TEFCA Signals Progress, With Work To Be Done

By EHRA Public Policy Leadership Workgroup

After a journey more than four years in the making, the Office of the National Coordinator for Health IT (ONC) and The Sequoia Project achieved a major milestone in the advancement of nationwide health information exchange: the publication of the Trusted Exchange Framework and Common Agreement (TEFCA) v1.0. ONC and The Sequoia Project have demonstrated their commitment to incorporating input from stakeholders across the industry, which created a process that produced significant improvements with each draft publication. We applaud the significant efforts undertaken by ONC and The Sequoia Project to collaborate with industry interoperability experts and create a framework that incorporates key principles of trusted exchange, like reciprocity, as well as a technical approach that leverages commonly adopted standards. 

For well over a decade, members of the Electronic Health Record Association (EHRA) have invested substantially in advancing the data sharing capabilities of the health IT systems used by healthcare organizations across the country with the belief that doing so will improve the quality and efficiency of health care. It is our sincere hope that TEFCA will continue to build on those investments for the benefit of patients.  

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Privacy and Security, and Building Patient Trust

Earlier this year, ONC published an updated “Guide to Privacy and Security of Electronic Health Information” to help healthcare providers and ambulatory practices understand existing federal law on protected health information (PHI).  It provides guidance on how providers can use certified electronic medical record technology (CEHRT) to provide secure communications with their patients and, via secure and interoperable health IT, share patient data with other care providers.

There is a great deal of practical information provided in this guide that helps explain who is and who is not a business associate (BA), per the HIPAA regulations.   It also provides clear guidance as to when it is permissible to disclose PHI, when patient authorizations are required, and how to provide patient access to their health information.  In addition, there is a useful section on general cybersecurity explaining the threat of cyber-attacks, the use of mobile devices, and email and texting among providers and their patients.

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EHRA Responds to ONC’s Interoperability Roadmap

After many conference calls, and lots of “on the job training” using Google Docs to manage the edits of many contributors, we were pleased to submit our response to ONC’s Interoperability Roadmap. . . just in time to start working on the interoperability aspects of the proposed rule for Stage 3 of the EHR Incentive Program . . .and to get ready for HIMSS15!

Overall, we’re positive about the framework the draft Roadmap is starting to put in place, its identified principles, and the pragmatic review of well-established and emerging interoperability standards and technologies. We did express some concern that ONC seems to view the many active, and increasingly successful, interoperability initiatives as a problem to be solved rather than work to inform go-forward strategies with valuable experiences to be built upon. In doing so, we provided some positive suggestions on how to approach interoperability governance in ways that rely on and leverage private sector efforts in the context of an effective public/private partnership.

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