There is a lot of activity at the ONC right now with a continued focus on rule making designed to promote the sharing of healthcare data (reducing information blocking). ONC’s new proposed rule HTI-1 has a fairly broad reach and touches on Health Data, Technology, and Interoperability: Certification Program Updates, Algorithm Transparency, and Information Sharing Proposed Rule (HTI-1 Proposed Rule.) It aims to implement key provisions of the 21st Century Cures Act, with a specific emphasis on health IT certification and information blocking.

Getting most of the attention (read the EHR Associations’ reaction), is the overall implementation timelines and the proposal of new policies that, if finalized, would promote greater trust in the predictive decision support interventions (DSIs) used in healthcare. The ONC (and other federal partners such as the FDA) believe these DSI related proposals would help enable users to determine whether the predictive DSI is fair, appropriate, valid, effective, and safe, and enable market competition and align with the FDA’s recent guidance on CDS.

But another part of HTI-1 caught our attention here at Zen.

ONC proposes a TEFCA Carrot as a Hedge Against Information Blocking


HTI-1 introduces the concept of making TEFCA a “manner exception” as long as the data requested aligns with the types of data supported under the TEFCA framework. This appears to be a major incentive to encourage providers and health systems (and other covered entities under TEFCA) to participate with a Qualified Health Information Network (QHIN).


Why creating a TEFCA Carrot Matters


Per the ONC’s analysis of a recent AHA survey, 51% of hospitals recently said they plan on participating with a QHIN. 65% of hospitals already participating in a national data exchange network say they are planning on joining a QHIN. While this is encouraging data, it’s focused on hospitals. If you are an Epic client – a candidate QHIN – that seems like a no-brainer.

There are a much larger number of healthcare providers and other types of healthcare organizations subject to the ONC Information Blocking rules that will need incentives to participate with TEFCA. While penalties (the stick, as opposed to the carrot in this metaphor) for providers who engage in information blocking are being considered by the ONC, we believe that carrots will be the most effective way to encourage more rapid and broader participation in TEFCA.

Knocking Down Remaining Barriers for TEFCA Participation


The ONC’s proposal to make TEFCA a safe harbor for information blocking is a significant advancement in fostering interoperability and streamlining healthcare data exchange.Another key step in accelerating TEFCA participation is ensuring that all healthcare organizations have an easier path to onboarding to a QHIN. There are thousands of healthcare vendors and hundreds of thousands of healthcare organizations that will have to evaluate their options and create their own path to choose and connect with a QHIN.

This is how Zen can help. Zen’s Stargate clients that are already onboarded to eHealth Exchange are a “click this box” away from TEFCA participation once the initial set of QHINs are live (expected before the end of 2023), and your organization can be in the same position.

Book a free 15-minute interoperability call to discuss your QHIN options or learn more how Stargate can accelerate QHIN access.

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