TEFCA Is Live – Clarifying Common Misperceptions
The following is a guest article by Jay Nakashima, President at eHealth Exchange
Change is scary. And when change is as big and complex as the Trusted Exchange Framework and Common Agreement™ (TEFCA™), we understand why some might want to take a wait-and-see approach.
But we believe that is a mistake.
At eHealth Exchange, which is one of the first Qualified Health Information Networks™ (QHINs™) under TEFCA, we have a front-row seat to the framework’s ongoing implementation.
So, to help our participants and others who may have questions and to ease their concerns, we’re addressing some of the most common misperceptions about TEFCA.
The First Step Is To Decide
Access to data via TEFCA is not always automatic. Depending on the QHIN, providers and others must take action to join a QHIN by either opting out or opting in to TEFCA-based exchange.
Currently, eHealth Exchange is one of seven Designated QHINs exchanging health information via TEFCA. Most of these QHINs operated as health information networks (HINs) prior to the launch of TEFCA last year, and they continue to share data among and between their participants through their existing frameworks and legal structures. This has led some participants to mistakenly believe that they are automatically connected to TEFCA, or automatically not connected to TEFCA. The exact process varies from QHIN to QHIN.
If you’re not sure whether you’re participating in TEFCA, contact your health information exchange (HIE), QHIN, or electronic health record (EHR) provider.
For example, eHealth Exchange participants are taking advantage of its single API to join Carequality and TEFCA with no additional subscription fees or paperwork to sign.
Yes, You Still Need Multiple Networks
TEFCA-based exchange is voluntary and still ramping up. Many providers and other prospective exchange partners have yet to join. This means you will need to maintain your existing connections to ensure broad access to patient health data for some time even after you begin participating in TEFCA.
This includes maintaining your existing HIE, QHIN, Carequality, or other connections, at least for now. The Common Agreement (CA) 2.0 acknowledges this reality, noting that organizations can (and may want to) belong to more than one network or exchange framework. This may be a conservative strategy for those organizations that welcome infrastructure redundancy to ensure uptime.
Will TEFCA one day be the only connection you need? Only time will tell. Carequality did just recently announce its hope to converge with TEFCA in the future. But until that happens, maximizing access to patient records hinges on maintaining your existing health data connections.
Consider Data Storage When Selecting a QHIN
Privacy laws, such as the Health Insurance Portability and Accountability Act (HIPAA), dictate when patient records can be retrieved, but the data can then be used for different purposes, as long as the law is followed. Under TEFCA, QHINs can store data, meaning any record that passes through the QHIN system can be kept on file, and the QHIN can use that data how it chooses, subject to HIPAA and other laws and in accordance with the Common Agreement.
The CA 2.0 outlines encryption rules to ensure QHINs adequately secure patient data, and it adds additional encryption requirements for individually identifiable information for all non-HIPAA entities (NHEs). But encrypted data can still be hacked, and any large trove of health data is an attractive target for cybercriminals.
The National Association of Healthcare Access Management notes that patient medical records are 10 times more valuable to hackers than credit card information. This is largely due to the bevy of sensitive information contained within the records, such as social security numbers, birthdates, addresses, telephone numbers, and medical conditions, all of which can be used for identity theft.
To minimize this threat, eHealth Exchange has chosen to not store any patient data. We believe the best way to protect patients’ information is to not store their data at all.
Payment and Health Care Operations Are Still Optional (At Least for Now)
The Payment and Health Care Operations exchange purposes are still optional under TEFCA. They are also optional under Carequality.
eHealth Exchange is embracing both use cases. We think it’s the right thing to do and that it will improve healthcare for providers and patients alike, and we encourage others to embrace these permitted exchange purposes as well.
We are fully invested in using Networked Fast Healthcare Interoperability Resources® (FHIR®) for connecting with payers. We’ve gained experience doing so through a collaboration with the U.S. Food and Drug Administration (FDA) to explore its use for reporting adverse effects in clinical trials. With this knowledge, we successfully leveraged the viability of Networked FHIR for prior authorization with UC Davis Health, Regence, and other eHealth Exchange participants. We have even offered financial incentives to push additional payers to engage with us via Networked FHIR.
