TEFCA in 2025: Expanding Interoperability, Openness, and Federal Engagement
The Trusted Exchange Framework and Common Agreement (TEFCA) is rapidly evolving from foundational framework to a functioning national network for health details exchange. As we move into the latter half of 2025, understanding the key priorities and upcoming developments within TEFCA is crucial for healthcare providers, payers, developers, and federal agencies alike. This article provides a comprehensive overview of the current state of TEFCA and outlines the strategic initiatives driving its expansion and impact.
The Core Promise of TEFCA: Nationwide Interoperability
TEFCA, mandated by the 21st Century Cures Act, isn’t intended to be the sole solution for health information exchange (HIE). Rather, it establishes a unifying framework for nationwide connectivity, simplifying participation and reducing costs when broad-scale exchange is required. Existing regional and state HIEs continue to play a vital role, and TEFCA complements these efforts by providing a standardized pathway for connecting across geographical boundaries.
Think of TEFCA as building the interstate highway system for health data. individual states and regions can maintain their local roads, but TEFCA provides the standardized on-ramps and rules of the road for seamless travel across the country.
Priority One: Increased Transparency and Collaborative Development
A cornerstone of TEFCA’s ongoing development is a commitment to transparency and broad stakeholder input. The TEFCA governance body is actively soliciting feedback on key technical specifications before finalization, ensuring the framework reflects the needs of the entire healthcare ecosystem.
Currently, the draft Qualified Health Information Network® (QHIN™) Technical Framework (QTF) v2.1 is open for public comment until July 28th. This document details the technical standards and requirements for organizations seeking to become QHINs – the entities responsible for securely exchanging health information across the TEFCA network. Access the draft QTF v2.1 and submit your feedback here: https://rce.sequoiaproject.org/draft-qtfv2-1-released-for-public-feedback-until-july-28/
Beyond the QTF, expect increased opportunities for non-TEFCA participants to engage in the process and gain greater visibility into TEFCA’s governance and participation details. This open approach is vital for building trust and fostering widespread adoption.
Priority Two: Driving participation and Expanding Use Cases
While initial TEFCA efforts focused on treatment exchange and individual access services, the network’s capabilities extend far beyond these core functions. TEFCA now supports exchange for:
Payment: Facilitating accurate and efficient claims processing.
Healthcare Operations: Supporting quality enhancement initiatives and data analytics.
Government Benefits Determination: streamlining eligibility verification for programs like Medicare and Medicaid.
Public Health: Enabling timely reporting of critical health data for population health management.
Leveraging FHIR for Enhanced Interoperability
A meaningful advancement is the availability of both document-based and FHIR®-based query capabilities via TEFCA-trusted FHIR APIs. FHIR (Fast Healthcare Interoperability Resources) is a modern standard for exchanging healthcare information electronically, offering greater flexibility and scalability than customary methods.
To accelerate adoption, TEFCA is launching short-term connectivity pilots, initially targeting payers and providers. These pilots will provide a guided “path to production” for organizations interested in leveraging TEFCA’s capabilities.
Addressing Information Blocking Concerns
The Office of the National Coordinator for Health IT (ONC) recently released a clarifying FAQ addressing potential information blocking concerns related to QHIN choice. This FAQ clarifies that developers of certified health IT are not considered to be interfering with information blocking regulations by allowing users to select their preferred QHIN.You can find the FAQ here: https://www.healthit.gov/faq/would-it-be-considered-interference-under-information-blocking-regulations-if-health-it
Priority Three: Activating Federal Partner Participation
TEFCA’s success hinges on the active participation of federal agencies. The TEFCA governance body is actively working