Carequality Interoperability Framework

The Carequality Principles of Trust is the policy foundation for connecting health data sharing networks throughout the U.S. The Carequality Interoperability Framework is a collection of documents that are used to operationalize data sharing and includes:


Legal and Governance Documents

Carequality Connected Agreement (11/04/2019)
This document contains the standard legal terms agreed by all implementers of the Carequality Framework. It provides the foundation for trusted exchange among implementers, by establishing the “rules of the road” and defining an implementer’s rights and obligations. (Note – the document linked here is the CCA itself, without any exhibits or schedules. Prospective implementers should contact Carequality at to obtain a complete legal package for execution.)

Carequality Connection (CC) Terms (11/04/2019) 
This document contains the standard terms that implementers are required to make legally binding on their members, customers, or participants who engage in exchange activities through the Carequality Framework and are listed in the Carequality Directory.

Dispute Resolution Process 
This document outlines the steps involved in addressing any formal disputes that may arise between implementers, or between implementers and Carequality.

Technical Trust Policy (08/05/2021)
This document outlines requirements that constitute technically enforceable evidence that the organization has met the associated criteria for being a Carequality Participating System, to ensure technical trust among any system that hosts an end point listed in the Carequality Directory, or directly originates a request to such an end point. Individual use case Implementation Guides may specify different requirements from those outlined in this policy and in such a case the Implementation Guide will take precedence.

Carequality Policy on Full Participation During COVID-19 Emergency
This document outlines a temporary waiver with respect to some aspects of Carequality’s Full Participation requirements for the Query-Based Document Exchange Use Case. This was developed in recognition that access to patient medical records through the Carequality Framework will be beneficial to clinicians battling the COVID-19 outbreak within the United States, and the extraordinary situation the outbreak represents.

Carequality Policy on Public Health Queries During COVID-19 Emergency
The Carequality Steering Committee recognizes that access to clinical information for public health agencies, and that the ability for public health agencies to leverage Carequality connectivity would be highly beneficial. This document addresses the existing barriers and outlines the temporary waivers to address these barriers in this policy.

Implementation Guides

Implementation Guides provide both technical specifications and requirements, as well as additional business and policy requirements, for a particular Carequality Use Case.

Query-Based Document Exchange Implementation Guide (Updated 2021) (PDF)
The initial Carequality Use Case is Query-Based Document Exchange.

Imaging Data Exchange Supplemental Implementation Guide (Updated 2019) (PDF)
This IG is an extension of the QBDE IG for Imaging Data Exchange purposes only. It is not its own Carequality element.

Electronic Case Reporting (eCR) Implementation Guide (Updated 2020) (PDF)
The second Carequality Use Case is Electronic Case Reporting.

FHIR-Based Exchange Implementation Guide (Updated 2020) (PDF)
The third Carequality Use Case is FHIR-Based Exchange







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