HIMSS23: TEFCA positioned to advance interoperability

Left to right: Moderator Didi Davis, Matt Becker, John Blair, Alan Swenson and Steven Lane discuss TEFCA at HIMSS23 in Chicago on Monday.

Photo: Jeff Lagasse/Healthcare Finance News

The Trusted Exchange Framework and Common Agreement (TEFCA) is now live, and exchange partners are signing up. Hot on its heels come rules from the Office of the National Coordinator for Health IT to prevent information blocking as required by the 21st Century Cures Act. 

According to a panel at the interoperability forum at the HIMSS23 global conference in Chicago, TEFCA is a needed move by the federal government to advance interoperability and data exchange.

Steven Lane, chief medical officer at Health Gorilla, said that while great progress has been made in advancing interoperability, Congress realized that something was lacking. By advancing TEFCA, it introduced new use cases to conform with current technology standards, including FHIR, with the goal of better engaging core users.

"It more effectively addresses digital needs, access, payment – all the use cases we've been wanting to unlock through care equality," said Lane.

If TEFCA goes as planned, it holds the potential to remove a lot of the friction around what it takes to achieve interoperability. John Blair, chief medical officer at MedAllies, said it provides a common framework for stakeholders when it comes to legal compliance, and establishes a strong "high floor" for security.

"It gets into service levels, so you know what you're getting," said Blair. "I think it will do a lot, which will bleed down to the users who use these systems. It will improve affordability and sustainability."

Matt Becker, vice president of interoperability at Kno2, added that TEFCA also allows for the opportunity to pursue innovation. 

"We need to serve the patient no matter where they are in their journey," said Becker. "The organizations that do that are doing a great job, but we need to connect everybody, and have information at scale, or else it's not going to work the way we want it to."

Care equality, and the conversation around that, was the genesis of much of what ended up in TEFCA. Alan Swenson, executive director of Carequality, said that since the first exchange was established in 2016, the specific problem was that organizations wanted a treatment-based exchange, and so that was the focus. The treatment component has been solved pretty well, said Swenson. As a company, Carequality also allows patient and payer access, and many of their use cases can be done, but they're all optional.

"We started with a treatment-based exchange, and as soon as you introduce somebody else into that, it's like talking a different language," said Swenson. "You bring in a payer, and payers say this and providers say that, and you can't talk to each other.

"TEFCA is the next logical step," he said, as it covers different types of exchanges and employs the levers of the federal government to help smooth things over between payers and providers. "TEFCA will be optional and voluntary, but the federal government will probably be pushing folks to participate."

Blair described it as a logical way to deal with contracting, adding that TEFCA also put together a way to introduce new use cases through a structured consensus process. 

While some may bristle at the requirements, Lane contended that it makes sense for TEFCA to be mandatory.

"We've seen how far volunteerism has gotten us, and it has its limits," he said. "The federal government has created some incentives. There'll be more and more incentives, and clearly, there's a huge push on the part of the federal government throughout HHS to look for opportunities to further strengthen the TEFCA exchange. We're going to start to see those walls come down."

To prep for TEFCA, Becker said providers should be contacting vendors now to find out what their plan is and what it's going to cost.

"What TEFCA does is allow folks to say, 'Now I can join a framework that solves most of my interoperability needs with specific use cases,'" he said. "We're moving in the right direction. We just need to make sure we're the stewards so everyone can join on that tail."
 

Twitter: @JELagasse
Email the writer: Jeff.Lagasse@himssmedia.com