EHR company Epic plans to join federal data-sharing network TEFCA

Epic plans to join the Trusted Exchange Framework and Common Agreement, which would connect nearly 2,000 hospitals and 45,000 clinics that use the company's medical records software to take part in the nationwide data-sharing framework.

The EHR vendor also announced Thursday that it intends to apply to be an inaugural Qualified Health Information Network, or QHIN, a federal designation introduced this year to mark networks that connect to one another to support national health information exchange. These QHINs will make up a national "network of networks," forming the backbone of interoperability by connecting to one another.

Epic is the first EHR company to sign up for QHIN designation. Several large national networks like CommonWell Health Alliance and eHealth Exchange have signaled their intention to participate in TEFCA and to apply to become QHINs.

Five years in the making, the nation's top health IT agency released the Trusted Exchange Framework and Common Agreement this past January, marking a critical step in establishing a nationwide data-sharing network.

The voluntary TEFCA framework is not binding, but the publication of the health information exchange principles marks a critical step toward creating a nationwide data-sharing network. 

TEFCA, which was mandated by the 21st Century Cures Act back in 2016, establishes a core set of data that needs to be available for exchange, laying out a common set of privacy and security requirements. 

The Office of the National Coordinator for Health, within HHS, released the first draft of the TEFCA back in January 2018. The framework provides the policies, procedures and technical standards necessary to exchange patient records and health information between providers, state and regional health information exchanges and federal agencies.

Last year, National Coordinator for Health IT Micky Tripathi said TEFCA aims to eliminate the burdens of costly point-to-point interactions healthcare organizations currently face by creating a common set of practices to allow providers, patients, payers and health IT vendors to securely communicate with one another.

"There is no requirement that people participate in TEFCA. We have to think about, how do we make it attractive to the industry to voluntarily participate in that? The trick for us, when we think about TEFCA, is to add value to the overall system, but we don't want it to be an additional tax on providers and technology vendors," Tripathi said.

It's expected that in the future TEFCA will expand to support use cases beyond clinical care, such as public health.

Epic executives said the company's participation in TEFCA builds on its own data exchange footprint.

In 2008, Epic launched Care Everywhere, a platform that links users of its software across the country. The company says its Care Everywhere platform exchanges more than 10 million patient charts, composed of 24 million actionable, standards-based documents, every day. Half of those exchanges occur with organizations that use different IT systems, the company says.

Nearly all of Epic's customers also choose to exchange data through Carequality, a nationwide exchange framework that includes roughly 70% of U.S. hospitals.

The company's participation in TEFCA is significant as it potentially connects its large customer base, including 2,000 hospitals and 45,000 clinics.

Epic says it collaborated with ONC, The Sequoia Project and the broader healthcare community to build consensus around the principles and procedures of TEFCA. 

"Our fundamental goal is to help all patients receive informed, personalized care—regardless of where they go to receive it," said Dave Fuhrmann, senior vice president of interoperability at Epic in a statement. "Our customers have led the way with large-scale interoperability through Carequality, and we're happy to help with the next stage in the evolution of interoperability."

Health data startup Health Gorilla also plans to apply to become a qualified health information network under TEFCA.

Epic's announcement also comes as Oracle, fresh off its $28 billion deal to acquire Epic competitor Cerner, announced bold plans to build a national health record database that would pull data from thousands of hospital-centric EHRs.

Oracle's chairman Larry Ellison said the database giant wants to use the combined tech power of Oracle and Cerner to make access to medical records more seamless.