During this session you will become familiar with the following important aspects of national trusted exchange networks:

     1.  Four common elements in national trusted exchange networks

     2.  How the national trusted exchange network has evolved over time

     3.  The big three largest active national trusted exchange networks

     4.  Trusted Exchange Framework and Common Agreement (TEFCA) regulations

Click the video below to begin the session. 

Session Summary – National Trusted Exchange Introduction

Welcome to our video series on national trusted exchange. With the ONC’s recent release of the final rule for information blocking this spring and the emergence of COVID-19, there has never been a more important time to consider your interoperability strategy.

As you lead your provider organization, technology team, or a health system through a complex maze of HIE and interoperability strategies. Our job at Zen is to help you understand and maximize your investment in interoperability technologies.

What is national trusted exchange?

National trusted exchange networks have four primary initiatives that include the following:

1. A business and legal framework for sharing data

2. A technical framework for sharing data

3. An onboarding or certification process to ensure adherence to rules

4. A primary focus on CCD/C-CDA exchange

When did the national trusted exchange get started?

In 2009, the first eHealth Exchange transactions begin to flow between federal partners such as the VA and Social Security Administration. Health information exchange milestones continued in 2010 with the launch of DirectTrust for trusted exchange of direct secure messages with validated healthcare providers. Then, in 2015, a collaborative between several very large electronic health record technology vendors including Cerner and McKesson formed Commonwell Health Alliance.

The years 2015 – 2018 saw additional exchange collaborations launch such as Carequality (pronounced “care-e-quality”) led in sponsorship by Epic. As this period ended, the industry saw the health information exchange formally establish across these two exchanges through their announcement in 2016 to share data across Commonwell and Carequality. In fact, 2018’s evolution in this journey was Commonwell becoming a Carequality implementer.

2019 was hallmarked by aggressive introductions at the national level of standards, regulations, and frameworks released by the Office of the National Coordinator (ONC) under the Secretary of Health and Human Services. Officially, TEFCA, which stands for Trusted Exchange Framework and Common Agreement was submitted for comment and ultimately became a final rule in 2020.

What are the three national trusted exchange networks?

To better understand and compare the HIE capabilities and approaches, this training includes an  at-a-glance comparison chart of the three major networks including eHealth Exchange, Carequality, and Commonwell. For eHealth Exchange, we have defined the types of participants to engage in the health information exchange. We also explore the cost and business model as well as the technical standards leverage by them. The same definitions around participant types, cost models, and technical capabilities are defined for Carequality and Commonwell.

What are some of the major differences in the three national trusted exchange networks.

Beyond the participants, cost models, and technical capabilities, one of the biggest differences is how these networks search and find a patient. Each network addresses the patient matching and master patient identifiers across the networks. A lot of efforts and discussions  both within the national exchanges themselves and national standards are taking place as we speak to improve the accuracy and management of patient identification.

Do you or your team need more training or information on how to best leverage national trusted exchange networks for health information exchange? 

Please share this training and the subsequent training below with your organization. We are here to answer questions and help you design an interoperability strategy that leverages these exchanges to maximize not only your investment in exchange, but also expand your influence on workflow and outcomes for your organization.

Ready for Your Next Session?

(next sessions coming soon)

Session 5

TEFCA’s Potential

Future Impact