National interoperability is getting a much-needed boost. New and revised drafts from the ONC seek to support the access, exchange, and use of health information between already existing health information networks. This is the second revision to the Trusted Exchange Framework (TEF) and Minimum Required Terms and Conditions, and the first draft of the Qualified Health Information Network (QHIN) Technical Framework. Together, these drafts create the basic technical and legal requirements to share electronic health information within a common national framework. This framework is crucial to easing the flow of healthcare data across industry. Together, the drafts form what will eventually be known as the Common Agreement.

The main goals for the Common Agreement are:

• To provide a single, centralized path to scalable nationwide connectivity and
• To ensure electronic health information securely follows patients and can be accessed on demand.

Enforcement Mechanism

As far as practical measures to implement these goals, the ONC is calling for an industry-based Recognized Coordinating Entity (RCE) to develop, update, implement, and maintain the Common Agreement and the QHIN Technical Framework. The RCE will be a 4-year cooperative agreement award, and applications are currently being accepted through the ONC website. Stakeholders voiced wide support for an RCE in the first round of public comments, although the distribution of work and authority between the two entities remains unclear.

Sweeping Changes

Stakeholder requests factored heavily into the new drafts, especially the QHIN Technical Framework. This framework provides a new definition and technical standards for networks who intend to qualify for national participation. Implementation guides were adopted as the primary method of distributing specifications and standards to ensure any updates the network(s) might require can be completed quickly and efficiently. A minimum list of strong security and privacy requirements for qualifying networks is outlined, safeguarding patient confidentiality and establishing consistency across the national framework. QHINS would have to abide by HIPAA privacy and security rules while also evaluating their security programs annually.

Your Comments Matter

It’s clear the ONC is taking the time to seriously consider stakeholder input in pursuit of true nationwide interoperability. As a result, we could be inching closer to a time when practices would only need to access a single network to get PHI from anywhere across the country. That is certainly the goal that Don Rucker, National Coordinator for Health Information Technology, is aiming for: “The future Common Agreement, made possible by the steps we take today, will provide the governance necessary to meet the interoperability demands of diverse stakeholders, including patients, healthcare providers, and health plans.” You can leave your comments on the drafts and revisions here through June 17th.