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FAH Submits Comments on ONC’s Draft Trusted Exchange Framework

Federation of American Hospitals recently submitted comments to the Office of the National Coordinator for Health Information Technology (ONC) regarding the Draft Trusted Exchange Framework and Common Agreement (Draft TEFCA). FAH expressed support for ONC's efforts to advance interoperability, while providing suggestions for improvements and requesting a number of clarifications to the TEFCA. Some key comments include:

Scope of the Draft TEFCA

  • The scope of the Draft TEFCA, which focuses on information exchange between health information networks (HINs), is too narrow. FAH recommended that ONC look beyond the current parameters of the Draft TEFCA to align with private-sector-led efforts to advance comprehensive interoperability, including plug-and-play interoperability among devices and systems.

Draft TEFCA Timeline

  • The Draft TEFCA raises a number of important questions that should be answered before being finalized. FAH recommended that ONC release a second version of the Draft TEFCA on which stakeholders would again have the opportunity to comment.

Recognized Coordinating Entity (RCE)

  • The RCE will be the linchpin for the success or failure of implementation of the TEFCA. FAH recommended that the RCE should be a sector-neutral (not an HIT developer or developer-affiliated group) entity that is able to represent the end-users of health information – primarily providers and patients.

Voluntary Participation

  • Participation in the Draft TEFCA is voluntary, which raises questions about how the RCE will enforce compliance with the TEFCA among Qualified HINs. FAH also urged ONC to ensure that hospitals and other health providers cannot be deemed “information blockers” if they decide not to participate under the TEFCA.

TEFCA-Associated Fees

  • The Draft TEFCA allows for Qualified HINs to charge fees for exchanging information among other Qualified HINs and participating hospitals and providers. FAH expressed support for the requirement that Qualified HINs make their fees public and encouraged ONC to require that fees and any fee increases be reasonable and consistent across Qualified HINs.

Patient Access to Data / HIPAA Protections

  • The information sharing and privacy requirements in the Draft TEFCA differ from those with which covered entities must comply under HIPAA, which FAH noted could lead to confusion and increased burden. FAH also strongly recommended that providing a patient with access to information that is not directly maintained by a health care provider should be the responsibility of the Qualified HIN.

You can read the entire comment letter here.