didn’t go to medical school and 5 years of residency to operate a fax machine.”

However, providers won’t get on board until they can see why TEFCA will be better than the information exchange and patient portals they’re already using, said Steven Lane, MD, MPH, chief medical officer at Health Gorilla, during the press conference. “It’s making it even easier, even cheaper, even faster, even more reliable than their existing network. Anything that we can do collectively, when we interact with our provider participants, to make this even easier … is going to be very important.”