TEFCA: A Leap Toward Achieving Nationwide Interoperability

by Sam Lambson, Vice President, Interoperability, Oracle Cerner —Aug 31, 2022

Let’s celebrate some good news: We’ve reached a huge milestone on the road toward national healthcare interoperability.

The CommonWell Health Alliance has announced its intention to apply to become a Qualified Health Information Network (QHIN) under the federal Trusted Exchange Framework and Common Agreement, known as TEFCA.

The participation of CommonWell—which Cerner became a founding member nearly a decade ago —is a leap forward in achieving our vision for interoperability. Our shared goal is to build a nationwide health information exchange that will help give patients access to their healthcare data regardless of where they receive care.

The nonprofit trade association, CommonWell, has created a vendor-neutral platform, which aims to break down the technological and process barriers that inhibit effective health-data exchange. Along with their members including Oracle Cerner, they are innovating together to drive nationwide health data exchange across an increasing number of disparate health IT systems and venues of care. As of May 2022, CommonWell connects 27,000 provider sites, retrieving over 2.3 billion health records annually, and servicing 166 million unique individuals.

Industry collaboration through TEFCA is aimed at creating a truly national network for which we’ve been striving and paving the way to better healthcare for all.


Creating a ‘minimum floor’

TEFCA, which springs from the 21st Century Cures Act (2016), establishes what the Office of the Coordinator for Health Information Technology calls a “minimum floor” of nationwide interoperability of health information. Policy goals include building on work already done to make data exchange possible and, ultimately, creating a single on-ramp to interoperability.

With the foundational framework in place, CommonWell is well-positioned to join as a QHIN, an intention it made public when TEFCA was in its infancy. In essence, CommonWell has already been doing much of what the TEFCA framework requires. The organization is, therefore, preparing to be successful as a QHIN after review and approval from the recognized coordinating entity. A key point is that CommonWell’s record location service enables providers to get data from connected sites across the country in milliseconds.


Better data access for patients

We’re also encouraged that TEFCA gives patients the same right to their data as providers.

Cerner has advocated for decades for patients and provi ders to have frictionless access to complete patient health records, wherever the data are stored.

Cerner co-founder Neal Patterson went to Congress in 2015 with a personal message about traversing the healthcare system with his wife, Jeanne, and having to tote shopping bags full of paper health records wherever they went. His message: We weren’t doing enough to eliminate these stacks of paper. Neal argued that it needs to be as easy as swiping a credit card to get all your records. Despite best intentions and positive progress to address the problem, unfortunately we are still too far from this vision for patients.

Today, Cerner’s passion and expertise in the nuanced challenges of health record interoperability pairs perfectly with Oracle, which has taken on similarly complex digital transformation challenges in other industries. Together, we’re reaching toward a future where our vision of ubiquitous, nationwide data exchange is a utility.

CommonWell laid the groundwork for true interoperability, demonstrating the value of a nationwide network in many examples. One that comes to mind is how connectivity made possible through CommonWell enabled NorthBay to deliver seamless care and ensure patient safety amid two crises. However, though the pipes are laid, and data is flowing through a network that can continue to grow under TEFCA, the tools that help enable providers to derive meaningful insights are still lacking. We must do more to connect providers in ways that benefit patients while lowering the administrative burden.


Eliminating duplicative data

Today, providers are flooded with more data than they can possibly reconcile. Insightful data from outside records often goes unutilized.

In response to client feedback, at Oracle Cerner, we’re focused on providing clinicians with simplified workflows aimed at eliminating duplicate data and providing a cleansed, holistic view of a patient’s care history. Through Seamless Exchange, we’re working to create a streamlined experience for providers so they can spend less time in the EHR and more time providing patient care.

Today, we celebrate the largest step toward interoperability since the founding of CommonWell. At Oracle Cerner, we fully support CommonWell on its journey to become a QHIN, and we remain committed to our initiatives to simplify data exchange to improve caregiver experience and patient outcomes.

As I often tell my team, it is an exciting time to be in interoperability.

Sam Lambson is vice president of interoperability at Oracle Cerner.