51 Percent of Hospitals Plan to Participate in TEFCA HIE Framework

Hospitals participating in national HIE networks were more likely to report plans to join TEFCA than hospitals that do not share data with national HIEs.

More than half of hospitals are aware of the Trusted Exchange Framework and Common Agreement (TEFCA) and plan to participate in the HIE framework, according to ONC analysis of American Hospital Association (AHA) survey data fielded through December 2022.

The survey found that 25 percent of hospitals were unaware of TEFCA, and 23 percent were aware of TEFCA but unsure if they would participate.  

Only one percent of responding hospitals said that they were aware of TEFCA and did not plan to participate.

Less-resourced hospitals were both less likely to be aware of TEFCA and less likely to plan to participate when they were aware:

  • 29 percent of independent hospitals reported plans to join TEFCA compared to 61 percent of multi-hospital system members.
  • 32 percent of critical access hospitals reported plans to participate compared to 59 percent of non-critical access hospitals.

The survey also revealed that 65 percent of hospitals that participate in one of three national health information exchange (HIE) networks (eHealth Exchange, CommonWell, or Carequality) plan to participate in TEFCA, compared to 18 percent of hospitals that do not participate in national HIE networks.

“Acknowledging that we are in the early stages of supporting data exchange through TEFCA, these trends, whereby low-resource hospitals are less likely to plan to join TEFCA, give us insight into opportunities for more education and engagement with these hospitals,” Kimberly Tavernia of HHS and Jordan Everson of ONC wrote in a HealthITBuzz blog post.

“The trend we see here is not surprising but rather reflects broader trends in data ONC has recently published on hospitals, physicians, and individuals, as well as broader work on the ‘digital divide’ in the use of health IT,” they added.

TEFCA aims to shrink the health IT digital divide by lowering the cost and complexity of interoperability.

The blog post noted that ONC is working to create educational resources to inform interested parties about how TEFCA will work.

The Sequoia Project, TEFCA’s recognized coordinating entity (RCE), recently published a document to assist qualified health information networks (QHINs), participants, and sub-participants in complying with Common Agreement flow-down obligations.

“This resource, along with others the RCE has published, will save entities interested in joining TEFCA significant time, resources, and legal fees,” Tavernia and Everson wrote.

“In addition, we expect that QHINs, once officially designated, will engage in significant outreach activities, which will also be a means of disseminating information to providers that are currently not aware of TEFCA,” they continued.

The officials also pointed out that they are working with federal and state partners to identify outreach opportunities tailored to underserved healthcare providers.

“ONC, the RCE, and our partners are committed to enabling TEFCA adoption to improve care and care coordination, reduce administrative overhead, expand public health reporting, facilitate emergency preparedness and response, and increase patient access to their healthcare information,” Tavernia and Everson concluded.

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