In 2024, Carequality outlined framework enhancements to ensure continuity of connectivity for the more than 50 networks and their more than one hundred thousand Carequality Connections that depend on Carequality for the exchange of more than 1 billion clinical documents each month. We also announced plans for the Carequality Interoperability Framework to more closely align with the Trusted Exchange Framework and Common Agreement™ (TEFCA™) to make participation in both easier.
Today, we are sharing more details on this two-pronged strategy and reporting on progress.
The Carequality Steering Committee, Advisory Council, and Board of Directors have prioritized a set of activities to further enhance trust and best align Carequality with developments in TEFCA. The governance groups have agreed that the top four issues to tackle first are:
- – Modifications to the “On Behalf Of” policy
- – Directory improvements
- – Connection vetting and onboarding
- – Narrowing the definition of treatment when response is required
In addition, a Subcommittee of the Steering Committee will be formed to address topics such as updating the dispute resolution process and conflict of interest policies. Additional topics to be addressed soon include use cases beyond treatment, as well as monitoring and reporting processes.
Framework Enhancements:
Activities are already underway, following Carequality’s Change Management process, to modify the “On Behalf Of” policy to provide more transparency when one entity is asking for information as part of a documented arrangement with another entity, such as a data visualization app that supports a health care provider organization.
Similarly, policies are being looked at to ensure that all Implementers and Connections have a common understanding of their obligations for fairness and nondiscrimination should they choose to implement the long-standing local Business Rules policy, an allowance to limit responses to queries in certain cases. One example could be for a healthcare provider organization to decide that it will limit responses for Treatment queries in alignment with the definition of Required Treatment under TEFCA.
Finally, the Carequality Board has authorized additional funds to support a review of the Carequality Directory, which includes over 100,000 entries. This review is now moving from the design phase to the operational phase. With input from the Steering Committee, Carequality identified specific questions and data points for the review. Once complete, this review will help inform the Steering Committee, Board, and Carequality community at large of additional actions to take in the context of vetting and onboarding.
TEFCA Alignment:
The Carequality staff has completed a comparison and significant analysis of both frameworks’ policies, identifying possible paths forward while also uncovering some complexity in how best to bring them into alignment without unduly impacting connectivity. This analysis supports decision-making by the Steering Committee, with input from the Advisory Council, and risk-based guidance from the Board. The Carequality community’s experiences with TEFCA will inform the policy alignment decisions. Our intent remains to optimize alignment between Carequality and TEFCA, while recognizing the need to also consider each framework separately.
The entire Carequality community shares the commitment of all healthcare organizations to protect patient privacy while maintaining appropriate exchange and current connectivity to improve health and healthcare. Carequality stands ready to work with the entire community of Implementers and Connections to make rapid progress in 2025.