Individual Access Isn’t What You Think
One of TEFCA’s major components is the inclusion of Individual Access Services (IAS), which allows patients to have greater access to their medical records.
Some have interpreted this to mean that QHINs must develop IAS solutions catering to individuals. That’s not the case.
Rather, IAS platforms join QHINs as any other participants. This allows their end users to request their own records directly through the IAS platform, triggering a query that the QHINs respond to as they would to any other query on the system.
This means there is no separate process or burden on providers to satisfy the individual access requirements in TEFCA.
eHealth Exchange supports consumers by responding to all TEFCA IAS requests.
The Time Is Now
New programs can be scary, but the time to participate in TEFCA is now.
In just the first year since TEFCA was officially launched, we’ve already seen massive changes in the interoperability landscape. The initial group of Designated QHINs has grown to seven. Carequality has announced its intention to converge with TEFCA. Many large organizations have already publicly stated their intentions to move to TEFCA by the end of 2025.
The momentum for TEFCA is clearly growing.
Providers, regional and state health information exchanges, EHRs, and other organizations should add TEFCA in their near-term IT plans. This will ensure no disruptions to connectivity or health information exchange, as well as keep them current with the larger interoperability ecosystem.
Jay Nakashima is president of eHealth Exchange, the nation’s largest health information network dedicated to the public good. Recognized for certified data quality, trusted governance, transparency, and its commitment to privacy, eHealth Exchange facilitates the secure exchange of patient records for more than 250 million patients and processes roughly 21 billion data exchanges annually. eHealth Exchange connects healthcare providers, regional and state health information exchanges, public health authorities, payers, and federal agencies to exchange medical data and improve patient care and public health. Active in all 50 states, eHealth Exchange connects to other national health information networks today via Carequality and now TEFCA as a Designated QHIN.
eHealth Exchange is a proud sponsor of Healthcare Scene.
The following is a guest article by Jay Nakashima, President at eHealth Exchange
Change is scary. And when change is as big and complex as the Trusted Exchange Framework and Common Agreement™ (TEFCA™), we understand why some might want to take a wait-and-see approach.
But we believe that is a mistake.
At eHealth Exchange, which is one of the first Qualified Health Information Networks™ (QHINs™) under TEFCA, we have a front-row seat to the framework’s ongoing implementation.
So, to help our participants and others who may have questions and to ease their concerns, we’re addressing some of the most common misperceptions about TEFCA.
The First Step Is To Decide
Access to data via TEFCA is not always automatic. Depending on the QHIN, providers and others must take action to join a QHIN by either opting out or opting in to TEFCA-based exchange.
Currently, eHealth Exchange is one of seven Designated QHINs exchanging health information via TEFCA. Most of these QHINs operated as health information networks (HINs) prior to the launch of TEFCA last year, and they continue to share data among and between their participants through their existing frameworks and legal structures. This has led some participants to mistakenly believe that they are automatically connected to TEFCA, or automatically not connected to TEFCA. The exact process varies from QHIN to QHIN.
If you’re not sure whether you’re participating in TEFCA, contact your health information exchange (HIE), QHIN, or electronic health record (EHR) provider.
For example, eHealth Exchange participants are taking advantage of its single API to join Carequality and TEFCA with no additional subscription fees or paperwork to sign.
Yes, You Still Need Multiple Networks
TEFCA-based exchange is voluntary and still ramping up. Many providers and other prospective exchange partners have yet to join. This means you will need to maintain your existing connections to ensure broad access to patient health data for some time even after you begin participating in TEFCA.
This includes maintaining your existing HIE, QHIN, Carequality, or other connections, at least for now. The Common Agreement (CA) 2.0 acknowledges this reality, noting that organizations can (and may want to) belong to more than one network or exchange framework. This may be a conservative strategy for those organizations that welcome infrastructure redundancy to ensure uptime.
