At Carequality, trust, privacy, and security are more than just values – they are the foundation of our mission to make health data exchange seamless and effective. Our mission is rooted in realizing the benefits of health information exchange in the United States, which has long sought to overcome barriers to interoperability and care coordination.
A group of industry leaders and subject matter experts came together 12 years ago to form Carequality to bring the entire healthcare industry together and create the first-ever national-level, consensus-built common interoperability framework to enable exchange among health data sharing networks. Today, we remain firmly committed to meeting the evolving expectations of the health care community in our role as a trusted interoperability partner. Trust in the framework is essential if we are to achieve the full potential of health data interoperability. We recognize that safeguarding our framework transparently goes beyond accessibility of information to the community and encompasses actively engaging implementers in our collaborative governance model. Proactively partnering with our community to protect its integrity will maintain and deepen the trust of the connections in our framework.
The healthcare interoperability landscape has faced rapid change in recent years, with data security, transparency, and accountability increasingly becoming areas of focus. For over a decade, we’ve facilitated the seamless exchange of health information, but as the ecosystem grows, so must the rules that govern it. By proactively identifying risks, enhancing governance processes, and aligning with federal frameworks such as TEFCA, we ensure that Carequality remains a trusted and reliable partner in the evolving health IT ecosystem.
Recent Enhancements
Our governance model embraces collaborative decision-making in partnership with the community. In the last few years, Carequality has made significant strides toward enhancing accountability across our framework. We ensure the framework operates with integrity, creating a safer, more reliable interoperability environment. Here are the key areas where we’ve taken action:
1. New Delegation of Authority Policy
In 2025, we introduced the Delegation of Authority policy, replacing the old “on behalf of” approach. This policy ensures that all requests from delegates are traceable, requiring formal, signed Delegation Notices. Effective this month, directory indicators now provide visibility into delegation relationships, improving transparency and confidence among connections. These reforms align with TEFCA’s approach and increase visibility into who is asking for data as the health data exchange ecosystem evolves.
2. Upgraded Dispute Resolution Process
In January 2026, we implemented enhancements to our Dispute Resolution Process to make it faster, clearer, and more transparent. Key updates include:
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- Streamlined timelines and a defined “Dispute Resolution Calendar” to ensure predictability for all participants.
- Specialized panels with external experts, such as HIPAA privacy specialists, for complex issues, such as disputes related to the Treatment Permitted Purpose.
- Plain-language summaries of findings for greater transparency.
These updates ensure that disputes are resolved efficiently and fairly, allowing the community to focus on delivering patient-centered care.
3. Steps Toward TEFCA Alignment
Carequality is continuing to actively align policies and technical requirements with the federal TEFCA framework. Our goal is to enable our Implementers and Connections to expand their reach and seamlessly participate in a wider ecosystem of data exchange.
Looking Ahead: Staying True to our Mission
Integrity and trust are the cornerstones of Carequality’s mission. Safeguarding health data and upholding transparency require vigilance, adaptability, and a shared commitment from all stakeholders. As we work to build a stronger, more transparent health data exchange community, we invite you to join us. Explore our updated policies, resources, and fact sheets, and share your feedback through public calls or direct outreach.
Carequality’s journey is one of continuous evolution, guided by the needs of our community and a shared vision of the right data available at the right time and place to support care. Let’s move forward together, strengthening collaboration and trust across the Carequality framework.