One of the things I found confused was the language around the participant and the participant`s member. They are described as “a natural person or an organization that has an agreement.” While this seems to apply to a perceived need for flexibility, which is always appreciated in the health field, flexibility can also be introduced by Abmiguity. We seem to be focusing on the entity, not the role. Is a provider in a health care system a member, participant or individual user? Ambiguity is the foundation of the walls that prevent us from having judicious interoperability. I think a good way to think about it is for a participant to agree to follow the data sharing rules with a QHIN and a member close to the participant and only one user agree to follow the rules necessary to provide and obtain health information. I think a “natural person” can work in different roles, depending on the type of application they have to do, so that each person can act as a member or an individual user. If you don`t agree or have any email comments on this, please let them know in the comments. A participant is essentially an entity that can request or provide health information. This can range from an EHR health system or a cloud-based health platform to a consumer mobile device application. To be a participant, this organization must have entered into an agreement to participate in a QHIN, as it is the only mechanism for exchanging information within the framework of the TEFCA.

In the 21st Century Cures Act, Congress identified the importance of interoperability by establishing a pathway for the implementation of an interoperable exchange of electronic health data and the collection of CS, with the implementation of significant interoperability provisions, pursuant to Title IV of the Cures Act, including the promotion of a Trusted Framework and a joint agreement to improve data exchange between health information networks. The TEF covers the IUE`s exchange methods for queries (Broadcast and Targeted) as well as for message push. The EUS`s exchange objectives for the use of the framework are also presented. These include individual access; Determining benefits Treatment and, improving quality. (Note: rules covered by HIPAA for companies and counterparties would apply).) The ONC will retain the TEF, while an industry-based non-profit organization, known as a Recognized Coordinating Organization (CSR), will receive funding for the development, updating, implementation and maintenance of the common agreement. As part of these efforts, the ONC will define the minimum conditions necessary to bridge the current differences between data exchange agreements, which prevent the flow of health information online. The sector-based NCE is responsible for developing the additional conditions necessary to implement the common agreement and meet the interoperability requirements of the 21st Century Cures Act. In the Cures Act, ONC is responsible for creating or selecting a TEFCA to allow exchanges on different networks. In the new ONC project, the stated objectives for TEFCA are the objectives: the U.S. Department of Health and Human Services (HHS) today released Project 2 of the Trusted Exchange Framework and Common Agreement (TEFCA), which will support the full exchange of health information at the national level within the network.

HHS has also issued an opinion on the possibility of funding to hire a non-profit organization based on the sector, which will promote interoperability at the national level.