Will TEFCA one day be the only connection you need? Only time will tell. Carequality did just recently announce its hope to converge with TEFCA in the future. But until that happens, maximizing access to patient records hinges on maintaining your existing health data connections.
Consider Data Storage When Selecting a QHIN
Privacy laws, such as the Health Insurance Portability and Accountability Act (HIPAA), dictate when patient records can be retrieved, but the data can then be used for different purposes, as long as the law is followed. Under TEFCA, QHINs can store data, meaning any record that passes through the QHIN system can be kept on file, and the QHIN can use that data how it chooses, subject to HIPAA and other laws and in accordance with the Common Agreement.
The CA 2.0 outlines encryption rules to ensure QHINs adequately secure patient data, and it adds additional encryption requirements for individually identifiable information for all non-HIPAA entities (NHEs). But encrypted data can still be hacked, and any large trove of health data is an attractive target for cybercriminals.
The National Association of Healthcare Access Management notes that patient medical records are 10 times more valuable to hackers than credit card information. This is largely due to the bevy of sensitive information contained within the records, such as social security numbers, birthdates, addresses, telephone numbers, and medical conditions, all of which can be used for identity theft.
To minimize this threat, eHealth Exchange has chosen to not store any patient data. We believe the best way to protect patients’ information is to not store their data at all.
Payment and Health Care Operations Are Still Optional (At Least for Now)
The Payment and Health Care Operations exchange purposes are still optional under TEFCA. They are also optional under Carequality.
eHealth Exchange is embracing both use cases. We think it’s the right thing to do and that it will improve healthcare for providers and patients alike, and we encourage others to embrace these permitted exchange purposes as well.
We are fully invested in using Networked Fast Healthcare Interoperability Resources® (FHIR®) for connecting with payers. We’ve gained experience doing so through a collaboration with the U.S. Food and Drug Administration (FDA) to explore its use for reporting adverse effects in clinical trials. With this knowledge, we successfully leveraged the viability of Networked FHIR for prior authorization with UC Davis Health, Regence, and other eHealth Exchange participants. We have even offered financial incentives to push additional payers to engage with us via Networked FHIR.
Individual Access Isn’t What You Think
One of TEFCA’s major components is the inclusion of Individual Access Services (IAS), which allows patients to have greater access to their medical records.
Some have interpreted this to mean that QHINs must develop IAS solutions catering to individuals. That’s not the case.
Rather, IAS platforms join QHINs as any other participants. This allows their end users to request their own records directly through the IAS platform, triggering a query that the QHINs respond to as they would to any other query on the system.
This means there is no separate process or burden on providers to satisfy the individual access requirements in TEFCA.
eHealth Exchange supports consumers by responding to all TEFCA IAS requests.
The Time Is Now
New programs can be scary, but the time to participate in TEFCA is now.
In just the first year since TEFCA was officially launched, we’ve already seen massive changes in the interoperability landscape. The initial group of Designated QHINs has grown to seven. Carequality has announced its intention to converge with TEFCA. Many large organizations have already publicly stated their intentions to move to TEFCA by the end of 2025.
The momentum for TEFCA is clearly growing.
Providers, regional and state health information exchanges, EHRs, and other organizations should add TEFCA in their near-term IT plans. This will ensure no disruptions to connectivity or health information exchange, as well as keep them current with the larger interoperability ecosystem.
Jay Nakashima is president of eHealth Exchange, the nation’s largest health information network dedicated to the public good. Recognized for certified data quality, trusted governance, transparency, and its commitment to privacy, eHealth Exchange facilitates the secure exchange of patient records for more than 250 million patients and processes roughly 21 billion data exchanges annually. eHealth Exchange connects healthcare providers, regional and state health information exchanges, public health authorities, payers, and federal agencies to exchange medical data and improve patient care and public health. Active in all 50 states, eHealth Exchange connects to other national health information networks today via Carequality and now TEFCA as a Designated QHIN.
eHealth Exchange is a proud sponsor of Healthcare Scene.
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2024-11-06 20:30
Except for the headline, this story has not been edited by Healthcare Central is published from a syndicated feed.
