ONC releases its Trusted Exchange Framework establishing a single ‘on ramp’ for interoperability

A stethoscope on a computer keyboard
Genevieve Morris says the Trusted Exchange Framework offers a "floor" for data exchange terms and conditions.(Getty/anyaberkut)

After several months of public meetings and industry input, the Office of the National Coordinator for Health IT has released its Trusted Exchange Framework and Common Agreement designed to improve data sharing between health information networks.

The framework (PDF), mandated by the 21st Century Cures Act, 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.

It also aims to eliminate the burdens of costly point-to-point interactions that 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.

The voluntary framework is also an attempt to resolve some of the nagging issues inhibiting data sharing across the industry, including inconsistencies within the terms and conditions of health information networks. Genevieve Morris, principal deputy national coordinator for health information technology at ONC, compares those variations to the early days of cell phones when texting over different networks was not yet possible.

“This is just the floor of what those required terms and conditions are,” she told FierceHealthcare. “We all just have to agree to the same terms in order for that exchange to happen.”

The draft framework is broken into two sections. Part A provides guardrails and standards to “engender trust between health information networks,” addressing issues around transparency, security, patient safety, and data-driven accountability.

Part B outlines a minimum set of terms and conditions addressing authentication, trusted exchange rules and core operational policies.

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Morris says the agency has built the framework largely based on existing trusted exchange models, recognizing the work that the private sector has already done to facilitate data sharing. But a key element of the Trusted Exchange Framework will be what ONC describes as “a single on-ramp” designed to reduce the number of point-to-point interactions that are "a cost to the system we, frankly can't afford," Morris says.

ONC has decided to shop out the implementation of the framework—specifically the common agreement outlined in Part B—to the private sector. In the spring, the agency plans to announce a competitive Funding Opportunity Announcement, allowing industry organizations to compete for a multiyear contract and cooperative agreement.  

Morris says that organization will build off the minimum requirements ONC addressed in the Common Agreement to address additional terms and conditions.

“At the end of the day, ONC as a federal agency is not set up to operationalize the Trusted Exchange Framework and Common Agreement, nor do we really see that as our role,” she says.

The draft framework is open for public comment through Feb. 18. Once the final version is in place, Morris expects that a common data sharing agreement will bring new, innovative solutions to the market and increase competition.

“We have to shift the market from competing on holding the data itself to providing services on the data,” she says. “The Trusted Exchange Framework and Common Agreement pushes us in that direction.”