On February 13th, 2023, the first round of QHIN applicants accepted to begin QHIN certification efforts will be announced. Is this the beginning of the end for existing national networks such as eHealth Exchange, Carequality and the Commonwell Alliance? Or is this going to create even more momentum?


Join us for a lively debate on Tuesday, February 28th, at 1pm PST. 


Marilee Benson, our President and Cofounder will lead the discussion, and include a brief update on the Annual Meetings for eHealth Exchange, Carequality and the Sequoia Project (the TEFCA RCE) held in D.C. last December.

A Few Nuances to Understand about the Current National Networks as a Starting Point for this Debate


To tackle the important question of will the existing national networks continue to thrive with the rollout of TEFCA, it is helpful to first understand a key difference between these three national networks.

It is more accurate to call Carequality, a trust framework versus a “network”, which means they are really very similar to TEFCA itself. Just ask Alan Swenson, Carequality’s Executive Director. He does a great job of explaining this concept. To see Carequality acting as a trust framework in action, note the cross network exchange already happening today (pre-TEFCA), with both Commonwell Alliance and eHealth Exchange acting as Carequality Implementers. It also explains why the RCE has assigned the Carequality team to act as the technical advisor for TEFCA. They have significant experience in the mechanics of setting up and running a trusted exchange framework for healthcare data.

The other two national networks, eHealth Exchange and Commonwell Alliance, act more like health information networks. For example, they have technology in place that adds value for their network participants which makes it easier to access data within their networks. This is similar to the role that a QHIN will play under TEFCA.

These nuances help frame this important debate. So let’s do it!

This will also be a great opportunity to review the selected QHIN applicants announced on February 13th, 2023. 

  • If both eHealth Exchange and Commonwell Alliance are selected as QHIN applicants, what are the ramifications? 
  • Why didn’t Carequality apply?  
  • Can non-profit QHINs co-exist with for-profit QHINs, assuming we end up with a mix of both?

    We really want to hear your thoughts on these important questions and considerations as the rollout of TEFCA begins in earnest, just as the national networks are really gaining traction.

    Be sure to register today!


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