In a major step toward advancing its strategy for nationwide data sharing, the Office of the National Coordinator for Health IT (ONC) awarded The Sequoia Project a cooperative agreement to serve as the recognized coordinating entity (RCE) for the Trusted Exchange Framework and Common Agreement (TEFCA).
As the coordinating entity, The Sequoia Project—a nonprofit that advocates for nationwide health information exchange—will be responsible for developing, updating, implementing and maintaining the common agreement component of TEFCA.
The common agreement will create the baseline technical and legal requirements for health information networks to share electronic health information and is part of the 21st Century Cures Act, according to ONC.
The program will be funded for fiscal 2019 at $900,000.
ONC released the first draft of the TEFCA back in January 2018 as a framework designed to improve data sharing between health information networks and as a single "on-ramp" for nationwide data sharing. 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.
When ONC released the first draft of the framework (PDF), it indicated that it would be shopping out the implementation of the framework—specifically the common agreement—to the private sector.
ONC released the second draft of TEFCA in April and also issued a competitive Funding Opportunity Announcement, allowing industry organizations to compete for a multiyear contract and cooperative agreement to implement the framework.
The Sequoia Project was selected through a competitive process to help with the interoperable flow of health information," Don Rucker, M.D., national coordinator for health IT, said in a statement.
"We look forward to working in close collaboration with The Sequoia Project and across the broader health system to create a Common Agreement that best serves the needs of all stakeholders,” Rucker said.
The Cures Act’s focus on trusted exchange is an important step toward fostering transparency and competition throughout the healthcare delivery system by addressing the technical barriers and business practices that impede the secure and appropriate sharing of electronic health information, according to ONC.
The Sequoia Project will collaborate with ONC to designate and monitor Qualified Health Information Networks (QHIN), modify and update accompanying QHIN technical requirements and engage with stakeholders through virtual public listening sessions. The RCE also will help adjudicate noncompliance with the common agreement and propose sustainability strategies to support TEFCA beyond the cooperative agreement’s period of performance.
“We have learned through our own operations that seamless nationwide sharing of health information is most readily enabled through trust agreements, consistent policy and technical requirements, and appropriate, balanced governance to provide assurance of trust and interoperability. We look forward to working alongside ONC as the Recognized Coordinating Entity,” Mariann Yeager, CEO of The Sequoia Project, said in a statement.
The RCE will play a critical role in implementing TEFCA as part of ONC's strategy to advance interoperability, according to industry stakeholders.
Founded in 2012, The Sequoia Project has grown into a central convener for interoperability.
The organization assumed stewardship of the nationwide health information network exchange (or NwHIN Exchange) from ONC in 2012. The eHealth Exchange is a public-private health information network and one of the largest of its kind in the country. Recognizing the maturity and sustainability of the network, the eHealth Exchange became independent of The Sequoia Project in 2018.
The organization also partnered with health IT leaders to develop Carequality, a network-to-network trust framework to connect existing and future data-sharing networks. Last year, Carequality relaunched as an independent nonprofit. The Sequoia Project also has conducted significant research on patient matching, an important issue to address on nationwide data exchange.
Many industry stakeholders welcomed the news that The Sequoia Project had been awarded the cooperative agreement to advance data sharing in the healthcare industry.
Medicare for all highlights the nation's attention on health, but it's really #TEFCA and @ONC_HealthIT Cures that shows we have incredible policy coming to help. It's bringing with it a culture and opportunity for innovation. Can't wait to see what @sequoiaproject does as RCE.— Brendan Keeler (@BrendanRedox) September 3, 2019