In recognition of the current environment for health information exchange, the Carequality Board of Directors has issued the following statement:
More than 10 years ago, Carequality brought together the health IT community to build a first-of-its-kind trusted exchange framework to establish nationwide interoperability that supports improved health and care. Today, the Carequality Interoperability Framework enables the seamless flow of over 1.2 billion clinical documents every month, connecting care providers and systems across the country.
As a non-profit committed to supporting its community of Implementers and their Connections, Carequality strives to maintain and improve operations to evolve with community needs.
The majority of Carequality Implementers have shared their intent to add the Trusted Exchange Framework and Common Agreement (TEFCA) to their interoperability strategy, and TEFCA exchange is growing. Our strategic alignment of Carequality policies with TEFCA is designed to actively smooth the path for our Implementers and Connections, ensuring continuity of connectivity through trusted exchange.
The Carequality board of directors is actively monitoring the evolving needs of the community and carefully analyzing the technical and policy paths that best support those who wish to participate in multiple frameworks or transition to a single, robust, and scalable ecosystem in the future. As that time comes, we will work with the community to support their choices through an orderly process that leaves no one behind.
The Steering Committee has supported this direction through a number of steps:
– Suspending onboarding of new Implementers and limiting development of new policies beyond those needed to strengthen trust and/or create alignment with TEFCA.
– Continued work to implement the Delegation of Authority policy within Carequality that builds upon TEFCA’s approach. This policy is a crucial step in formalizing how one organization authorizes another to query on its behalf within our framework, providing greater clarity on existing relationships and enhanced confidence among health data exchange partners. Carequality is pioneering the implementation of this policy, built on TEFCA’s approach, and is developing practical guidance for Implementers to support this transition. Guidance will address how to reflect the delegation relationship in the Directory, the process for completing Delegation Notices that document a Principal-Delegate relationship, and how to identify whether a Connection is a Delegate.
– Refinements to processes for dispute resolution. Last year, the dispute resolution process was used for the first time. Refining and strengthening this process to account for lessons learned will ensure that our community members have a clear, reliable pathway to address concerns, maintaining the integrity and trust of the Carequality community. The updates to the Dispute Resolution Process are currently in the change management process with an anticipated implementation in January 2026.
As we move forward, Carequality remains dedicated to innovation and collaboration. We look forward to sharing more updates as we continue this important journey together.