A crucial moment for health data interoperability. Carequality will thoughtfully align with TEFCA to support fully connected health IT networks for better care.
Health IT Interoperability is more than just technology; it’s about fostering trust, collaboration, and a shared commitment to patient care. Success requires a complex ecosystem where data flows appropriately and securely. Carequality was founded more than 10 years ago as one of the first interoperability frameworks, recognizing the critical role of policies and governance in the technical data exchange transforming healthcare delivery. Today, Carequality, a 501c3 non-profit, is announcing enhancements to the framework to bolster trust in the current connectivity, and plans to forge a strategic path of alignment with the Trusted Exchange Framework and Common Agreement (TEFCA) in support of future transitions.
The Carequality Story
From humble beginnings of a handful of networks, Carequality has grown into a framework of more than 45 networks that connect over 600,000 care providers, 50,000 clinics, and 4,200 hospitals. Today, we support the exchange of 940 million documents monthly, enormous growth from the 59 million documents exchanged under our framework in 2018. This achievement on behalf of patients across the country is a testament to the collective efforts of our community and our commitment to improving healthcare outcomes.
This success was not achieved overnight — it took years of careful planning, implementation, and refinement. We must approach future developments with the same level of deliberation and foresight to protect the trust that patients and providers have in how sensitive healthcare information is exchanged while recognizing the accelerating pace of change in healthcare.
Carequality’s framework is mature and supported by a deliberative governance structure. We are committed to further advancing interoperability while protecting patient data. With the Carequality community’s consensus-based change management process, we learn from and evolve with our community. These are the clinicians, health IT vendors, consumers, and service providers who are on the ground dealing with the nuance and complexity of health information exchange every day in a rapidly changing healthcare industry. This includes their experiences participating in the TEFCA, now that it is live and exchange is ramping up. Carequality’s experience has informed other trust frameworks.
Ensuring Continuity of Connectivity with Framework Enhancements
As consensus builds around TEFCA, Carequality is focused on making improvements to the framework’s policies and procedures to continue to support the exchange of nearly 1 billion clinical documents monthly. This ongoing improvement is critical to ensure there is no net loss in healthcare connectivity, especially as some begin to transition frameworks. The iteration and evolution of Carequality in addition to TEFCA alignment includes:
- – Ongoing monitoring and auditing of Carequality Connections;
- – Expeditiously resolving disputes and emerging issues;
- – Enhancing and simplifying the dispute resolution process; and
- – Augmenting policies to enhance trust within the community.
Aligning with and Supporting Migration to TEFCA
Authorized by the bipartisan 21st Century Cures Act, TEFCA is a federally endorsed framework that helps health exchange networks connect with each other. The community-led Carequality Interoperability Framework and TEFCA share many characteristics. As TEFCA forges its own path ramping up production rollout this year, the Carequality community is watching, learning, and, in some cases, participating in TEFCA. Carequality supports and encourages all appropriate and secure health information exchange, and to that end has engaged in the development of TEFCA, and is actively supporting those participating in TEFCA or seeking to migrate to TEFCA.
The Carequality Steering Committee meets regularly to continue evaluating lessons learned from TEFCA and aligning the Carequality framework where appropriate. With an eye towards future convergence of the two frameworks, Carequality has aligned, or is in the process of aligning, its own policies with TEFCA, including:
- – Leveraging existing Carequality policies now to address community concerns about required responses to queries;
- – Accelerating the ongoing consideration and adoption of policy revisions to align with TEFCA’s approach to the definition of treatment;
- – Instituting stronger directory integrity controls; and
- – Incorporating TEFCA Delegate policies into our existing On-Behalf-Of policies to increase transparency and controls.
Making Strategic Plans for the Future
We know that when interoperability is done right, patients receive care that allows them to make informed decisions about their health journey. Disrupting the existing frameworks of interoperability poses too great a risk on patient outcomes. This is why we are strategically and methodically evolving to meet the needs of our dynamic community now, while making a plan to converge with TEFCA in the future. Together, we can build upon our successes, ensuring that interoperability is trusted and continues to be a cornerstone of a healthier future for all.